Peripheral Neuropathy: Clinical Evaluation and Differentiation of Diabetic Polyneuropathy through Sensitivity Testing and Conduction Velocity Analysis

Peripheral neuropathy is a common condition affecting the peripheral nervous system, often manifesting as distal tingling, pain, or loss of sensitivity in a "glove and stocking" pattern. The differentiation of diabetic polyneuropathy is crucial, as diabetes mellitus is one of the most prevalent causes of peripheral neuropathy. Proper clinical evaluation and the use of sensitivity testing are essential for accurate diagnosis and effective management.

Clinical Evaluation and Differentiation

The clinical evaluation of peripheral neuropathy begins with a detailed medical history and a thorough physical examination. It is fundamental to identify the anatomical pattern of symptoms and, if necessary, perform electrodiagnostic studies to distinguish between axonal and demyelinating diseases. The prevalence of peripheral neuropathy varies, being more common in individuals over 50 years of age. Identifiable causes include diabetes, nerve compression, alcohol use, exposure to toxins, hereditary diseases, and nutritional deficiencies.

Diabetic polyneuropathy (DPN) is the most common form of neuropathy in diabetic patients, typically presenting as a symmetric distal polyneuropathy. Painful DPN affects a significant percentage of patients, increasing morbidity and mortality. Conduction velocity measurement is a useful tool for assessing nerve function and differentiating DPN from other neuropathies.

Additionally, alternative treatments such as acupuncture and physical exercise have been explored, showing benefits in improving symptoms and quality of life for patients with diabetic neuropathy.

Conclusions

Peripheral neuropathy, particularly diabetic polyneuropathy, represents a significant clinical challenge. Early identification and precise differentiation are essential for implementing effective management strategies. While glycemic control remains the cornerstone of treatment, research continues to explore new therapies that may modify the natural history of the disease. The integration of traditional and alternative approaches may provide significant symptomatic relief and improve the quality of life for patients.

Referencias

• [1] Peripheral Neuropathy: Evaluation and Differential Diagnosis
• [2] Painful and non-painful diabetic neuropathy, diagnostic challenges and implications for future management
• [3] Acupuncture treatment of diabetic peripheral neuropathy: An overview of systematic reviews
• [4] Exercise and Neuropathy: Systematic Review with Meta-Analysis

Created 13/1/2025