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Published on: October 7, 2021
H-reflex and clinical examination in the diagnosis of diabetic polyneuropathy
Ro Millán-Guerrero1, B Trujillo-Hernández, S Isais-Millán
1Clinical Epidemiology Research Unit, Mexican Institute of Social Insurance, Zone 1 General Hospital of Colima, Colima, Mexico.
Objectives:
To determine among adult patients with type-2 diabetes mellitus the proportion diagnosed with diabetic polyneuropathy (DPN) by clinical evaluation and by the Hoffmann reflex (H-reflex). In addition, the predictive value of the H-reflex in the diagnosis of DPN was evaluated.
Methods:
Studies were carried out on 150 adult patients referred for neuropathy screening. Diagnostic criteria for DPN were at least two abnormalities in clinical neurophysiological examinations and electrophysiological testing (H-reflex and nerve conduction velocity). Logistic regression analysis was performed to identify unique contributions of study characteristics to positive versus negative outcomes.
Results:
H-reflex was absent in 39.3% (59/150) and latency was prolonged in 43.3% (65/150) of patients. Ulnar nerve motor branch nerve conduction showed prolonged latency in 9.3% (14/150) of patients. Logistic regression analysis indicated that the H-reflex was significantly associated with positive outcomes.
Conclusion:
The H-reflex could have a predictive value in DPN, providing more quantitative information regarding diagnosis than conventional nerve conduction studies.
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