Association between asymptomatic median mononeuropathy and diabetic polyneuropathy severity in patients with diabetes mellitus

Eleftherios Stamboulis, Konstantinos Voumvourakis, Athina Andrikopoulou, Georgios Koutsis, Nicholas Tentolouris, Adonis Kodounis, Georgios Tsivgoulis

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Asymptomatic median mononeuropathy (AMM) and diabetic polyneuropathy (DPN) often coexist and can be difficult to distinguish electrophysiologically. Moreover, the potential association between AMM and DPN has not been extensively evaluated. Objective: We investigated the relation between AMM and DPN severity in consecutive diabetic patients. Methods: The non-dominant limb was studied electrophysiologically in 100 consecutive diabetic patients with no symptoms of carpal tunnel syndrome on the non-dominant side. AMM was diagnosed based on previously validated electrophysiological criteria. DPN severity was graded according to the Michigan diabetic neuropathy score. Results: AMM was discovered in 28% of the study population (Adjusted Wald 95% CI: 20%-37%). It was more common in women, displayed a tendency of being more common in patients over 50 years old and correlated with the severity of DPN and the number of abnormal nerves on nerve conduction studies. It was present in 18.1% of patients without evidence of DPN. No correlation was found with the duration and type of diabetes. In multivariate logistic regression models increasing severity of DPN was independently associated with the presence AMM (Wald test = 10.557, df = 3, p = 0.014). Patients with DPN stage III and IV had a five-fold (OR = 5.06, 95% CI = 1.49-17.19) and a four-fold (OR = 4.50, 95% CI = 1.15-17.65) respectively increased likelihood to present with AMM in comparison to DPN stage I (reference group). Conclusions: Our results confirmed the high incidence of AMM in diabetic patients. AMM was present in a significant number of patients in the absence of DPN and the likelihood of AMM detection increased with increasing severity of DPN.

Original languageEnglish (US)
Pages (from-to)41-43
Number of pages3
JournalJournal of the Neurological Sciences
Volume278
Issue number1-2
DOIs
StatePublished - Mar 15 2009
Externally publishedYes

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Mononeuropathies
Diabetic Neuropathies
Diabetes Mellitus
Logistic Models
Carpal Tunnel Syndrome
Neural Conduction

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

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Association between asymptomatic median mononeuropathy and diabetic polyneuropathy severity in patients with diabetes mellitus. / Stamboulis, Eleftherios; Voumvourakis, Konstantinos; Andrikopoulou, Athina; Koutsis, Georgios; Tentolouris, Nicholas; Kodounis, Adonis; Tsivgoulis, Georgios.

In: Journal of the Neurological Sciences, Vol. 278, No. 1-2, 15.03.2009, p. 41-43.

Research output: Contribution to journalArticle

Stamboulis, Eleftherios ; Voumvourakis, Konstantinos ; Andrikopoulou, Athina ; Koutsis, Georgios ; Tentolouris, Nicholas ; Kodounis, Adonis ; Tsivgoulis, Georgios. / Association between asymptomatic median mononeuropathy and diabetic polyneuropathy severity in patients with diabetes mellitus. In: Journal of the Neurological Sciences. 2009 ; Vol. 278, No. 1-2. pp. 41-43.
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AU - Voumvourakis, Konstantinos

AU - Andrikopoulou, Athina

AU - Koutsis, Georgios

AU - Tentolouris, Nicholas

AU - Kodounis, Adonis

AU - Tsivgoulis, Georgios

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AB - Background: Asymptomatic median mononeuropathy (AMM) and diabetic polyneuropathy (DPN) often coexist and can be difficult to distinguish electrophysiologically. Moreover, the potential association between AMM and DPN has not been extensively evaluated. Objective: We investigated the relation between AMM and DPN severity in consecutive diabetic patients. Methods: The non-dominant limb was studied electrophysiologically in 100 consecutive diabetic patients with no symptoms of carpal tunnel syndrome on the non-dominant side. AMM was diagnosed based on previously validated electrophysiological criteria. DPN severity was graded according to the Michigan diabetic neuropathy score. Results: AMM was discovered in 28% of the study population (Adjusted Wald 95% CI: 20%-37%). It was more common in women, displayed a tendency of being more common in patients over 50 years old and correlated with the severity of DPN and the number of abnormal nerves on nerve conduction studies. It was present in 18.1% of patients without evidence of DPN. No correlation was found with the duration and type of diabetes. In multivariate logistic regression models increasing severity of DPN was independently associated with the presence AMM (Wald test = 10.557, df = 3, p = 0.014). Patients with DPN stage III and IV had a five-fold (OR = 5.06, 95% CI = 1.49-17.19) and a four-fold (OR = 4.50, 95% CI = 1.15-17.65) respectively increased likelihood to present with AMM in comparison to DPN stage I (reference group). Conclusions: Our results confirmed the high incidence of AMM in diabetic patients. AMM was present in a significant number of patients in the absence of DPN and the likelihood of AMM detection increased with increasing severity of DPN.

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