당뇨병성 신경병증의 진단에서 제1족지 교감신경 피부반응의 유용성
The Usefulness of Sympathetic Skin Response at Big Toe in Diagnosis of Diabetic Polyneuropathy
박용범, 박윤길, 이상철, 문재호, 조수경, 유지현,
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박용범 ( Park Yong-Bum )
연세대학교 의과대학 재활의학교실 및 근육병 재활연구소
박윤길 ( Park Yoon-Ghil )
연세대학교 의과대학 재활의학교실
이상철 ( Lee Sang-Chul )
연세대학교 의과대학 재활의학교실
문재호 ( Moon Jae-Ho )
연세대학교 의과대학 재활의학교실
조수경 ( Cho Soo-Kyung )
연세대학교 의과대학 재활의학교실
유지현 ( Yoo Jee-Hyun )
연세대학교 의과대학 재활의학과
KMID : 0860920060080020091
Abstract
Objectives: The aim of this study was to determine whether the sympathetic skin responses (SSR) recorded from the big toe are more useful than conventional nerve conduction study in the diagnosis of diabetic neuropathy.
Methods: We recorded big toe SSR (SSRBT) and plantar SSR (SSRP) in 53 diabetic patients and 40 agematched normal controls. For SSRP, surface electrodes were attached on the sole (G1) and dorsum of foot (G2). For SSRBT, surface electrodes were attached on the toe-tip (distal phalanx, G1) and the dorsum of the proximal phalanx of the big toe (G2). Peak to peak SSR amplitude of the response with the largest amplitude was measured. A deep inspiration was used as a stimulus.
Results: All of the patients and control subjects were assessed by routine nerve conduction study and SSR (SSRBT & SSRP). the sensitivity was 43.39% for conventional nerve conduction study, 37.74% for SSRP, and 68.15% for SSRBT. 75.49% of our patients showed abnormal results in any of three methods.
Conclusion: For detecting diabetic polyneuropathy, SSRBT is more useful than routine nerve conduction study or conventional SSRP. Therefore, SSRBT might be better to be included in the electrophysiological investigation of diabetic polyneuropathy.
키워드
Sympathetic skin response;Diabetic neuropathy;Big toe
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