THERMAL THRESHOLD DETERMINATION IN ALCOHOLIC POLYNEUROPATHY - AN IMPROVEMENT OF DIAGNOSIS

Reports on the incidence of alcoholic polyneuropathies are variable de pending on diagnostic tools. In this study, 50 chronic alcoholics with positive MALT (Munich Alcoholism Test) and greater than seven years h istory of excessive alcohol abuse were examined neurologically. Tibial and peroneal motor and sural nerve conduction velocities (NCV) were s tudied. Warm and cold perception was evaluated in the area behind the internal malleolus using a Somedic-Thermotest. Thresholds were determi ned by the method of limits. The effect of a slow, medium and fast tem perature change rate on thermal perception was tested. Thirty-eight pa tients (76%) showed signs of neuropathy. Thermal perception was more o ften abnormal(62%) than NCV (42%) and clinical examination (56%). A me dium temperature change rate of 2.0-2.5 degrees C/s was the most sensi tive index of small fiber neuropathy. Thermal threshold measurement pr oved to be a reliable, sensitive and easy to perform method that shoul d become standard in the examination of polyneuropathies.