Does This Patient With Diabetes Have Large-Fiber Peripheral Neuropathy?

The Journal Of The American Medical Association, April 21, 2010 – Vol 303, No.15 1526-1532

Results:
Out of 1388 identified articles, 9 articles were on diagnostic accuracy and 3 articles were on precision of diagnosing large-fiber peripheral neuropathy. It was found that the most useful examination findings were vibratory perception with a 128-Hz tuning fork and pressure sensation with a 5.07 Semmes-Weinstein monofilament. Other tests that were included were deep tendon reflexes as well as dermatological exams, which were looking for the evidence of ulcerations or pre-ulcerative lesions.

Conclusion:
When diagnosing a diabetic patient with LFPN, a thorough physical exam along with a detailed patient history is needed. Abnormal results from the vibratory and monofilament testing alone or in combination help aid in the correct diagnosis of LFPN. Those tests, combined with ulcerations or pre-ulcerative lesions help make the precision of the diagnosis that much greater. Nerve conduction studies along with nerve biopsy and skin biopsies can provide additional valuable information as to the degree of nerve damage, as well as axonal degeneration.

Dr. Werber of inMotion foot and ankle specialists, has an expertise in diagnosing and treating diabetic sensory neuropathy, and patients with non diabetic peripheral neuropathy as well. We have biopsy techniques that are utilized in the office, and Dr. Werber is trained in performing nerve decompressions that may be contributing to the neuropathic pain.

Bruce Werber DPM, FACFAS

InMotion Foot & Ankle Specialists

Associate Professor Midwestern University
InMotion Foot and Ankle Specialists
10900 N. Scottsdale Road Suite 604
Scottsdale, AZ 85254
office phone 480 948-2111
inmotionfootandankle@gmail.com

www.inmotionfootandankle.com