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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.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Sullivan JP
Department of Neurology, University of Rochester Medical Center, Rochester, NY 14642, USA.
Logigian EL
No affiliation info available
Kocharian N
No affiliation info available
Herrmann DN
No affiliation info available

MeSH

Action PotentialsAdultElectrodiagnosisFemaleHumansMaleMiddle AgedNeural ConductionPolyneuropathiesPredictive Value of TestsProbabilityRadial NerveSural NerveTibial Nerve

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_ DB - PRIME DP - Unbound Medicine ER -