Vibratory and cooling detection thresholds compared with other tests in diagnosing and staging diabetic neuropathy.

Increasingly more tests are being used to detect and characterize diabetic polyneuropathy, but their value in setting minimal criteria for the diagnosis of neuropathy and for staging severity remains inadequately studied. In 180 diabetics, we compared the percentage of patients with test abnormalities and associations among test results, evaluating neuropathic symptoms [neuropathy symptom score (NSS) and neuropathy scale of neuropathy symptom profile (NNSP)], deficits [neurologic disability score (NDS) and vibratory (VDT) and cooling (CDT) detection thresholds], or nerve dysfunction [nerve conduction (NC)]. The percentage of patients that were abnormal varied considerably depending on criteria for abnormality and the tests used.

Motor neuron disease (ALS): evaluation of detection thresholds of cutaneous sensation.

Cutaneous touch-pressure, vibration, and thermal cooling detection thresholds were estimated on the skin of one foot for 80 patients with motor neuron disease (MND) and compared with that of more than 300 site, age, and sex-matched healthy controls. Fourteen of the patients had elevated thresholds (greater than or equal to 95th percentile): 7 showed elevated thresholds of sensitive points, 5 an increased number of insensitive grid points, and 2 a combination of these criteria. Therefore, raised vibration thresholds occur more frequently in MND patients than in controls (p less than 0.

Computer assisted sensory examination to detect and quantitate sensory deficit in diabetic neuropathy.

In this report we describe computer assisted systems to evaluate cutaneous sensation to detect raised thresholds of cutaneous sensation. Normative data has been obtained so that thresholds are known for face, hand and foot. Results show that thresholds vary with site, age, and sex.

Introduction of automated systems to evaluate touch-pressure, vibration, and thermal cutaneous sensation in man.

Systems for automatic assessment of cutaneous touch-pressure, vibratory, and thermal sensation have been developed. These systems use stimuli which are quantified and reproducible, a two-alternative forced-choice technique, and programmed steps to test, score, and report. If normal responses from series of healthy persons have been measured, percentile values specific for test, site, age, and sex can be determined.

Clinical vs quantitative evaluation of cutaneous sensation.

A comparison of the evaluation of cutaneous sensation by neurologic examination and by quantitative assessment in 107 patients with various neuromuscular disease has shown that there is a reasonably good correlation between the recognition of abnormalities of cutaneous sensation by clinical and by quantitative methods. Clinical neurologists tend to underestimate abnormalities of touch-pressure sensation. The quantitative evaluation of cutaneous sensation is useful in quality control of the clinical examination, in correlating the nature of sensation loss with the compound action potential and morphometry of biopsied nerve, in providing a score of sensation to follow the course and the effect of treatment protocols, and in monitoring for an adverse effect on sensation by an environmental or industrial poison.