Relationship between Toronto Clinical Scoring System and Severity of Diabetic Neuropathy

J Korean Assoc EMG Electrodiagn Med 2007;9(1):24-29.
Published online May 10, 2007.

Abstract

Objective: To investigate the relationship between the Toronto Clinical Scoring System (Toronto CSS) and electrophysiologic severity of diabetic neuropathy. Methods: Electrophysiologic study was performed in 98 patients (male 63, female 35, average age 56.4) with diabetes mellitus. Electrophysiologic findings were interpreted as normal, mild, moderate and severe degrees of peripheral neuropathy. Toronto CSS was also examined in all the subjects. The ANOVA test was used for statistical analysis. Results: Total scores of Toronto CSS were 2.47±3.26 in normal, 8.00±4.00 in mild, 10.68±4.07 in moderate and 16.27±2.05 in severe neuropathy. Total scores, as well as each reflex, symptom, and sensory test scores showed statistically significant differences between normal and mild neuropathy, mild and severe neuropathy, and between moderate and severe neuropathy (p<0.05), but not between mild and moderate neuropathy. Conclusion: Toronto CSS yielded higher scores according to the presence or absence and the electrophysiologic severity of diabetic neuropathy. Therefore, the Toronto CSS may be a useful tool suspecting severity of peripheral neuropathy for diabetic patients.

Key Words: Diabetic neuropathy, Nerve conduction study, Electromyography, Toronto Clinical Scoring System