Computerized Dynamic Posturography to Detect Unsteadiness in Aged Patients with Large-Fiber Peripheral Neuropathy

ABSTRACT

BACKGROUND: Large-fiber peripheral neuropathy is prevalent in the elderly and risk of falling is higher in patients with it. This study`s aim is to see if, using computerized dynamic posturography(CDP), sway patterns differ between patients with large-fiber peripheral neuropathy and normal control subjects and, if it did, to compare CDP with conventional electromyography(EMG) as screening tools for large-fiber perip- heral neuropathy. METHODS: Thirty patients who came to the neurophysiology laboratory with a preliminary diagnosis of peripheral neuropathy(made by their referring physicians) were compared with 30 nonmatched control subjects. All subjects received a neurologic examination and underwent CDP and conventional EMG. RESULTS: CDP showed abnormal sway patterns only in patients who had EMG abnormalities consistent with large fiber peripheral neuropathy. These sway patterns differed significantly from those of the control subjects. Center of gravity(COG) wandered farther and faster per unit of time in the patients with polyneu- ropathy than in control subjects. It means that the control mechanism provided by peripheral nerves limi- ting total displacement and the speed of COG wandering is defective in the patients with large-fiber peri- pheral neuropathy. CONCLUSION: CDP seems to be a useful and well-tolerated screening test for patients with a history suggestive of peripheral neuropathy, and results of CDP agree with those of conventional EMG. Moreover, posturography directly measures increased sway in these patients and may be used as a screening test for risk of falls in this population of old age.