Compaison of qst, enmg and neuropathic pain scales in teh early diagnosis of painful polyneuropathies

AIM: The aim of this study was to compare the effectiveness and clinical validity of QST as an early diagnostic tools at patients who have been diagnosed as peripheral neuropathy by conventional neurologic examination methods.METHODS: Totally 80 patients, in three groups were included in this study. In group E (ENMG +) and group Q (ENMG -), who had neuropathic pain according to LANNS ( ? 12 points) and DN4 scales,there were 30 patients at each; and in control group there were 20 healthy individuals.Electrophysiological testswere done at the neurophysiology laboratory.Quantitative sensory tests were applied with CASE IV device to the patients who have normal ENMG findings but neuropathic pain and to the control group. Dorsal surface of hands and foot were usedfor measuring the coolingdetectionthreshold (CDT), warmdetection threshold (WDT) and vibratory detection threshold (VDT).RESULTS: In neuropathic pain group with ENMG (-) patients (Group Q), CDT, WDT and VDT values were significantly higher when compared with control group.CONCLUSION: In group Q, in which thick myelinated fiber involvement could not be detected by ENMG, VDT was found in pathological limits by QST. This finding suggests that QST can detect this change earlier than ENMG.On the other hand, in group E where thin fiber involvement was confirmed by LANSS and DN4 scales, concurrently QST (higher CDT and WDTvalues) gave the same findings. These results suggested that both QST and neuropathic pane scales have the same validity to determine thin fiber abnormalities.