Akademik Veri Yönetim Sistemi
10th Congress of the European Academy, Helsinki, Finlandiya, 29 Haziran - 02 Temmuz 2024, cilt.31, ss.38-39, (Özet Bildiri)
EUROPEAN JOURNAL OF NEUROLOGY
Volume 31, Supplement 1, June 2024
Abstracts of the 10th Congress of the European Academy of Neurology
Helsinki, Finland
EPO-058 | Sural-to-medial femoral cutaneous amplitude ratio in early diagnosis of uremic neuropathy
Ş. Deveci1; Z. Matur2; D. Mermi Dibek1; A. Öge3
1University of Health Sciences Turkey, Basaksehir Cam and Sakura City Hospital, Clinic of Neurology, Istanbul, Turkey; 2Bezmialem Vakif
University Faculty of Medicine, Department of Neurology, Istanbul, Turkey; 3Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey
Background and Aims: Chronic Renal Failure (CRF) is typically associated with length-dependent axonal polyneuropathy and secondary demyelination. This study aimed to clinically and electrophysiologically assess CRF patients experiencing polyneuropathy-related complaints before initiating dialysis. The sural-to-medial femoral cutaneous nerve action potential (NAP) amplitude ratio (SMFCAR) was evaluated for its sensitivity and specificity in early electrophysiological diagnosis. Methods: The study included 32 CRF patients (mean age 60.0 ± 9.6 years) and 30 age and sex-matched controls (58.9 ± 6.6 years). Assessments encompassed neurological examination, Michigan Neuropathy Screening Instrument (MNSI) A-B, and Semmes-Weinstein monofilament (10 g–5.07 mm) test. Radial, median, ulnar, medial femoral cutaneous, sural, and superficial peroneal sensory; median, ulnar, tibial, and peroneal motor conduction studies were performed. Sural-to-radial amplitude ratio (SRAR) and SFMCAR were calculated, and their diagnostic sensitivities were compared.
Results: The patients were in the CRF stages of 3 (59.4%), 4 (34.4%), and 5 (6.3%). The average CRF duration was 54.3 ± 46.1 (8–276) months. MNSI-B indicated clinical polyneuropathy in 59% of the patients, while routine nerve conduction studies diagnosed it in 72%. Median SRAR and SMFCAR values were significantly lower in patients than controls (p < 0.001 for both). At 90% specificity, SMFCAR's cut-off was <2.8 with a sensitivity of 59%, while SRAR's was <0.77 with a sensitivity of 35%.
Conclusion: In some CRF patients with symptoms compatible with length-dependent polyneuropathy, peripheral nerve involvement might be in a stage that cannot be detected by routine examination and electrophysiology. SMFCAR may be a useful alternative to SRAR in the early diagnosis.