Related Experiment Video
Updated: Jan 5, 2026

Nerve Ultrasound Protocol to Detect Dysimmune Neuropathies
Published on: October 7, 2021
Sural nerve sensory response in diabetic distal symmetrical polyneuropathy
Yun-Ru Lai1,2,3, Chih-Cheng Huang3, Wen-Chan Chiu4
1Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan.
Introduction:
The sural sensory nerve action potential (SNAP) amplitude is a measure of the number of axons. We tested the hypothesis that sural SNAP amplitude can be used as a marker in screening, severity evaluation, and follow-up of diabetic distal symmetrical polyneuropathy (DSPN).
Methods:
Patients with type 2 diabetes underwent nerve conduction studies and were followed for 6 years. Composite amplitude scores (CASs) were determined to evaluate DSPN severity.
Results:
Sural SNAP amplitudes were negatively correlated with CAS (r = -.790, P < .0001), and changes in sural SNAP amplitudes were negatively correlated with those of CAS after controlling for follow-up duration (r = -.531, P = .028).
Discussion:
When a patient's baseline sural SNAP amplitude is above zero, it can be used as one measure of DSPN in screening, severity evaluation, and follow-up. However, if the patient's sural SNAP value is zero, CAS can be used as a follow-up measure.
Related Concept Videos
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
Pulse Assessment Sites
Local Anesthetics: Differential Sensitivity of Nerve Fibers
Peripheral Artery Disease V: Postoperative Nursing Management
Peripheral Artery Disease IV: Nursing Management
Assessment of the Cardiovascular System III: Palpation
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...

