Sympathetic Skin Response in Hemodialysis Patients: Correlation with Nerve Conduction Studies and Adequacy of Dialysis

Background. Established electrophysiological methods have limited clinical utility in the diagnosis of small fiber neuropathy. The cutaneous silent period (CSP) may be useful as a method for the evaluation of smaller and unmyelinated fiber dysfunctions. Hyperlipidemia is a very rare cause of small fiber neuropathy. In this study, hyperlipidemia and small fiber neuropathy in symptomatic patients with normal nerve conduction studies were evaluated with autonomic tests and cutaneous silent periods. Methods. Twenty-five patients with clinically suspected small fiber neuropathy and 23 healthy volunteers were included. CSP latency and duration, as well as CSP latency difference of the upper and lower extremities, were examined. Two tests were used to assess the autonomic nervous system, namely, the R-R interval variation test in basal and profound breath conditions and the sympathetic skin response. Results. Twenty-five patients with clinically suspected small fiber neuropathy and normal nerve conduction studies were compared with 23 controls. In the upper extremities, patients had prolonged CSP latencies (P=0.034) and shortened CSP durations (P=0.039), whereas in the lower extremities, patients had shortened CSP durations (P=0.001). The expiration-to-inspiration ratios were also reduced in patients groups. There was no significant difference between sympathetic skin response latencies and amplitude of the case and control groups. Conclusion. Our findings indicate that CSP may become a useful technique for the assessment of small fiber neuropathy in hyperlipidemic patients.

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Nerve conduction studies, electromyography and sympathetic skin response in Fabry's disease

Journal of the Neurological Sciences ◽

10.1016/s0022-510x(03)00172-2 ◽

2003 ◽

Vol 214 (1-2) ◽

pp. 21-25 ◽

Cited By ~ 18

Author(s):

Irenio Gomes ◽

Daniel B. Nora ◽

Jefferson Becker ◽

João Arthur C. Ehlers ◽

Ida V.D. Schwartz ◽

...

Keyword(s):

Nerve Conduction ◽

Sympathetic Skin Response ◽

Nerve Conduction Studies ◽

Fabry’S Disease ◽

Fabry's Disease ◽

Skin Response

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Nerve Conduction Studies and Prediction of Mortality in Hemodialysis Patients

Renal Failure ◽

10.1080/08860220802212890 ◽

2008 ◽

Vol 30 (7) ◽

pp. 695-699 ◽

Cited By ~ 7

Author(s):

Milan Stosovic ◽

Ana Nikolic ◽

Mirjana Stanojevic ◽

Sanja Simic-Ogrizovic ◽

Milan Radovic ◽

...

Keyword(s):

Nerve Conduction ◽

Hemodialysis Patients ◽

Nerve Conduction Studies ◽

Prediction Of Mortality

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Clinical and electrophysiological characteristics of neuropathic pain in leprosy patients: A prospective cross-sectional study

Indian Journal of Dermatology Venereology and Leprology ◽

10.25259/ijdvl_917_19 ◽

2021 ◽

Vol 0 ◽

pp. 1-4

Author(s):

Danusa Neves Somensi ◽

Emanuel de Jesus Soares de Sousa ◽

Geovanna Lemos Lopes ◽

Gustavo Celeira de Sousa ◽

Marilia Brasil Xavier

Keyword(s):

Neuropathic Pain ◽

Clinical Data ◽

Nerve Conduction ◽

Late Complication ◽

Sympathetic Skin Response ◽

Diagnostic Methods ◽

Sensory Loss ◽

Number Of Patients ◽

Skin Response ◽

Leprosy Patients

Introduction: Neuropathic pain is a common and disabling late complication of leprosy. We investigated the clinical and electrophysiological characteristics of neuropathic pain in leprosy patients by evaluating nerve conduction, sympathetic skin response (SSR) and A-waves. Methods: Twenty one leprosy patients with neuropathic pain validated by the Douleur Neuropathique en 4 (DN4)Questionnaire were selected for study. Pain intensity was measured by the visual analog scale. Demographic and clinical data were collected for all patients. Clinical data included appraisal of the median, ulnar, radial, tibial and common peroneal nerves, assessment of the sympathetic skin response and conventional electrophysiological recordings. Results: Among all electroneuromyographic presentations, multifocal mononeuropathy was still the most prevalent. Sensory loss was observed more frequently than motor deficits. As most patients presented advanced clinical forms of leprosy and were under treatment, this high mean was found and the ulnar nerve was most frequently affected. The sympathetic skin response was absent in 16 patients. Higher DN4 Questionnaire scores were observed in women and in those receiving corticosteroid therapy. These inferences are possible to be made, but our study's limitations don't allow us to be certain about it. The statistical significance found only permits us to evidence what we related on the textual part of the study. Limitations: The small number of patients studied, the lack of sophisticated diagnostic methods for leprosy, as well as the difficulties in assessing nerve conduction were the main limitations of this study. Conclusion: The neurophysiological and clinical findings in leprous neuropathy were modest despite the conspicuous neuropathic pain. Although electrophysiological studies are a vital tool to verify nerve damage, variations in the clinical presentation of leprosy neuropathic pain render the diagnosis challenging. Further studies are needed to describe the neurophysiological evolution of this disease.

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Peripheral Nerve Conduction And Sympathetic Skin Response Are Reliable Methods to Detect Diabetic Cardiac Autonomic Neuropathy

Frontiers in Endocrinology ◽

10.3389/fendo.2021.709114 ◽

2021 ◽

Vol 12 ◽

Author(s):

Xiaopu Lin ◽

Chuna Chen ◽

Yingshan Liu ◽

Yu Peng ◽

Zhenguo Chen ◽

...

Keyword(s):

Lower Limb ◽

Nerve Conduction ◽

Peroneal Nerve ◽

Operating Characteristic ◽

Sympathetic Skin Response ◽

Cardiac Autonomic Neuropathy ◽

Optimal Cutoff ◽

Skin Response ◽

Reliable Methods ◽

Diabetic Cardiac Autonomic Neuropathy

AimThis study aimed to investigate the role of nerve conduction studies (NCS) and sympathetic skin response (SSR) in evaluating diabetic cardiac autonomic neuropathy (DCAN).MethodsDCAN was diagnosed using the Ewing test combined with heart rate variability analysis. NCS and SSR were assessed by electrophysiological methods. The association between NCS/SSR and DCAN was assessed via multivariate regression and receiver-operating characteristic analyses.ResultsThe amplitude and conduction velocity of the motor/sensory nerve were found to be significantly lower in the DCAN+ group (all P < 0.05). A lower amplitude of peroneal nerve motor fiber was found to be associated with increased odds for DCAN (OR 2.77, P < 0.05). The SSR amplitude was lower while the SSR latency was longer in the DCAN+ group than in the DCAN– group. The receiver-operating characteristic analysis revealed that the optimal cutoff points of upper/lower limb amplitude of SSR to indicate DCAN were 1.40 mV (sensitivity, 61.9%; specificity, 66.3%, P < 0.001) and 0.85 mV (sensitivity, 66.7%; specificity, 68.5%, P < 0.001), respectively. The optimal cutoff points of upper/lower limb latency to indicate DCAN were 1.40 s (sensitivity, 61.9%; specificity, 62%, P < 0.05) and 1.81 s (sensitivity, 69.0%; specificity, 52.2%, P < 0.05), respectively.ConclusionsNCS and SSR are reliable methods to detect DCAN. Abnormality in the peroneal nerve (motor nerve) is crucial in predicting DCAN. SSR may help predict DCAN.

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