diabetic polyneuropathy DPN DPN DPN NCS

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1 diabetic polyneuropathy DPN DPN DPN DPN NCS M M 4 DPN DPN golden standard DPN Key Words : nerve conduction study, staging of diabetic neuropathy, sensory nerve action potential, compound muscle action potential, diagnostic algorithm diabetes mellitus DM DM 2,000 1 DM diabetic polyneuropathy DPN DM DPN DM 3, DPN DM DPN prickling/tingling sensation painful DPN DPN painless DPN DPN DM DPN Michigan Neuro pathy Diagnostic Instrument 4 Tronto Neuropathy Clinical Score 5 golden standard nerve conduction study NCS DM NCS sensory conduction velocity SCV motor

polyneuropathy DPN DM DPN DM 3,000 7 2 3 DPN DM 30 40 DPN prickling/tingling sensation painful DPN DPN painless DPN DPN DM DPN Michigan Neuro pathy

2 144 conduction velocity MCV F DPN 9 DPN sensory nerve action potential SNAP SNAP NCS DPN NCS NCS DPN NCS DPN 10 NCS NCS DPN NCS DPN 11 distal axonal degeneration 41 3 DPN DM CIDP DPN 1 NCS NCS DPN NCS NCS DM DPN NCS F NCS 14 F NCS 15 NCS NCS 2 NCS NCS DPN SNAP compound motor muscle action potential CMAP DPN DPN DPN

degeneration 41 3 DPN DM CIDP DPN 1 NCS NCS DPN NCS NCS DM 80 2 3 40 12 13 DPN NCS F

3 2013. DPN mv DM 17 DPN CMAP epiphenomenon MCV SCV DPN MCV cm MCV SCV MCV DM Kimura F F 1 m F 19 DPN F MCV F NCS DM CMAP CMAP DPN CMAP 12 MCV F CMAP SNAP DPN NCS 145 CMAP DPN MCV F CMAP 2 mv MCV epiphenomenon DPN 1 NCS NCS 10 cm 1 cm SCV 10 SCV EMG onoff 37 1 SCV 19 DPN SCV SNAP DM SNAP SNAP SNAP SNAP 2 NCS DPN NCS NCS SNAP near-nerve SNAP

CMAP SNAP DPN NCS 145 CMAP DPN MCV F CMAP 2 mv MCV epiphenomenon DPN 1 NCS NCS 10 cm 1 cm SCV 10 SCV

4 146 NCS 20 Near-nerve / SNAP DPN near-nerve NCS Nagaki 21 DPN nearnerve DPN NCS DPN SNAP SCV 22 SNAP NCS 50 NCS DPN Dyck NCS 5 Σ Σ5 NCS NCS NCS DPN SNAP SNAP over diagnosis under diagnosis 41 3 SNAP SNAP 1 epiphenomenon SNAP SCV MCV F by Chance SNAP F A 25 A EDB DPN CMAP 26 CMAP NCS NCS DPN 2 SNAP 5 μv CMAP

SNAP SNAP over diagnosis under diagnosis 41 3 SNAP SNAP 1 epiphenomenon SNAP

5 NCS 2013 NCS / DPN F ms/ m and/or MCV 42 m/s and/or A and/or SCV 42 m/s and/or CMAP 2 mv and/or MCV 42 m/s CSAP 5 μv CMAP 2 5 mv CMAP 2 mv NCS 0 NCS NCS NCS NCS SNAP CMAP 5 mv 6 mv 5 mv 5 μv SNAP 5 mv CMAP 2 mv CMAP SNAP 5 μv NCS 1 NCS DPN NCS DPN NCS DPN 2011 NCS DPN NCS DM 57 NCS NCS NCS 9 DPN NCS DPN NCS DM 57 10

mv CMAP 2 mv NCS 0 NCS NCS NCS NCS SNAP CMAP 5 mv 6 mv 5 mv 5 μv SNAP 5 mv CMAP 2 mv CMAP SNAP 5 μv NCS

6 148 2 NCS A / A B / CMAP B A B CSAP A A CSAP A / CMAP B A B CMAP / A A NCS 0 1 NCS DPN 2 NCS NCS NCS NCS 2 SNAP SNAP 5 μv SNAP 5 μv NCS SCV F MCV A NCS CMAP NCS 0 SNAP 5 μv CMAP SNAP 5 μv CMAP 2 mv DPN NCS DPN 2013 DPN 2 SNAP 5 μv SNAP 5 μv CMAP CMAP 5 mv NCS CMAP 5 mv 2 mv NCS CMAP 2 mv NCS CMAP 2 mv SNAP 2 μv SNAP CMAP 2 mv 5 μv SNAP DPN CIDP DPN CMAP 3 SNAP SNAP NCS F CMAP

