TY - JOUR T1 - Subclinical diabetic polyneuropathy: early detection of involvement of different nerve fibre types. JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry SP - 509 LP - 514 DO - 10.1136/jnnp.56.5.509 VL - 56 IS - 5 AU - P H Hendriksen AU - P L Oey AU - G H Wieneke AU - B Bravenboer AU - A C van Huffelen Y1 - 1993/05/01 UR - http://jnnp.bmj.com/content/56/5/509.abstract N2 - Nerve conduction studies, tests of autonomic function and terminal nerve branches, and soleus muscle H reflexes were applied to 60 patients with insulin dependent diabetes mellitus who had no clinical symptoms but abnormal vibratory or temperature perception thresholds indicating subclinical neuropathy. In most patients neurophysiological examination yielded a broad spectrum of neural dysfunction. The perception threshold for cold stimuli was sometimes selectively impaired and abnormal pupillometry results were common, suggesting that small fibres are vulnerable in the early stage of diabetic neuropathy. The arms were less frequently and less severely affected than the legs, an effect that may be related to nerve length. The neurophysiological test results did not change in 30 patients followed up for one year. ER -