H-Reflex and Clinical Examination in the Diagnosis of Diabetic Polyneuropathy

Abstract

OBJECTIVES: To determine among adult patients with type-2 diabetes mellitus the proportion diagnosed with diabetic polyneuropathy (DPN) by clinical evaluation and by the Hoffmann reflex (H-reflex). In addition, the predictive value of the H-reflex in the diagnosis of DPN was evaluated. METHODS: Studies were carried out on 150 adult patients referred for neuropathy screening. Diagnostic criteria for DPN were at least two abnormalities in clinical neurophysiological examinations and electrophysiological testing (H-reflex and nerve conduction velocity). Logistic regression analysis was performed to identify unique contributions of study characteristics to positive versus negative outcomes. RESULTS: H-reflex was absent in 39.3% (59/150) and latency was prolonged in 43.3% (65/150) of patients. Ulnar nerve motor branch nerve conduction showed prolonged latency in 9.3% (14/150) of patients. Logistic regression analysis indicated that the H-reflex was significantly associated with positive outcomes. CONCLUSION: The H-reflex could have a predictive value in DPN, providing more quantitative information regarding diagnosis than conventional nerve conduction studies.

Keywords

Diabetes Mellitus Diabetic Neuropathy Polyneuropathy Diagnosis Hoffmann Reflex Electrophysiological Tests Nerve Conduction Velocity

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