H reflexes as a measure for uremic polyneuropathy. A longitudinal study in patients treated with dialysis or renal transplantation

Weerd, A.W. de; Nihom, Jik; Rozeman, C. A. M.; Poortvliet, D.C.J.; Jonkman, E.J.; Maas, A. P. C. van der; Tjandra, Y. I.

doi:10.1016/0168-5597(94)90029-9

Cited by 5 publications

(3 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[37][38][39] It is better established that patients with diabetic or uraemic neuropathy show early subclinical abnormalities of the soleus H reflex. [40][41][42] The high rate of abnormality in this test was confirmed in the present study.…”

Section: Discussionsupporting

confidence: 86%

Neurophysiological testing correlates with clinical examination according to fibre type involvement and severity in sensory neuropathy

Créange²

2004

Journal of Neurology, Neurosurgery & Psychiatry

View full text Add to dashboard Cite

Objective: To investigate a comprehensive battery of neurophysiological tests for objective evaluation of sensory neuropathies including fibre type involvement and severity, and to determine the relation between neurophysiological data and clinical examination. Methods: 45 patients referred for sensory neuropathy were studied using a standardised clinical evaluation of large and small fibre symptoms and an original neurophysiological battery. Clinical evaluation included: assessment of tactile, vibratory, and pin sensation; tendon reflexes; toe position sense; ataxia score; pain level; and presence of trophic, vasomotor, or sudomotor abnormalities. The neurophysiological battery included: recording of large fibre and small fibre components of the sural sensory nerve action potential; somatosensory evoked cortical potentials and soleus H reflex following tibial nerve electrical stimulation; laser evoked potentials following Nd:YAG laser stimulation of the foot; and plantar sympathetic skin response to median nerve stimulation. Neuropathy was classified according to the predominantly affected fibre type, and a severity score was established based on clinical and neurophysiological abnormalities. Results: On clinical examination there were 22 patients with large fibre sensory neuropathy (LFSN), 18 with mixed sensory neuropathy (MSN), and five with small fibre sensory neuropathy (SFSN). Neurophysiological classification identified 25 patients with LFSN, 13 with MSN, and seven with SFSN. Clinical and neurophysiological classifications and severity scores were correlated, whatever the type of neuropathy. Conclusions: The correlation between clinical examination and the results of an original neurophysiological test battery offers a comprehensive clinical and neurophysiological approach to the objective assessment of peripheral neuropathies according to fibre type involvement and overall severity.T he severity of a neuropathy is usually quantified by an objective evaluation of clinical scores and neurophysiological data. Correlations between nerve conduction studies and clinical scores have been reported, but not with the aim of qualifying the neuropathy according to fibre type involvement. Determination of the predominantly affected nerve fibre type remains a challenge in the sensory neuropathies. Several clinical scores have been validated and are currently used to quantify neuropathy severity, 1-4 but they do not focus on the profile of nerve damage.4 Sensory nerve fibres of large diameter are easily explored using neurophysiological methods, but small nerve fibre assessment requires more unusual techniques, such as quantified thermal sensory testing or sympathetic skin response recordings. 5Somatosensory evoked potentials can be obtained by selectively stimulating each type of fibre-large fibres in response to electrical stimulation and small fibres in response to laser stimulation. 6 To distinguish between large fibre sensory neuropathy (LFSN), small fibre sensory neuropathy (SFSN), and mixed (large and small) sen...

show abstract

Section: Discussionsupporting

confidence: 86%

Neurophysiological testing correlates with clinical examination according to fibre type involvement and severity in sensory neuropathy

Créange²

2004

Journal of Neurology, Neurosurgery & Psychiatry

View full text Add to dashboard Cite

show abstract

“…This could be due to small numbers of subjects. Other studies showed a high sensitivity of the H‐reflex for a variety of PNPs such as diabetic, uremic, alcoholic‐induced PNP, and GBS . These studies mainly looked at H‐reflex latency and the H/M interval, whereas our data were analyzed in a dichotomized (absent vs present) way.…”

