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J Korean Assoc EMG Electrodiagn Med 2000;2(2):83-89.
Published online May 10, 2000.
Segmental Demyelination in Diabetic Neuropathy
Abstract
Objectives : Conduction block is an electrophysiological hallmark of segmental demyelination. If segmental demyelination was a prominent part of the pathology of diabetic neuropathy, then conduction block should be common in patients with diabetic neuropathy. The purpose of this study is to assess the degree of conduction block and relationship between conduction block and clinical features in diabetic patients. Methods : We performed median, ulnar, and deep peroneal motor nerve conduction studies in 31 normal adults and 36 patients with diabetic neuropathy. We measured amplitude dacay, area decay, and temporal dispersion of compound muscle action potentials. In normal subjects, the upper normal limits (mean+2SD) of amplitude decay, area decay, and temporal dispersion of compound muscle action potentials were calculated. In the patients group, beyond the upper normal limit of amplitude decay or area decay without increase of upper normal limit of temporal dispersion was considered as conduction block. In case amplitude or area decay were greater than 30%, we considered them as conduction block although temporal dispersion went beyond upper normal limit in this study. Results : In diabetic patients, a total of 208 nerve segments was evaluated. The criteria for conduction block were met in only 17 (8.2%) nerve segments in 10 patients. In the 17 nerve segments with conduction block, the mean amplitude decay was 28.6% and the mean area decay was 26.1%. Statistically, the clinical features of the patients showed no significant difference according to the presence of conduction block in terms of duration of disease, blood glucose level, and HbA1c. Conclusion : With the criteria of conduction block as described above, conduction block was uncommon in diabetic neuropathy. In addition, the presence of conduction block was not related to the severity of clinical features in diabetic patients.
Key Words: Diabetic neuropathy, Segmental demyelination, Conduction block


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