title: Selecting a prospective test for early detection of diabetic polyneuropathy.
abstract: Microneurolysis of entrapped peripheral nerve has the best chance of success when compression has not created significant axonal loss. The purpose of this study is to learn the best way to identify potential surgical candidates at the earliest time for intervention, by examining patients in a clinical setting using objective, electrodiagnostic nerve conduction studies (NCS), and subjective touch threshold studies, Semmes-Weinstein monofilaments (SWM) and Pressure-Specified Sensory Device™ (PSSD). Fifty-five patients with diabetic polyneuropathy over the age of 30 years were included. Neuropathy symptom score was the gold standard for statistical calculation, with a prevalence of 70%. In the symptomatic population, prevalence was 64% for NCS (n = 25), 59% for SWM (n = 43), and 88% for PSSD (n = 51). In the asymptomatic population, prevalence was 70% for NCS, 27% for SWM, and 92% for PSSD. It is concluded that the PSSD is the most sensitive device of those tested for identifying peripheral neuropathy in an at risk population of patients.
authors.affiliation: Department of Internal Medicine, Landesklinik St. Veit im Pongau, SALK, Paracelsus Medical University, Salzburg, Austria.|Department of Anatomy and Musculoskeletal Research, Paracelsus Medical University, Salzburg, Austria.
authors.forename: Anja S
authors.initials: AS
authors.lastname: Ruhdorfer
authors.affiliation: Department of Internal Medicine, Landesklinik St. Veit im Pongau, SALK, Paracelsus Medical University, Salzburg, Austria.
authors.forename: Mihran
authors.initials: M
authors.lastname: Azaryan
authors.affiliation: Department of Neurology, Christian-Doppler-Klinik, SALK, Paracelsus Medical University, Salzburg, Austria.
authors.forename: Joerg
authors.initials: J
authors.lastname: Kraus
authors.affiliation: Department of Neurology, Christian-Doppler-Klinik, SALK, Paracelsus Medical University, Salzburg, Austria.
authors.forename: Susanne
authors.initials: S
authors.lastname: Grinzinger
authors.affiliation: Research Office (biostatistics), Paracelsus Medical University, Salzburg, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hitzl
authors.affiliation: Department of Internal Medicine, Landesklinik St. Veit im Pongau, SALK, Paracelsus Medical University, Salzburg, Austria.
authors.forename: Johannes
authors.initials: J
authors.lastname: Ebmer
authors.affiliation: Professor of Plastic Surgery and Neurosurgery, Johns Hopkins University, Baltimore, MD.
authors.forename: A Lee
authors.initials: AL
authors.lastname: Dellon
authors.affiliation: Department of Internal Medicine, Landesklinik St. Veit im Pongau, SALK, Paracelsus Medical University, Salzburg, Austria.
authors.forename: Bertram
authors.initials: B
authors.lastname: Hölzl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003929:Diabetic Neuropathies / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D009460:Neurologic Examination / Q000295:instrumentation / Q000379:methods*; D011446:Prospective Studies; D057566:Self Report; D012680:Sensitivity and Specificity