Section: Discussionmentioning

confidence: 99%

Utility of the H‐reflex in diagnosing polyneuropathy

et al. 2019

View full text Add to dashboard Cite

Introduction An absent Hoffman (H)‐reflex, the electrophysiological equivalent of the Achilles reflex, is assumed to be one of the first detectable signs of polyneuropathy (PNP). In this study we compare the H‐ and Achilles reflexes in patients with suspected PNP to evaluate the diagnostic utility of the H‐reflex. Methods Data from clinical examination and nerve conduction studies (NCS) were analyzed in patients with suspected PNP. Results The PNP diagnosis was confirmed by follow‐up in 209 patients. The sensitivities of the H‐ and Achilles reflexes were similar (70.3% vs 71.8%), whereas the H‐reflex had higher specificity (85.2% vs 70.5%) (P < .001). Adding H‐reflex to the NCS protocol increased the diagnostic sensitivity from 80.9% to 87.6%. Discussion The H‐reflex is a sensitive method that could provide added value to standard NCS in PNP diagnosis. The simplicity and high specificity make it superior to its clinical equivalent, the Achilles reflex.

show abstract

“…Perbedaan-perbedaan pada gambaran gangguan late response ini dikarenakan subjek pada penelitian lainnya merupakan PGK stadium 5 dengan kerusakan ginjal yang lebih berat. [24,26] Gangguan pada late response seperti pada gelombang F dapat terjadi meskipun gambaran konduksi saraf lainnya abnormal. Keadaan tersebut dapat terjadi pada lesi demielinating.…”

Section: Pembahasanunclassified

Gambaran Konduksi Saraf Tepi Neuropati Asimptomatik Pada Penyakit Ginjal Kronis Stadium 3 Dan 4 4

Sananta¹

2022

View full text Add to dashboard Cite

Pendahuluan Neuropati merupakan komplikasi neurologis tersering pada Penyakit Ginjal Kronis (PGK). Umumnya neuropati terjadi pada PGK dengan laju filtrasi glomerolus kurang dari 12mL/menit (stadium 5), namun faktor-faktor yang menyebabkan neuropati sebenarnya sudah terdapat pada PGK stadium lebih awal. Saat ini belum diketahui bagaimana gambaran konduksi saraf tepi neuropati asimptomatik pada PGK stadium 3 dan 4. Tujuan Mengetahui gambaran konduksi saraf tepi neuropati asimptomatik pada PGK stadium 3 dan 4 Metode Penelitian bersifat deskriptif observasional, dengan rancangan potong lintang dilakukan pada subjek penderita PGK stadium 3 dan 4 yang tidak memiliki gejala dan tanda neuropati. Penelitian dilakukan pada dua rumah sakit di Bandung, dari Desember 2017 sampai Maret 2018. Pemeriksaan konduksi saraf tepi dilakukan pada seluruh subjek. Hasil Terdapat 16 subjek berusia 22-72 tahun (laki-laki 81% dan perempuan 19%) dengan Laju Filtrasi Glomerolus (LFG) 32,2±11,6ml/menit. Pemeriksaan menunjukkan bahwa 37,5% subjek mengalami gangguan konduksi saraf tepi. Kelainan terbanyak adalah polineuropati sensorik motorik tipe aksonal. Serabut saraf yang terkena dominan berada di ekstremitas bawah. Prevalensi neuropati pada PGK stadium 4 adalah sebesar 57,14% dan pada stadium 3 sebesar 22,22%. Diskusi Pemeriksaan konduksi saraf tepi menunjukkan kerusakan akson serabut sensorik motorik, dimana akson yang lebih banyak terganggu adalah akson yang lebih panjang dan lebih jauh dari badan sel. Neuropati lebih banyak terjadi pada pasien dengan kerusakan ginjal yang lebih berat. Polineuropati terdapat pada sepertiga pasien PGK stadium 3 dan 4 walaupun belum memiliki gejala dan tanda klinis. Kata kunci : neuropati asimptomatik, penyakit ginjal kronis stadium 3 dan 4

show abstract

H reflexes as a measure for uremic polyneuropathy. A longitudinal study in patients treated with dialysis or renal transplantation

Cited by 5 publications

References 17 publications

Neurophysiological testing correlates with clinical examination according to fibre type involvement and severity in sensory neuropathy

Neurophysiological testing correlates with clinical examination according to fibre type involvement and severity in sensory neuropathy

Utility of the H‐reflex in diagnosing polyneuropathy

Gambaran Konduksi Saraf Tepi Neuropati Asimptomatik Pada Penyakit Ginjal Kronis Stadium 3 Dan 4 4

Contact Info

Product

Resources

About