Acta Neurol Scand 1995 May;91(5):389-93

Thermal threshold determination in alcoholic polyneuropathy: an improvement of

diagnosis.

Hilz MJ, Zimmermann P, Claus D, Neundorfer B.

Department of Neurology, New York University Medical Center, NY 10016, USA.

Reports on the incidence of alcoholic polyneuropathies are variable depending on

diagnostic tools. In this study, 50 chronic alcoholics with positive MALT

(Munich Alcoholism Test) and greater than seven years history of excessive

alcohol abuse were examined neurologically. Tibial and peroneal motor and sural

nerve conduction velocities (NCV) were studied. Warm and cold perception was

evaluated in the area behind the internal malleolus using a Somedic-Thermotest.

Thresholds were determined by the method of limits. The effect of a slow, medium

and fast temperature change rate on thermal perception was tested. Thirty-eight

patients (76%) showed signs of neuropathy. Thermal perception was more often

abnormal (62%) than NCV (42%) and clinical examination (56%). A medium

temperature change rate of 2.0-2.5 degrees C/s was the most sensitive index of

small fiber neuropathy. Thermal threshold measurement proved to be a reliable,

sensitive and easy to perform method that should become standard in the

examination of polyneuropathies.