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.