{"id":2399,"date":"2012-02-17T13:45:31","date_gmt":"2012-02-17T13:45:31","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/neudspn\/"},"modified":"2025-05-13T20:28:23","modified_gmt":"2025-05-13T20:28:23","slug":"neudspn","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/es\/neudspn\/","title":{"rendered":"Criterios Diagn\u00f3stico para Polineuropat\u00eda Sensitivomotora Diab\u00e9tica"},"content":{"rendered":"<div class=\"7ca9444b8380138fe077da07353677a4\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>La polineuropat\u00eda sensitivomotora diab\u00e9tica (PNSMD) es sim\u00e9trica, polineuropat\u00eda sensitivomotora\u00a0dependiente de la longitud, atribuible a\u00a0alteraciones\u00a0metab\u00f3licas y microvasculares, como resultado de la exposici\u00f3n a la hiperglucemia cr\u00f3nica (diabetes) y a covariables de riesgo cardiovascular.<br \/>\n<!--more--><br \/>\n<strong>Definiciones de los criterios m\u00ednimos para PNSMD<\/strong><br \/>\n<strong><br \/>\n<\/strong><strong>1.\u00a0<\/strong><strong>PNSMD\u00a0Cl\u00ednica Posible<\/strong><br \/>\nS\u00edntomas o signos de PNSMD. Los s\u00edntomas pueden incluir: disminuci\u00f3n de la sensaci\u00f3n, s\u00edntomas sensoriales neurop\u00e1ticos positivos(por ejemplo, \u00abentumecimiento o adormecimiento\u00bb, \u00abpinchazos\u00bb o \u00abpunzante\u00bb, \u00abquemaz\u00f3n\u00bb o \u00abdolor\u00bb) principalmente en los dedos de los pies, los pies o las piernas. Los signos pueden incluir: disminuci\u00f3n de la sensibilidad distal sim\u00e9trica o disminuido de manera inequ\u00edvoca, o ausencia del reflejo aquileano.<br \/>\n<strong><br \/>\n2.\u00a0<\/strong><strong>PNSMD<\/strong><strong>\u00a0Cl\u00ednica Probable<\/strong><br \/>\nUna combinaci\u00f3n de s\u00edntomas y signos de polineuropat\u00eda sensitivomotora distal con dos o m\u00e1s de los siguientes: s\u00edntomas neurop\u00e1ticos, disminuci\u00f3n de la sensibilidad distal, o\u00a0disminuci\u00f3n\u00a0inequ\u00edvoca o ausencia del reflejo aquileano.<br \/>\n<strong><br \/>\n3.\u00a0<\/strong><strong>PNSMD\u00a0Cl\u00ednica Confirmada<\/strong><br \/>\nUn estudio de conducci\u00f3n nerviosa anormal y un s\u00edntoma o s\u00edntomas o un signo o signos de polineuropat\u00eda sensitivomotora. La severidad de PNSMD puede ser evaluada por etapas o enfoques continuos descritos anteriormente y por puntuaciones o scores de disfunci\u00f3n y discapacidad.<br \/>\n<strong><br \/>\n4.\u00a0<\/strong><strong>PNSMD\u00a0Subcl\u00ednica<\/strong><br \/>\nAusencia de signos o s\u00edntomas de polineuropat\u00eda.\u00a0La conducci\u00f3n nerviosa anormal, como se ha descrito anteriormente, est\u00e1 presente.<br \/>\n<strong><br \/>\n<\/strong><br \/>\n<strong>Etapas de severidad de\u00a0<\/strong><strong>Dyck\u00a0para\u00a0PNSMD<\/strong><br \/>\nUn enfoque alternativo para la estimaci\u00f3n de la severidad es indicar la severidad por grados:<\/p>\n<ul>\n<li>Grado 0 = sin anormalidad en la conducci\u00f3n nerviosa (CN), por ejemplo, sumatoria\u00a05 CN normal\u00a0desviada\u00a0&lt; percentil 95 o en otro\u00a0criterio\u00a0adecuado de CN<\/li>\n<li>Grado 1a =\u00a0anormalidad\u00a0de CN, por ejemplo, sumatoria\u00a05 CN normal desviada &gt;\/= percentil 95, sin s\u00edntomas o signos<\/li>\n<li>Grado 1b =\u00a0anormalidad\u00a0de CN\u00a0de la fase 1a m\u00e1s signos neurol\u00f3gicos t\u00edpicos de\u00a0PNSMD\u00a0pero sin s\u00edntomas de neuropat\u00eda<\/li>\n<li>Grado 2a =\u00a0anormalidad\u00a0de CN\u00a0de la fase 1a, con o sin signos (pero si est\u00e1 presente, &lt;2b) y con s\u00edntomas neurop\u00e1ticos t\u00edpicos<\/li>\n<li>Grado 2b =\u00a0anormalidad\u00a0de CN\u00a0de la fase 1a, un grado moderado de debilidad (es decir, 50%) de la dorsiflexi\u00f3n del tobillo con o sin s\u00edntomas de neuropat\u00eda.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>Bibliograf\u00eda:<\/strong><\/p>\n<ol>\n<li>Dyck PJ, Albers JW, Andersen H, Arezzo JC, Biessels GJ, Bril V, Feldman EL, Litchy WJ, O&#8217;Brien PC, Russell JW; on behalf of the Toronto Expert Panel on Diabetic Neuropathy. Diabetic Polyneuropathies: Update on Research Definition, Diagnostic Criteria and Estimation of Severity. Diabetes Metab Res Rev. 2011; 27: 620\u2013628. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/21695763\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Tesfaye S, Boulton AJ, Dyck PJ, Freeman R, Horowitz M, Kempler P, Lauria G, Malik RA, Spallone V, Vinik A, Bernardi L, Valensi P; Toronto Diabetic Neuropathy Expert Group. Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care. 2010 Oct;33(10):2285-93. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/20876709\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Dyck PJ. Detection, characterization, and staging of polyneuropathy: assessed in diabetics. Muscle Nerve. 1988 Jan;11(1):21-32. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/3277049\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Creado Feb 17, 2012.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>La polineuropat\u00eda sensitivomotora diab\u00e9tica (PNSMD) es sim\u00e9trica, polineuropat\u00eda sensitivomotora\u00a0dependiente de la longitud, atribuible a\u00a0alteraciones\u00a0metab\u00f3licas y microvasculares, como resultado de la exposici\u00f3n a la hiperglucemia cr\u00f3nica (diabetes) y a covariables de riesgo cardiovascular.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[2],"tags":[16,15,211,1120,1119,14,13,1118,1117,1116,1121],"class_list":["post-2399","post","type-post","status-publish","format-standard","hentry","category-neurology","tag-criteria","tag-criterios","tag-diabetes","tag-diabetic","tag-diabetica","tag-diagnostic","tag-diagnostico","tag-dspn","tag-polineuropatia","tag-polyneuropathy","tag-sensorimotor"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2399","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/comments?post=2399"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2399\/revisions"}],"predecessor-version":[{"id":8954,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2399\/revisions\/8954"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/media?parent=2399"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/categories?post=2399"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/tags?post=2399"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}