Electrophysiological study of diabetic autonomic and sensorimotor polyneuropathy
Abstract
Neurological complications of Diabetes Mellitus were
looked for in a group of 31 patients using clinical examination
and electrophysiological tests. Clinically evident sensorimotor
neuropathy was found to be prsent in 41.9% and clinical
autonomic neuropathy in 15% of the patients. Electrophysiological
tests showed evidence of sensorimotor neuropathy in 80% and
autonomic nerve dysfunction in 35% of the same patients. Autonomic
neuropathy was found to occur always in association with
sensorimotor neuropathy.
The electrophysiological tests were found to be convenient
as they were easy, and required little cooeration from the patient.
Sensory nerve tests were found to be more sensitive than motor
nerve tests alone and the yield of anyone test was found to
increase the more nerves one examined. Electrocardiographic tests
for autonomic neuropathy ( i.e. 'beat to beat variation' of pulse
rate and the 'valsalva ratio' ) were found to be of equal
sensitivity, but the former was easier to carry out and is
therefore recommended. The use of postural blood pressure changes
to assess autonomic nerve function was found to be too insensitive
for any practical use. When postural hypotension is present, other
signs of neuropathy are usually grossly evident.
Citation
Masters of MedicinePublisher
University of Nairobi School of Medicine