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Yield of the sural/radial ratio versus the medial plantar nerve in sensory neuropathies with a normal sural response.
J Clin Neurophysiol. 2008 Apr; 25(2):111-4.JC

Abstract

The electrodiagnostic yield of the medial plantar nerve action potential (NAP) amplitude versus the sural/radial amplitude ratio (SRAR) was determined in 110 consecutive patients with clinically diagnosed distal sensory polyneuropathy (SN) and normal sural responses. Forty-five consecutive patients with clinically diagnosed lumbosacral radiculopathy served as disease controls. Of the 110 SN patients, 32 were classified clinically as SN with large-fiber involvement (SN-LFI), whereas 78 had clinically pure small-fiber SN. Plantar NAP amplitudes were abnormal in 18 of 32 patients (56%) with SN-LFI, and 15 of 78 (19%) with small-fiber SN. A SRAR <0.21 (fifth percentile of normal) was found in 7 of 32 patients (22%) with SN-LFI and 8 of 78 (10%) with small-fiber SN. In the control group, the medial plantar NAP was normal in all 45 subjects (100%), whereas the SRAR was >0.21 in 43 subjects (96%). Thus, for a 50% pretest probability of SN-LFI, the positive predictive value of an abnormal medial plantar was 100% versus 85% for a SRAR <0.21. The medial plantar NAP amplitude is a more useful measure of SN, than is the SRAR, in patients under age 70, with suspected SN-LFI. The yield of the SRAR and plantar NAP amplitude is poor when clinical signs of large-fiber sensory dysfunction are lacking.

Authors+Show Affiliations

Department of Neurology, University of Rochester Medical Center, Rochester, NY 14642, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18340276

Citation

Sullivan, John P., et al. "Yield of the Sural/radial Ratio Versus the Medial Plantar Nerve in Sensory Neuropathies With a Normal Sural Response." Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society, vol. 25, no. 2, 2008, pp. 111-4.
Sullivan JP, Logigian EL, Kocharian N, et al. Yield of the sural/radial ratio versus the medial plantar nerve in sensory neuropathies with a normal sural response. J Clin Neurophysiol. 2008;25(2):111-4.
Sullivan, J. P., Logigian, E. L., Kocharian, N., & Herrmann, D. N. (2008). Yield of the sural/radial ratio versus the medial plantar nerve in sensory neuropathies with a normal sural response. Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society, 25(2), 111-4. https://doi.org/10.1097/WNP.0b013e31816a2060
Sullivan JP, et al. Yield of the Sural/radial Ratio Versus the Medial Plantar Nerve in Sensory Neuropathies With a Normal Sural Response. J Clin Neurophysiol. 2008;25(2):111-4. PubMed PMID: 18340276.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Yield of the sural/radial ratio versus the medial plantar nerve in sensory neuropathies with a normal sural response. AU - Sullivan,John P, AU - Logigian,Eric L, AU - Kocharian,Naira, AU - Herrmann,David N, PY - 2008/3/15/pubmed PY - 2008/7/3/medline PY - 2008/3/15/entrez SP - 111 EP - 4 JF - Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society JO - J Clin Neurophysiol VL - 25 IS - 2 N2 - The electrodiagnostic yield of the medial plantar nerve action potential (NAP) amplitude versus the sural/radial amplitude ratio (SRAR) was determined in 110 consecutive patients with clinically diagnosed distal sensory polyneuropathy (SN) and normal sural responses. Forty-five consecutive patients with clinically diagnosed lumbosacral radiculopathy served as disease controls. Of the 110 SN patients, 32 were classified clinically as SN with large-fiber involvement (SN-LFI), whereas 78 had clinically pure small-fiber SN. Plantar NAP amplitudes were abnormal in 18 of 32 patients (56%) with SN-LFI, and 15 of 78 (19%) with small-fiber SN. A SRAR <0.21 (fifth percentile of normal) was found in 7 of 32 patients (22%) with SN-LFI and 8 of 78 (10%) with small-fiber SN. In the control group, the medial plantar NAP was normal in all 45 subjects (100%), whereas the SRAR was >0.21 in 43 subjects (96%). Thus, for a 50% pretest probability of SN-LFI, the positive predictive value of an abnormal medial plantar was 100% versus 85% for a SRAR <0.21. The medial plantar NAP amplitude is a more useful measure of SN, than is the SRAR, in patients under age 70, with suspected SN-LFI. The yield of the SRAR and plantar NAP amplitude is poor when clinical signs of large-fiber sensory dysfunction are lacking. SN - 0736-0258 UR - https://www.unboundmedicine.com/medline/citation/18340276/Yield_of_the_sural/radial_ratio_versus_the_medial_plantar_nerve_in_sensory_neuropathies_with_a_normal_sural_response_ L2 - http://dx.doi.org/10.1097/WNP.0b013e31816a2060 DB - PRIME DP - Unbound Medicine ER -