Hemmi S, Inoue K, Murakami T, Sunada Y
Division of Neurology, Department of Internal Medicine Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan.
Electromyogr Clin Neurophysiol. 2010 Sep-Oct;50(6):269-75.
The purpose of this study was to determine the most sensitive diagnostic test for nerve conduction study (NCS) of the foot for early detection of diabetic polyneuropathy. We compared the sensitivities for diagnosis of sensory polyneuropathy of four different nerve conduction techniques in the same nerves: nerve conduction studies of the medial plantar nerve with surface electrodes using three different techniques and a nerve conduction study of the digital and interdigital nerves of the foot using a near-nerve needle technique. In 25 patients with diabetic polyneuropathy with normal routine NCS, diagnosis of sensory neuropathy was confirmed by medial plantar NCS in 5 patients (20.0%) using Guiloff's method, in 5 patients (20.0%) using Ponsford's method and in 9 patients (36.0%) using Hemmi's method. In digital and interdigital NCS of the foot, a definite neuropathy pattern was observed in 15 patients (60.0%). The most common abnormality was low amplitude of sensory nerve action potential, indicating axonal degeneration. This study demonstrated that digital and interdigital NCS using the near-nerve needle technique is a more sensitive method for detection of early-stage diabetic polyneuropathy.
本研究的目的是确定用于足部神经传导研究（NCS）以早期检测糖尿病性多发性神经病的最敏感诊断测试。我们比较了同一神经中四种不同神经传导技术对感觉性多发性神经病的诊断敏感性：使用三种不同技术的表面电极对足底内侧神经进行神经传导研究，以及使用近神经针技术对足部趾间神经和趾神经进行神经传导研究。在25例常规NCS正常的糖尿病性多发性神经病患者中，使用吉洛夫方法通过足底内侧NCS确诊感觉性神经病的有5例（20.0%），使用庞斯福德方法的有5例（20.0%），使用赫米方法的有9例（36.0%）。在足部趾间和趾神经NCS中，15例（60.0%）观察到明确的神经病模式。最常见的异常是感觉神经动作电位幅度降低，提示轴索性变性。本研究表明，使用近神经针技术进行足部趾间和趾神经NCS是检测早期糖尿病性多发性神经病更敏感的方法。
