Electrophysiological Study of Lateral and Medial Branches of Nervus Radialis Superficialis

摘要

Objective: To find whether any difference exists between the electrophysiological measurements of lateral and medial branches of recently defined superficial branch of radial nerve (NRS) between normal healthy individuals and patients with diabetes mellitus and determine diagnostic use (if any) in the early diagnosis of diabetic polyneuropathy patients or its contribution to the diagnosis.Methods: This prospective and methodologic investigation included 26 diabetes mellitus patients and 26 normal healthy individuals. All study participants underwent EMG with routine PNP protocol and electrophysiological examination of lateral and medial branches of NRS. Diabetic patients were requested to fill DN4 questionnaire forms. HbA1c values and micro-macroalbuminuria of patients were also measured.Results: Both groups did not differ significantly in terms of age and gender. A significant correlation was found between the presence of PNP on EMG and DN4 scores. Mean DN4 scores in cases with manifest and borderline PNP (5.00±1.78) were significantly higher than healthy individuals (2.54±1.81) (p=0.002). A negative correlation was detected between age and DNA scores (rho=-0.49). As for sural and radial nerve amplitudes ratio, no difference was detected between two groups.Conclusion: Sural nerve was found to be the firstly affected nerve in diabetes mellitus. We also detected that especially in advanced stages, in measurements of NRS an upper extremity sensory nerve can be used in order to monitor progression of the disease. However, conduction of large-scale studies is needed so as to determine the optimal EMG values for NRS and its lateral and medial branches.