An Evaluation of the Course of Peripheral Neuropathies Based on Clinical and Neurographical Re-Examinations

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Abstract
68 patients with a peripheral neuropathy were re-examined clinically and electroneurographically. They were divided into four groups: 24 patients had polyneuritis of the Guillain-Barré type, 14 suffered from neuropathy with diabetes mellitus, 5 from neuropathy with alcohol abuse, and in 24 patients the aetiology was unknown. The re-examinations followed after time intervals between 21 months and 10.5 years after the first admission to hospital. The frequency of remaining disabilities, determined neurographically and by physical examination was compared with the severity of the symptoms in the acute stage of the disease. The results show that polyneuritis Guillain-Barré follows the most favourable course. The most numerous defects occur in peripheral neuropathies with diabetes mellitus or alcohol addiction. The maximum span of conduction velocities between the motor nerve fibres of a muscle (hypothenar) proved to be a more precise measure for the evaluation of residual damage to the peripheral nerves than the maximum conduction velocity. In 4 cases we were able to show by re-examinations that early values for the maximum conduction velocity lying in the ‘lower normal’ range had later to be interpreted as pathologically decreased. This indicates that information on the peripheral nervous function which has missed detection at a single examination, can be obtained by re-examinations.

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