BACKGROUND Diabetic peripheral neuropathy is a long term complication of diabetes. Traditionally, clinical history, physical examination and electro physiological studies were relied upon for diagnosis. Currently, High resolution ultrasonography has come into picture in the diagnosis of peripheral neuropathy due to the ease, time saving ability and noninvasiveness of the procedure. We wanted to correlate the cross-sectional area and maximum thickness of nerve fascicles of the ulnar nerve with the presence and severity of diabetic peripheral neuropathy. METHODS A retrospective study was conducted between October 2018 and January 2019. The study group consisted of 85 type 2 diabetic patients. 55 Diabetic patients with clinical signs and symptoms of peripheral neuropathy were assigned to Group I. Group II comprised of 30 diabetic patients with no clinical signs and symptoms of peripheral neuropathy. 70 healthy volunteers were also recruited for the study, and assigned to Group III. The cross sectional area and maximum thickness of nerve fascicles of the ulnar nerve were measured at every predetermined site. RESULTS The cross sectional area of the ulnar nerve was measured at three sites (inlet of the cubital tunnel, outlet of the cubital tunnel and Guyon tunnel). The mean cross sectional area and maximum thickness of nerve fascicles of the ulnar nerves in the above three sites in Group I compared with both Group II and III was significantly larger, and statistically significant correlation was found with the Toronto Clinical Neuropathy Score (p<0.001). The Group II patients also had a significantly larger mean cross sectional area and maximum thickness of nerve fascicles than Group III. CONCLUSIONS High resolution ultrasonography of ulnar nerve is an easy non-invasive tool for the early diagnosis of diabetic peripheral neuropathy by assessing the cross sectional area and maximum thickness of nerve fascicles.
BACKGROUND Trigeminal neuralgia is one of the most debilitating facial pain disorders. Differentiation among various aetiologies is important because the treatment strategy changes. MRI helps in diagnosing the disease, finding the cause for neuralgia and follow up of patients after treatment. We wanted to evaluate the aetiology among patients clinically suspected to be suffering from trigeminal neuralgia using 3D CISS sequence of Magnetic Resonance Imaging (MRI). METHODS A hospital based cross-sectional study was done from November 2017 to May 2019 in a tertiary care centre of South India, where 56 patients with clinical suspicion of Trigeminal neuralgia were evaluated with MRI of brain. The MRI data collected was analysed and described. RESULTS Out of 56 patients in our study group, 24 (42.9%) were males and 32 (57.1%) were females, with slightly more female predilection. Majority of patients was in the 5 th decade (23.2%). Neurovascular compression was the most common aetiology accounting for 71.1% of the patients, followed by tumours (15.8%), demyelination (7.9%) and infarct (5.3%) aetiologies. CONCLUSIONS MRI is the best imaging modality for evaluation of trigeminal neuralgia. 3D CISS sequence helps in better depiction of neurovascular conflicts. It is the most sensitive and specific tool for characterisation of tumours involving cerebellopontine angle, although the final tool for confirmation is histopathology. The present study was aimed at evaluating the causes of trigeminal neuralgia on MRI. This was done by correlating MRI findings with clinical features.
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