Validity of F-wave minimal latency of median and ulnar nerves for diagnosis and severity assessment of carpal tunnel syndrome in type II diabetes mellitus

Type II diabetes mellitus is a common problem and is sometimes associated with Carpal Tunnel Syndrome [CTS] due to compression of median nerve at wrist. Electrophysiological tests are frequently used for its diagnosis. In this work, F-wave minimal latency [FWML] difference between median and ulnar nerve and F-ratio is used to facilitate the diagnosis and severity of CTS in type II diabetes mellitus [T2DM]. Thirty control cases were selected who were physically fit for normal electrophysiological values. Thirty-two patients with a long history of type II diabetes mellitus were studied for electro-diagnostic tests. All patients had clinical evidence of CTS. Among all diabetics about 20 cases had poor glycaemic control [HbA1c>7.5]. F-wave minimal latency [FWML] were measured in median and ulnar nerves and F-ratio of median nerve were also noted. The mean values in different groups were compared using t-test and p

Brainstem auditory evoked potentials and electrocochleographic findings in patients with idiopathic sudden sensorineural hearing loss

To determine the status of cochlea, auditory pathway and hearing threshold by recording brainstem auditory evoked potential [BAEP] and electrocochleography in patients with idiopathic sudden sensorineural hearing loss [ISSNHL]. Observational study. Department of Clinical Physiology at King Abdul Aziz University Hospital, Riyadh, Saudi Arabia, from May 2002 to November 2007. Patients diagnosed with idiopathic sudden sensorineural hearing loss [ISSNHL] based on clinical features and pure tone audiometry were studied. Brainstem auditory evoked potential [BAEP] and electrocochleography [ECOG] was performed in them according to standard protocols for assessment of auditory pathway and hearing threshold. Out of 23 patients [14 males and 9 females] left ear was affected in 9 [39.1%] patients, right ear in 13 [56.5%] and both in 1 [4.3%]. Absolute latency of wave I and wave V were significantly prolonged in affected ear compared to unaffected ears [p=0.0031], while interpeak I-V latency was significantly higher in affected ears versus unaffected ears [p=0.0544]. Six patients [26.1%] had type II Diabetes mellitus, five cases [21.7%] had hypertension and 5 cases [21.7%] had dyslipidemia. ECOG revealed absence of summation potential [SP] and action potential [AP] response even at 95 dB in 17 out of 23 cases [73.9%]. Patients with ISSNHL had significant abnormalities in BAEP and ECOG recordings showing predominantly cochlear involvement. Thus, these tests provide useful diagnostic information in patients with ISSNHL in addition to pure tone audiometry

F-ratio, a surrogate marker of carpal tunnel syndrome

To explore the correlation of F-ratio and F-wave minimal latency [FWML] in carpal tunnel syndrome [CTS]. This retrospective study was conducted from January 2006 to January 2007 at the clinical physiology lab, King Abdul-Aziz University Hospital, Riyadh, Saudi Arabia. Motor and sensory nerve conduction studies, FMW latencies of median and ulnar nerves, and F-ratio were carried out in 54 CTS patients and 30 controls. Out of 54 CTS patients, there were 14 were males [26%], and 40 females [74%], CTS was bilateral in 32 [59%], and unilateral in 22 [41%] patients. Fifty-one patients [94.4%] had involvement of the right hand, 28 patients [51.8%] had dyslipidemia and 20 patients [37%] had hypertension. The FWML [ms] in the right median nerve was 25.46 +/- 2.2, and 25.79 +/- 1.7 in the right ulnar nerve in the control group [p = 0.5224], while it was 29.1 +/- 3.35 in the right median nerve and 26.46 +/- 4.35 in the right ulnar nerve in patients with CTS [p = 0.0008]. A similar statistically significant increase in the median nerve latency was observed in the left hand. A statistically significant reduction in the F-ratio was found consistently in all patients with CTS in both the hands [p = 0.0001]. The present study reveals prolongation of FWML in the median nerve, and a statistically significant reduction of F-ratio in all CTS patients. A significant inverse correlation was found between FWML and F-ratio in CTS patients. Both FWML and F-ratio support the diagnosis of CTS

Entrapment of medial plantar nerve [tarsal tunnel syndrome] in type 2 diabetes mellitus: An electrophysiological study

With increase in type 2 diabetes mellitus patients the complications of diabetes are being seen more frequently. Patients with diabetic neuropathy often present with distressing symptoms such as pain and burning sensation in the feet. Tarsal tunnel syndrome with electrophysiological changes may be a causative or contributing factor. The present study was designed to assess the presence and features of tarsal tunnel syndrome in diabetes mellitus patients. In this study a group of 10 normal volunteers were selected who had no neurological complaints or foot trauma. Another group of 33 patients having longstanding diabetes mellitus with complaints of pain, burning sensation and paraesthesia in the feet were selected for electrophysiological tests and median plantar nerve was studied. In the present study we observed that 15 [45%] of diabetic cases showed abnormal findings e.g., prolonged distal motor latency, decreased amplitude of M-response, low or absent sensory response suggesting tarsal tunnel syndrome. This study shows that the tarsal tunnel syndrome may be present in a significant number of diabetic patients with subjective neuropathic symptoms in the feet. The tarsal tunnel syndrome should be kept in mind during the diagnostic workup and management of diabetes mellitus