13. Electrodiagnostic Classification of Neuropathies in DMElectrodiagnostic Classification of Neuropathies in DM
DiscussionDiscussion
Diabetic Neuropathy referrals formed only 7.3% of the
total referrals which is surprising as type 2 Diabetes
Mellitus has a prevalence of about 12 to 18% in the age
group 25 to 75 years, and about 17 to 19.1% of them
have diabetic neuropathy.
64% of the study group had moderately severe and
chronic sensory-motor peripheral neuropathy and were
undergoing electrodiagnostic examination for the first
time. This suggests that diabetic neuropathy is under-
diagnosed or under-investigated.
14. Section of a Normal Nerve withSection of a Normal Nerve with
Myelinated Fibres & GoodMyelinated Fibres & Good
VascularityVascularity
15. Diabetic Nerve Shows Thickening of theDiabetic Nerve Shows Thickening of the
Nerve Sheath As Well As of the VesselsNerve Sheath As Well As of the Vessels
With Demyelination of the Nerves atWith Demyelination of the Nerves at
PlacesPlaces
57. Patients neurolysed 25
Male 17
Female 8
Nerves total 28
Bilateral release 3
Ulcerated side neurolysed 9
Died 5
Age
group
35-45 4
46-55 7
56-65 8
66-85 6
58. ID NAME
M
/F
AG
E
DIAG CLINICAL
DATE
NEUROLYSI
S
NEUROLY
SIS
1 SP F 56 rt dmf
Rt great toe
gangrene
28/01/2000 Lt
2
JA M 44 b/l dmf
b/l neuropathic
Daibetic feet
21/07/2000 Lt
3 18/08/2000 Rt
4 TS F 70 rt dmf
Rt plantar
ulcer
25/08/2000 Lt
5
DT M 50 lt dmf
Lt plantar
aspect necrosis
02/09/2000 Rt
6 08/09/2000 Lt
7 KB F 45 lt dmf
2 plantar
ulcers L foot
15/09/2000 Lt
NEUROLYSED
59. ID NAME
GEND
ER
AGE DIAG CLINICAL
DATE
NEUROLY
SIS
NEUR
OLYSI
S
8 NB M 50 lt dmf Lt 5th
toe gangrene 24/02/2001 Rt
9 MG M 60 rt dmf
rt leg necrotizing
fasciitis
02/03/2001 Lt
10 BK M 55 rt dmf rt great toe ulcer 08/03/2001 Lt
11 YV M 60 rt dmf 24/03/2001 Lt
12 LG M 58 rt dmf Neuropathic pain 13/07/2001 Lt
13 MN F 35 lt dmf
Lt foot blackened
skin
14/09/2001 Rt
14 NS F 75 28/12/2001 Rt
15 AS M 67 rt dmf
rt 1st
mt ulcer,, 2nd
3rd toes tips
ischaemic
13/09/2002 Rt
60. ID NAME M/F AGE DIAG CLINICAL
DATE
NEUROLYS
IS
NEUROL
YSIS
16 GS M 53 lt dmf
Lt tation of 1st
2nd toes ampu;
raw areas
07/11/2003 Rt
17 PR M 43 lt dmf
Lt cellulitis upto
thigh
14/11/2003 Rt
18 SP M 69 lt dmf
Lt dmf lt knee
raw area
15/11/2003 Rt
19 MD F 60 rt dmf rt foot heel ulcer 29/11/2003 Rt
20 NK M 63 lt dmf abscess lt foot; 26/12/2003 Rt
21 KJ M 53 b/l dmf
chronic callosities
both 1st MPJs
07/02/2004 Rt
22 SS F 60 b/l dmf 1st
mt head ulcers 08/10/2004 Rt
61. ID NAME M/F AGE DIAG CLINICAL
DATE
NEUROLYS
IS
NEUROL
YSIS
23 FA F 67 Rt dmf Rt charcot 22/01/04 Lt
24 FA F 67 Rt dmf Rt charcot 2/03/05 Rt
25 BC M 55 Lt dmf Lt gr toe amp 7/03/05 Lt
26 BJ 52 Lt dmf Lt nec fascii 28/10/05 Rt
27 SB 63 Lt dmf
Lt forefoot
plantar necrosis
16/7/05 Rt
28 TR 82 Bil dmf Gr toe pl ulcer 12/5/06 Rt
68. Nerve Site Rec Site
Amp Lat
Pre
6w
Post
Pre
6w
post
R
Tibial
Below ankle AH 2.0 2.0 4.35 3.65
At ankle AH 0.9 1.9 5,70 4.85
Knee AH 0.6 1.8 16.25 14.4
PRE-RELEASE
6wk POST
70. AS
Release of the Artery
Extent of Release of the Nerve
Level of stocking anaesthesia
71. Benefits of DecompressionBenefits of Decompression
Early onset of feeling of improved
sensation
Improvement of circulation
Ease of walking
Reduction of tiredness
Freedom from cramps
Healing of ulcers, absence of recurrence