Acta Neurol Scand 1995 May;91(5):389-93
Thermal threshold determination in alcoholic polyneuropathy: an improvement of
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.