Neurophysiologic evaluation of peripheral nerve function in uremic Egyptian children

Abstract

Information concerning clinical and sub-clinical peripheral neuropathy in uremic children is still scarce. We aimed to evaluate role of neurophysiologic testing for detection of peripheral nerve dysfunction in asymptomatic uremic Egyptian children. A cohort of 81 uremic children was enrolled from Pediatric Nephrology Unit in Mansoura University Children's Hospital. It comprised 39 cases on conservative therapy; conservative group (CG) (27 males and 12 females, with mean age 9.8 ± 3.3 years) and 42 cases under regular hemodialysis for at least 6 months; hemodialysis group (HG) (27 males and 15 females, with mean age 11.8 ± 1.6 years). A third group of twenty healthy children was taken as control (12 males, and eight females, with mean age 9.9 ± 2.4 years). Nerve conduction studies including motor and sensory functions were done successfully in most cases; data were analyzed using SPSS version 10.0. Different proportions of abnormal motor and sensory conduction studies were reported in both patients' groups with reference to pediatric ranges built-in Sierra II software. Comparing these observations to controls, motor peroneal and median conduction velocities as well as sensory ulnar conduction velocity were significantly delayed in HG (38.46 ± 4.49 vs. 48.33 ± 3.35 for peroneal, 50.68 ± 10.87 vs. 57.22 ± 7.13 for median and 32.82 ± 9.8 vs. 52.08 ± 20.12 for ulnar nerve). However, in CG antidromic sensory median conduction was the only significant abnormality detected (41.13 ± 9.63 vs. 53.89 ± 12.32). F wave latencies in CG were almost normal but in HG they were moderately affected compared to controls. We can conclude that sensory dysfunction could be early detected in asymptomatic uremic children by neurophysiologic testing. Further prospective studies should be warranted to evaluate sequential electrophysiological changes in response to hemodialysis.