Open AccessH-Reflex and Clinical Examination in the Diagnosis of Diabetic Polyneuropathy
Author(s) -
RO Millán-Guerrero,
Benjamı́n Trujillo-Hernández,
Sara Isaís-Millán,
Emilio Prieto-Díaz-Chávez,
Clemente Vásquez,
JR Caballero-Hoyos,
J García-Magaña
Publication year - 2012
Publication title -
journal of international medical research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.421
H-Index - 57
eISSN - 1473-2300
pISSN - 0300-0605
DOI - 10.1177/147323001204000233
Subject(s) - medicine , reflex , nerve conduction velocity , logistic regression , polyneuropathy , diabetes mellitus , nerve conduction , electromyography , h reflex , nerve conduction study , anesthesia , gold standard (test) , physical medicine and rehabilitation , endocrinology
OBJECTIVES: 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. CONCLUSION: The H-reflex could have a predictive value in DPN, providing more quantitative information regarding diagnosis than conventional nerve conduction studies.