Is the spinal cord lesion rare in diabetes mellitus? Somatosensory evoked potentials and central conduction time in diabetes mellitus.
Pavel Varsik, Pavol Kucera, Darina Buranova, Marek Balaz
Med Sci Monit 2001; 7(4): CR712-715
BACKGROUND: Diabetic neuropathy and autonomic nervous system neuropathy are recognized as the most common clinical pictures of nervous system disorders caused by DM, while the damage to the brain and the spinal cord is considered to be rare. The aim of this work is to indicate the importance of somatosensory evoked potentials (SEP) for the early diagnosis of nerve system damage related to diabetes mellitus.
MATERIAL AND METHODS: We studied 20 patients (aged 35-50 years), with type 2 diabetes mellitus lasting for 5-10 years. The control group population comprised of 30 healthy individuals of the same median age. The spinal and cortical somatosensory evoked potentials (SEP) after stimulation of median and fibular nerves were examined in both groups of patients. We measured the latencies and amplitudes of individual wave deflections, peripheral and central conduction time (PCT and CCT) of spinal and cortical SEP.
RESULTS: The examination proved and confirmed the elongation not only of peripheral conduction time but also of the central conduction time - especially in spinal cord structures. The spinal cord changes connected with decrease of myelinated fibers which are able of conduction from periphery have to be accepted. The comparison of CCT1 and CCT2 conduction times showed that in group of diabetic patients the spinal cord structures are responsible for prolongation CCT.
CONCLUSIONS: We confirm that the use of somatosensory evoked potentials examination and conduction times measurement has the significance in the confirmation of inapparent lesion of the spinal cord in diabetics.
Keywords: peripheral conduction time and central conduction time, somatosensory evoked potentials, diabetic neuropathy, Diabetes Complications