Tactile directional sensibility and diabetic neuropathy

Five different procedures used to diagnose neuropathy were compared in a "b lind" study with diabetic patients. The aim was to evaluate tests of tactil e directional sensibility. Three matched groups were examined, two groups w ith type I diabetes, either with or without suspected neuropathy, and one o f healthy controls. Testing consisted of: (1) examination by a specialist i n neurology, (2) electrophysiologic measurement of nerve conduction velocit y and determination of cool sensitivity, and (3) determination of direction al sensibility in two stages, with categorical and quantitative techniques. Abnormal test results were obtained for both groups of diabetic patients. Quantitatively measured directional sensibility had the highest sensitivity (89%) and specificity (85%) when calculated for patients who had received a diagnosis of neuropathy from the neurologist, despite one case of abnorma l directional sensibility among the healthy controls. Conduction velocity t esting was almost comparably sensitive (80%) and cool sensitivity, comparab ly specific (85%) when calculated in the same manner. (C) 2001 John Wiley & Sons, Inc.