Diagnostic Test of Toronto and Modified Toronto Scoring, Monofilament Test, and Vibrate Sensation Test Using 128 Hz Tuning Fork for Diabetic Polineuropathy

Purbasari, Bethasiwi; Anggraini, Vivi Laras; Pratiwi, Made Dinda; Husna, Machlusil; Kurniawan, Shahdevi Nandar

doi:10.21776/ub.mnj.2018.004.01.5

Cited by 3 publications

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“…In this study, it was found that abnormalities in sensory nerve fibers were more numerous than in motor nerve fibers, as the results indicated by other studies. 11,16,17,21,22 The majority type of nerve damage in this study was mixed type (52.33% in the median nerve, 60.47% in the ulnar nerve, 72.10% in the tibial nerve, and 54.65% in the peroneal nerve in the motor nerve conduction study and 80.23% in the median nerve and 88.37% in the peroneal nerve in the study of sensory nerve). This was in contrast to several other studies, which shows that the nerve susceptibility of diabetes mellitus generally results as axonopathy.…”

Section: Discussionmentioning

confidence: 73%

Electroneuromyography Examination of Diabetic Polyneuropathy Patients

Nurlaela

Kurniawan

Husna

2019

MNJ

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Background: Diabetic polyneuropathy (DPN) is one of the chronic complications that occur in approximately 80% of diabetes mellitus (DM) patients. This condition is a results of metabolic, vascular, and immunological disorders. Objective: To determine the profile of electroneuromyography (ENMG) examination of DPN patients at neurology clinic of Saiful Anwar General Hospital. Methods: This cross-sectional observational descriptive study was carried out at Saiful Anwar General Hospital Malang from June 1, 2015 to December 31, 2015, with purposive sampling method. A total of 43 DM patients with symptoms of polyneuropathy fulfilling inclusion criteria and no exclusion criteria were examined for ENMG. ENMG examirnation were including distal latency, amplitude and nerve conduction velocity of 4 motoric nerves (median, ulnar, tibial, peroneal) & 3 sensory nerves (median, ulnar, sural), and F waves of ulnar, median and peroneal nerves of the left and right extremities. Results: Of the 43 patients evaluated in this study, the mean sensory sural nerve conduction velocity was 13.01 m/s. The majority type of nerve damage in diabetic polyneuropathy patients in this study were mixed type (52.33% in the median nerve, 60.47% in the ulnar nerve, 72.10% in the tibial nerve, and 54.65% in the peroneal nerve in motor nerve studies and 80.23% in the median nerve and 88.37% in the peroneal nerve in the sensory nerve studies). Conclusion: The nerve damage that occurs in DPN patients at Saiful Anwar general Hospital is severe, with the majority being the axonal demyelinating type, especially in the sensory nerve fibers in the inferior extremities.

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Section: Discussionmentioning

confidence: 73%

Electroneuromyography Examination of Diabetic Polyneuropathy Patients

Nurlaela

Kurniawan

Husna

2019

MNJ

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“…al., where test using tuning fork resulted in similar validity and positive predictive value with Monofilament test, even produced similar result with SWM test combined with PNP-DM test score. [38][39][40] TCSS shown the highest diagnostic value for HIV-DSP and can be reliably used as DSP screening tool on HIV patients. A follow up research with bigger sample size and more specific sample criteria is needed to evaluate the value of other diagnostic tools.…”

Section: Subject Characteristicmentioning

confidence: 99%

Diagnostic Test of Polyneuropathy Score, 10-G Semmes Wenstein Monofilament (Swm) and Vibration Perception Treshold (Vpt)-Quantitative Sensory Testing (Qst) in Distal Sensory Polyneuropathy (Dsp)-Human Immunodeficiency Virus (Hiv)

Purbasari

Kurniawan

Husna

et al. 2019

MNJ

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Background: HIV/AIDS is a worldwide pandemic. Peripheral neuropathy is the most common neurologic complication with distal sensory polyneuropathy (HIV-DSP) as the most frequent form of manifestation. HIV-DSP is one of the major causes of global pain morbidity and often undiagnosed earlier, resulting in treatment given when HIV-DSP grade is already severe. Early detection is imperative to prevent the progression of HIV-DSP and improve patient's quality of life. Polyneuropathy score, 10-g Semmes-Weinstein Monofilament (SWM) and vibration perception threshold (VPT)-quantitative sensory testing (QST) are considered to be potential candidates for HIV-DSP screening tool. Objective: To measure the reability of Polyneuropathy Score, SWM and VPT-QST in diagnosing HIV-DSP. Methods: This research is a descriptive study with cross-sectional design. Research was conducted on 77 patients of HIV/AIDS outpatient clinic in RS Saiful Anwar (RSSA) during November 2016 -April 2017 (n = 77). Patients were screened for HIV-DSP by using polyneuropathy score, such as: Michigan Neuropathy Screening Instrument (MNSI), Toronto Clinical Scoring Sysytem (TCSS), Brief Peripheral Neuropathy Score (BPNS), SWM, and VPT-QST. Sensitivity, specificity, positive predictive value and negative predictive value of BPNS, TCSS, MNSI, SWM and VPT-QST are analyzed using cross tabulation. Area under receiver operating characteristic (ROC) curve analysis was used to measure diagnostic accuracy of each tools. SPSS 19.0 was used for statistical analysis. Results: TCSS had a sensitivity, specificity, positive predictive value, negative predictive value positive likelihood ratio, negative likelihood ratio, and accuracy as much as: 70%, 97%, 97%, 74%, 23,33, 0,28 and 83%. The result of TCSS analysis using ROC showed that TCSS had excellent diagnostic value with AUC (Area Under Curve) of 0.89 (95%CI 82%-96,5%). The AUC of BPNS score, monofilamen and VPT-QST respectively: 0,469, 0,194, and 0,189. Conclusion: The result of the HIV-DSP diagnostic test using TCSS score has the best value compared to other tools.

