T-wave response: a sensitive test for latent alcoholic polyneuropathy.
To date, the H-reflex is the most sensitive test to measure nerve conduction velocity in alcoholic polyneuropathy. Analogous to the H-reflex, we investigated the T-wave response from the soleus muscle using a hand-held reflex hammer. Twenty-four inpatients suffering from chronic alcoholism and 24 healthy volunteers were recruited. All probands had a careful neurological examination and were graded (PNP-classifications). The T- and H-reflexes were measured. In the clinical examination, only a few patients exhibited symptoms of alcoholic PNP. However, when the autonomic nervous system was also tested, 50% exhibited signs of alcoholic PNP. Both the T- and H-reflex responses were pathologically retarded, indicating latent alcoholic PNP in 60% of the patients. Thus the main finding in our study is the difference between clinical and electrophysiological examinations: only a few of the patients had neurological symptoms for alcoholic PNP but 14 patients (60%) exhibited a so-called latent, subclinical alcoholic PNP by showing delayed reflex latencies. Measuring the T-wave proved to be a simple and painless screening method for diagnosis and monitoring of alcoholic PNP. Among the clinical tests the best indicator for alcoholic PNP was the test for autonomous alcoholic PNP.
Department of Psychiatry and Psychotherapy, University of Tuebingen, Germany.
Klaus
K
Schott
Gerd
G
Schäfer
Arthur
A
Günthner
Mathias
M
Bartels
Karl
K
Mann
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020269:Alcoholic Neuropathy / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology; D004568:Electrodiagnosis / Q000295:instrumentation*; D004576:Electromyography / Q000295:instrumentation*; D005260:Female; D006181:H-Reflex / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology; D009431:Neural Conduction / Q000502:physiology*; D011930:Reaction Time / Q000502:physiology; D012016:Reference Values; D014159:Transducers