Clinical utility of dorsal sural nerve conduction studies in healthy and diabetic children

Abstract

Objective Monitoring of the dorsal sural sensory nerve action potential (SNAP) is a sensitive method for detection of peripheral neuropathies. We tried to determine the normal dorsal sural nerve conduction values of the childhood population and assessed the clinical utility of this method in diabetic children who have no clinical sign of peripheral neuropathy. Methods In the study, 36 healthy and 27 diabetic children were included. In all subjects peripheral motor and sensory nerve studies were performed on the upper and lower limbs including dorsal sural nerve conduction studies. Results The dorsal sural SNAP mean amplitude was 8.24±3.08 μV, mean latency was 2.47±0.48 ms, mean sensory conduction velocity was 41.63±5.43 m/s in healthy children. Dorsal sural SNAPs were absent bilaterally in one diabetic patient. In the other 26 diabetic patients, the mean dorsal sural nerve distal latency was longer (2.93±0.63 ms, P=0.004), mean SCV was slower than in healthy subjects (36.68±7.66 m/s, P=0.005). However, dorsal sural nerve amplitude was not different between the groups. A dorsal sural nerve latency of more than 2.9 ms had a sensitivity of 50% and a specificity of 75%. A dorsal sural nerve velocity of less than 36 m/s had a sensitivity of 54% and a specificity of 92%. Conclusions We designated the reference values of the dorsal sural nerve in healthy children. In addition, our findings suggest that dorsal sural nerve conduction studies may have value to determine neuropathy in the early stages in children with diabetes. Significance The dorsal sural nerve conduction studies in diabetic children may have value to determine the neuropathy in its early stages.