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“…8 Elektrofisiologis merupakan pemeriksaan paling sensitif, terpercaya, dan akurat untuk menilai fungsi saraf. 13,14 Studi mengenai aktivitas elektrofisiologis otot skeletal dalam kondisi istirahat dan kontraksi dengan bantuan EMG dan konduksi impuls saraf di sepanjang saraf perifer dengan Nerve Conduction Study (NCS), telah menjadi uji diagnostik yang sangat bermanfaat untuk penilaian fungsi saraf perifer dan konfirmasi neuropati pada lepra. 4,7 Pemeriksaan ini dapat memberikan penilaian ulang secara lengkap mengenai gangguan neuromuskular yang dapat menjadi informasi penting untuk mengkonfirmasi atau mengubah sebuah diagnosis klinis dan mencegah kesalahan diagnostik serius.…”

Section: Diskusiunclassified

Interpretation of Nerve Conduction Study in Polyneuropathy With Multibacillary Leprosy Type 2 Reaction

Sari¹,

Widasmara²,

Kurniawan³

2018

MNJ

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ABSTRAKReaksi lepra berkontribusi besar terhadap terjadinya kecacatan akibat kerusakan saraf perifer. Pemeriksaan nerve conduction study (NCS) memberikan gambaran fisiologis saraf perifer secara mendalam. Studi ini bertujuan untuk melaporkan kasus polineuropati pada lepra dengan reaksi tipe 2 yang dievaluasi dengan menggunakan NCS. Wanita 33 tahun mengeluh muncul benjolan nyeri pada lengan dan tungkai, demam, dan kaki bengkak sejak 2 hari yang lalu. Pasien riwayat terdiagnosis kusta. Pemeriksaan dermatologis, pada palpebra superior kanan, lengan dan tungkai kanan dan kiri didapatkan nodul eritema multipel dengan nyeri tekan; claw hand manus sinistra; dan edema kedua tungkai. Pemeriksaan slit skin smear positif. Pemeriksaan histopatologis mendukung gambaran reaksi lepra tipe 2. Kesimpulan pemeriksaan NCS, terjadi polineuropati sensorik dan motorik demyelinasi akson berat, dengan derajat lebih berat pada sisi kiri. Pasien diterapi MDT-MB, tirah baring, metilprednisolon peroral, vitamin B kompleks, parasetamol, sulfas ferosus, dan oleum olivarum topikal. Didapatkan perbaikan klinis setelah 2 minggu terapi. Pemeriksaan NCS berfungsi untuk menilai konduksi impuls saraf di sepanjang saraf perifer. Pada kasus ini, didapatkan bahwa temuan NCS menunjukkan neuropati dini pada saraf-saraf yang secara klinis belum terdeteksi. Dapat disimpulkan bahwa pemeriksaan NCS menjadi uji diagnostik penting untuk deteksi dini neuropati dan mengkonfirmasi diagnosis neuropati klinis pada lepra. Kata kunci: Nerve conduction study, reaksi lepra ABSTRACT Leprosy reaction contributes to disability due to peripheral nerve damage. Nerve conduction study (NCS) provides a profound physiological description of peripheral nerves. This study aims to report a case of polyneuropathy in leprosy with type 2 reactions (T2R) which is evaluated using NCS. A 33-year-old woman complain of painful bumps in her arms

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Diagnostic Test of Toronto and Modified Toronto Scoring, Monofilament Test, and Vibrate Sensation Test Using 128 Hz Tuning Fork for Diabetic Polineuropathy

Cited by 3 publications

References 0 publications

Electroneuromyography Examination of Diabetic Polyneuropathy Patients

Electroneuromyography Examination of Diabetic Polyneuropathy Patients

Diagnostic Test of Polyneuropathy Score, 10-G Semmes Wenstein Monofilament (Swm) and Vibration Perception Treshold (Vpt)-Quantitative Sensory Testing (Qst) in Distal Sensory Polyneuropathy (Dsp)-Human Immunodeficiency Virus (Hiv)

Interpretation of Nerve Conduction Study in Polyneuropathy With Multibacillary Leprosy Type 2 Reaction

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