H-reflex and clinical examination in the diagnosis of diabetic polyneuropathy

J Int Med Res. 2012;40(2):694-700. doi: 10.1177/147323001204000233.

Abstract

Objectives: To determine among adult patients with type-2 diabetes mellitus the proportion diagnosed with diabetic polyneuropathy (DPN) by clinical evaluation and by the Hoffmann reflex (H-reflex). In addition, the predictive value of the H-reflex in the diagnosis of DPN was evaluated.

Methods: Studies were carried out on 150 adult patients referred for neuropathy screening. Diagnostic criteria for DPN were at least two abnormalities in clinical neurophysiological examinations and electrophysiological testing (H-reflex and nerve conduction velocity). Logistic regression analysis was performed to identify unique contributions of study characteristics to positive versus negative outcomes.

Results: H-reflex was absent in 39.3% (59/150) and latency was prolonged in 43.3% (65/150) of patients. Ulnar nerve motor branch nerve conduction showed prolonged latency in 9.3% (14/150) of patients. Logistic regression analysis indicated that the H-reflex was significantly associated with positive outcomes.

Conclusion: The H-reflex could have a predictive value in DPN, providing more quantitative information regarding diagnosis than conventional nerve conduction studies.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetic Neuropathies / diagnosis*
  • Diabetic Neuropathies / etiology
  • Female
  • H-Reflex*
  • Humans
  • Male
  • Middle Aged
  • Neural Conduction*
  • Neurologic Examination
  • Ulnar Nerve / physiology