The cross sectional area of posterior tibial nerve (PTN) is increased in diabetic patients with distal symmetric polyneuropathy (DSPN) as compared to diabetic patients without DSPN. This study aims to evaluate whether the cross sectional area of the Posterior Tibial Nerve (PTN) as measured by ultrasound is increased in patients with distal symmetric polyneuropathy (DSPN) as compared to diabetic patients without DSPN.
Regional anesthesia is associated with a low frequency of neurologic injury that can result in permanent deficit. It is believed that patients with neuropathies might be at higher risk of injury but detailed investigation of the diabetic patient is lacking yet anesthetic practices may be altered nevertheless. This study intends to investigate the appearance and sonographic qualities, as well as electrophysiologic measures, of the posterior tibial nerve (PTN) in diabetic patients undergoing nerve conduction studies in order to compare PTN characteristics between diabetic patients with peripheral neuropathy to those without. Ultimately, we hope that ultrasound, a commonly used non-invasive tool, will be able to assist in the identification of patients at higher risk of injury from regional anesthesia
Study Type
OBSERVATIONAL
Enrollment
100
An NCS will be performed on each patient to confirm or exclude DSPN. Following this, a systematic ultrasound examination of the posterior tibial nerve will be performed for all the patients.
Toronto Western Hospital
Toronto, Ontario, Canada
Association of mean cross-sectional area of the PTN, as measured by sonographic imaging, with the presence of DSPN in diabetic patients.
Time frame: 30 minutes
Association of mean cross-sectional area of the PTN, and the severity of DSPN (graded mild, moderate, and severe) in diabetic patients with peripheral neuropathy.
Time frame: 30 minutes
Descriptive sonographic appearance of PTN (ie. focal compression, hypo/hyper echogenicity, and texture).
Time frame: 30 minutes
Association of mean cross-sectional area of the PTN, and the severity of DSPN (graded mild, moderate, and severe) in diabetic patients with peripheral neuropathy.
The criteria for assessment of severity of DSPN is as follows: 1. No neuropathy: diabetic patients with no sign or symptoms of neuropathy, and normal NCS; 2. Incipient neuropathy: diabetic patients with signs, and symptoms of neuropathy, and normal NCS; 3. Subclinical neuropathy: Diabetic patients without signs of symptoms of neuropathy and abnormal NCS; 4. Moderate neuropathy: diabetic patients with signs and symptoms of neuropathy and abnormal NCS; 5. Severe neuropathy: diabetic patients with signs and symptoms of neuropathy and abnormal NCS, with absence of the sural nerve response.
Time frame: 30 minutes
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.