title: H-reflex and clinical examination in the diagnosis of diabetic polyneuropathy.
abstract: OBJECTIVE
  To determine among adult patients with type-2 diabetes mellitus the proportion diagnosed with diabetic polyneuropathy (DPN) by clinical evaluation and by the Hoffmann reflex (H-reflex). In addition, the predictive value of the H-reflex in the diagnosis of DPN was evaluated.
  
  
  METHODS
  Studies were carried out on 150 adult patients referred for neuropathy screening. Diagnostic criteria for DPN were at least two abnormalities in clinical neurophysiological examinations and electrophysiological testing (H-reflex and nerve conduction velocity). Logistic regression analysis was performed to identify unique contributions of study characteristics to positive versus negative outcomes.
  
  
  RESULTS
  H-reflex was absent in 39.3% (59/150) and latency was prolonged in 43.3% (65/150) of patients. Ulnar nerve motor branch nerve conduction showed prolonged latency in 9.3% (14/150) of patients. Logistic regression analysis indicated that the H-reflex was significantly associated with positive outcomes.
  
  
  CONCLUSIONS
  The H-reflex could have a predictive value in DPN, providing more quantitative information regarding diagnosis than conventional nerve conduction studies.
authors.affiliation: Clinical Epidemiology Research Unit, Mexican Institute of Social Insurance, Zone 1 General Hospital of Colima, Colima, Mexico.
authors.forename: Ro
authors.initials: R
authors.lastname: Millán-Guerrero
authors.forename: B
authors.initials: B
authors.lastname: Trujillo-Hernández
authors.forename: S
authors.initials: S
authors.lastname: Isais-Millán
authors.forename: E
authors.initials: E
authors.lastname: Prieto-Díaz-Chávez
authors.forename: C
authors.initials: C
authors.lastname: Vásquez
authors.forename: J R
authors.initials: JR
authors.lastname: Caballero-Hoyos
authors.forename: J
authors.initials: J
authors.lastname: García-Magaña
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003929:Diabetic Neuropathies / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006181:H-Reflex; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D009460:Neurologic Examination; D014459:Ulnar Nerve / Q000502:physiology