Median neuropathy at the wrist as an early manifestation of diabetic neuropathy

Journal of Diabetes Investigation

Shuji Horinouchi⁴  Takahisa Deguchi²  Kimiyoshi Arimura¹  Aiko Arimura²  Yukari Dochi²  Tadashi Uto²  Tomonori Nakamura³  Yumiko Arimura³  Yoshihiko Nishio² 

[1] Ookatsu Neurology and Rehabilitation Hospital, Kagoshima, Japan;Department of Diabetes and Endocrine Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan;Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan;Department of Internal Medicine, Kagoshima City Hospital, Kagoshima, Japan

关键词: Carpal tunnel syndrome;    Diabetic neuropathy;    Median neuropathy;   

DOI  :  10.1111/jdi.12211

来源: Wiley

【 摘 要 】

Abstract

Aims/Introduction

To elucidate the clinical significance of median neuropathy at the wrist (MN) in patients with diabetes.

Materials and Methods

In total, 340 patients with diabetes who were hospitalized for glycemic control were enrolled in the present study. The diagnoses of MN and diabetic polyneuropathy (DPN) were based on electrophysiological criteria. A total of 187 patients were divided into four subgroups: patients without MN or DPN; patients with MN without DPN; patients with MN and DPN; and patients with DPN without MN. Intergroup comparisons of clinical characteristics and results of nerve conduction studies were carried out.

Results

A total of 71 patients had neither MN nor DPN; 25 had MN, but no DPN; 55 had MN and DPN; and 36 had DPN, but no MN. In comparison with the MN and DPN group, the MN without DPN group included more patients in the early phase of diabetes (diagnosed within the past 5 years) and fewer patients with diabetic microangiopathy. Comparative median nerve conduction studies showed significantly lower motor and sensory nerve conduction velocities, longer F-wave latencies, and smaller sensory nerve action potentials in patients with MN and DPN than in those without DPN.

Conclusions

MN in patients with diabetes could be attributed to an impairment in axonal function at common entrapment sites, and could be used to identify an early manifestation of diabetic neuropathy.

【 授权许可】

CC BY-NC-ND   
© 2014 The Authors. Journal of Diabetes Investigation published by Asian Association of the Study of Diabetes (AASD) and Wiley Publishing Asia Pty Ltd

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