ELECTRONEUROMYOGRAPHY IN DIAGNOSTICS OF EARLY STAGES OF DIABETIC NEUROPATHY – INVITATION OF ENDOCRINOLOGISTS, NEUROLOGISTS AND ELETCROPHYSIOLOGISTS TO DISCUSSION
The urgency of the problem of diabetic distal polyneuropathy (DDPN) is preconditioned by its great prevalence, according to specialized studies data, late diagnostics and serious consequences. The importance of DDPN diagnostics at its early stage doesn't generate doubts: just at this period disturbance of peripheral nerves is of reciprocal nature and the therapy is effective to the maximum degree. But the objectification of the DDPN diagnosis is difficult: the data of neurologic and electrophysiological tests often do not correspond to the clinical symptoms and signs as these methods evaluate lesions of large nervous fibers whereas in DDPN it's small fibers that are damaged in the first place. Use of skin biopsy and confocal corneal microscopy for evaluation of small fibers is extremely restricted in a clinical practice. Possibilities of electroneuromyography (ENMG) are analyzed as an option: parameters with their subjective peculiarities, selection of nerves and their number for DDPN diagnostics as a context of topographic neurology and neurophysiology of distal fibers.