μv CMAP 2 mv DPN 41 3 2 NCS DPN 2013 DPN 2 SNAP 5 μv SNAP 5 μv CMAP CMAP 5 mv NCS CMAP 5 mv 2 mv

7 2013. NCS m 2 m 8 m μv SNAP SNAP 2.5 μv 10 μv 5 μv 10 μv 2.5 μv 8 μv SNAP 4 16 μv 5 μv μv 2 μv 1 4 μv 1 pp Tesfaye S, Boulton AJM, Dyck PJ, et al: Diabetic neuropathies. Update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care 33: , : , Herman WH, Pop-Busui R, Braffett BH, et al: Use of the 149 Michigan Neuropathy Screening Instrument as a measure of distal symmetrical peripheral neuropathy in type 1 diabetes. Results from the diabetes control and complication trial/ epidemiology of diabetes interventions and complications. Diabet Med 29: , Bril V, Tomioka S, Buchanan RA, et al: Reliability and validity of the modified Toronto Clinical Neuropathy Score in diabetic sensorimotor polyneuropathy. Diabet Med 26: , Gilliatt RW, Willison RG: Peripheral nerve conduction in diabetic neuropathy. J Neurol Neurosurg Psychiatry 25: 11 18, Noel P: Sensory nerve conduction in the upper limbs at various stages of diabetic neuropathy. J Neurol Neurosurg Psychiatry 36: , Behse F, Buchthal F, Carlsen F: Nerve biopsy and conduction studies in diabetic neuropathy. J Neurol Neurosurg Psychiatry 40: , Hotta N, Kawamori R, Atsumi Y, et al: Stratified analysis for selecting appropriate target patients with diabetic peripheral neuropathy for long-term treatment with an aldose reductase inhibitor, epalrestat. Diabet Med 25: , : , Yagihashi S, Mizukami H, Sugimoto K: Mechanism of diabetic neuropathy: Where are we now and where to go? J Diabetes Invest 2: 1 32, Baba M, Suzuki C, Arai A, et al: Extensor digitorum brevis muscle in diabetic patients. J Peripher Nerv Syst 14 S2 : 10 11, Severinsen K, Andersen H: Evaluation of atrophy of foot muscles in diabetic neuropathy. A comparative study of nerve conduction studies and ultrasonography. Clin Neurophysiol 118: , Andersen H, Stalberg E, Falck B: F-wave latency, the most sensitive nerve conduction parameter in patients with diabetes mellitus. Muscle Nerve 20: , Baba M, Kimura K, Suda T, et al: Three-year inhibition of aldose reductase on development of symptomatic neuropathy in diabetic patients. J Peripher Nerv Syst 11: , Lamontagne A, Buchthal F: Electrophysiological studies in diabetic neuropathy. J Neurol Neurosurg Psychiatry 33: , Greene DA, Arezzo JC, Brown MB: Effect of aldose reductase inhibition on nerve conduction and morphometry in diabetic neuropathy. Neurology 53: , Baba M, Gilliatt RW, Harding A, et al: Effect of diphtheria toxin to Schwann cells in the presence of axonal atrophy. J Neurol Sci 64: , Kohara N, Kimura J, Kaji R, et al: F-wave latency serves as the most reproducible measure in nerve conduction studies of diabetic polyneuropathy. Multicenter analysis in healthy subjects and patients with diabetic neuropathy. Diabetologia 42:

3 50: 799 806, 2007. 4 Herman WH, Pop-Busui R, Braffett BH, et al: Use of the 149 Michigan Neuropathy Screening Instrument as a measure of distal symmetrical peripheral neuropathy in type 1 diabetes.

8 , Trojaborg W: The electrophysiologic profile of diabetic neuropathy. Semin Neurol 16: , Nagaki J, Kajiwara K, Miyamoto F, et al: Studies on electrophysiological abnormalities of the sural nerve in diabetic patients. In Ward J, Goto Y eds Diabetic Neuropathy Wiley, Chichester, UK, pp , Reeves ML, Seigler DE, Ayyar DR, et al: Medial plantar sensory response. Sensitive indicator of peripheral nerve dysfunction in patients with diabetes mellitus. Am J Med 76: , Dyck PJ, Overland CJ, Low PA, et al: Signs and symptoms vs nerve conduction to diagnose diabetic sensorimotor polyneuropathy. Muscle Nerve 42: , : 72 77, A 19: , : , : , p 22, pp , : 419, 2012.

In Ward J, Goto Y eds Diabetic Neuropathy Wiley, Chichester, UK, pp 297 308, 1990. 22 Reeves ML, Seigler DE, Ayyar DR, et al: Medial plantar sensory response.

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