Electrophysiological study of the palmar cutaneous nerves in diabetics

Abstract

Background: Polyneuropathy in diabetics which may be asymptomatic, targets particularly sensory neurons and their axons, starting in their distal terminals. Aims and Objectives: Aim of the present study was to identify the presence of subclinical neuropathy in Type 2 diabetic patients with the help of sensory nerve conduction studies (NCS). Material and Methods: Diabetic and control groups underwent standard antidromic technique of sensory NCS and recording of sensory nerve action potentials (SNAPs) of the palmar digital branches of the median and ulnar nerves using Neuro perfect software on windows based computerized electromyographic/nerve conduction velocity/evoked response Mark II system and surface electrodes. Results: On comparing the parameters of NCS it was found that distal latency of both the nerves was higher in diabetics than controls with a statistically significant difference. Results also showed a statistically significant decrease in conduction velocities of both nerves in diabetics. The mean SNAP amplitudes for all tested nerves were found to be decreased significantly in diabetics. Conclusions: Sensory nerves are found affected in diabetics with no clinical sign and symptoms of neuropathy. NCS is a sensitive test which can be used to identify subclinical cases.