T-reflex Changes in Asymptomatic Diabetics

J Korean Neurol Assoc > Volume 17(5); 1999 > Article

Journal of the Korean Neurological Association 1999;17(5): 675-682.

무증상 당뇨환자의 T 반사 변화

안규환, 조용진 ·김상화 ·사은희 ·임용빈 ·김대성 ·정대수 ·박규현

부산대학교 의과대학 신경과학교실

T-reflex Changes in Asymptomatic Diabetics

Kyu-Hwan An, M.D., Yong-Jin Jo, M.D., Sang-Hwa Kim, M.D., Eun-Hee Sa, M.D., Yong-Bin Yim, M.D., Dae-Seong Kim, M.D., Dae-Soo Jung, M.D. and Kyu-Hyun Park, M.D.

Department of Neurology, College of Medicine, Pusan National University

Abstract

Background : The loss or depression of ankle jerk has been considered one of the earliest physical findings of dia-betic polyneuropathy, even in asymptomatic cases. Therefore, the electronic ankle T-reflex test (ATR) could be a sensi-tive, objective test for the early detection of polyneuropathy among diabetics. Methods : In order to verify the sensitivi-ty and usefulness of the ATR, the ankle jerk and ATR were studied in 99 legs of 50 patients with diabetes who did not have any symptoms related to neuropathy or peripheral vascular disease at the time of the study. A sensory nerve con-duction study (SNCS) of sural and superficial peroneal nerves was also performed and the results were compared with the ATR. Results : The ATR response was abnormal in 42.4% of the legs tested and was more sensitive than the sural SNCS (18.2%) or superficial peroneal SNCS (30.3%) in revealing subclinical abnormalities. Our results confirm that ATR abnormalities in asymptomatic diabetics are more frequent than conventional SNCS abnormalities and are a reli-able indicator of peripheral nerve dysfunction in diabetic patients. Conclusions : The ATR seems to be a sensitive test in detecting subclinical abnormalities in diabetics and would be useful especially in early or equivocal cases of J Kor Neurol Ass 17(5):675~682, 1999 Key Words : Diabetes mellitus, Subclinical neuropathy, Ankle jerk, Electronic T-reflex, Electrophysiology