Diagnostic Value of Tendon Reflex in Diabetic Peripheral Neuropathy

ABSTRACT

OBJECTIVE: To investigate the role of tendon reflex test in the diagnosis of diabetic peripheral neuropathy. METHOD: Patellar tendon reflex (PTR) and achilles tendon reflex (ATR) were recorded in forty six diabetic patients and thirty seven normal adults by delivering tendon taps with an electric reflex hammer. Forty six diabetic patients were divided into two groups based on nerve conduction study and diabetic neuropathy score: group 1 consisted of nineteen patients with peripheral neuropathy, group 2 consisted of twenty seven patients without peripheral neuropathy. Multiple regression equations using latency as a variable dependent on age and height were used and upper crossing of the 3 standard deviation level with regression on height and age was considered abnormal. RESULTS: Mean latencies of PTR and ATR were prolonged in the diabetic patients in comparison with the controls (p<0.01) and were prolonged in group 1 compared to group 2. In group 1, PTR was abnormal in 14 cases (sensitivity: 73.6%, specifity: 88%) and ATR was abnormal in 13 cases (sensitivity: 68.4%, specifity: 85.1%). In group 2, PTR was abnormal in 3 cases and ATR was abnormal in 4 cases. CONCLUSION: Tendon reflex test would be a valuable supplement to conventional nerve conduction studies for detection of diabetic peripheral neuropathy, especially in the proximal segment.