{"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\/neudspn\/","title":{"rendered":"Diagnostic Criteria for Diabetic Sensorimotor Polyneuropathy (DSPN)"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" 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>The Diabetic Sensorimotor Polyneuropathy (DSPN) is a symmetrical, length-dependent sensorimotor polyneuropathy attributable to metabolic and microvessel alterations as a result of chronic hyperglycemia exposure (diabetes) and cardiovascular risk covariates.<br \/>\n<!--more--><br \/>\n<strong>Definitions of minimal criteria for DSPN<\/strong><br \/>\n<strong><br \/>\n1. Possible Clinical DSPN<br \/>\n<\/strong>Symptoms or signs of DSPN. Symptoms may include: decreased sensation, positive neuropathic sensory symptoms (e.g. \u2018asleep numbness\u2019, \u2018prickling\u2019 or \u2018stabbing\u2019, \u2018burning\u2019 or \u2018aching\u2019 pain) predominantly in the toes, feet, or legs. Signs may include: symmetric decrease of distal sensation or unequivocally decreased or absent ankle reflexes.<\/p>\n<p><strong>2. Probable Clinical DSPN<\/strong><br \/>\nA combination of symptoms and signs of distal sensorimotor polyneuropathy with any two or more of the following: neuropathic symptoms, decreased distal sensation, or unequivocally decreased or absent ankle reflexes.<br \/>\n<strong><br \/>\n3. Confirmed Clinical DSPN<\/strong><br \/>\nAn abnormal nerve conduction study and a symptom or symptoms or a sign or signs of sensorimotor polyneuropathy. Severity of DSPN can be assessed by staged or continuous approaches described above and by dysfunction and disability scores.<br \/>\n<strong><br \/>\n4. Subclinical DSPN<\/strong><br \/>\nNo signs or symptoms of polyneuropathy. Abnormal nerve conduction, as described above, is present.<strong><br \/>\n<\/strong><br \/>\n<strong>Dyck&#8217;s Stages of Severity for DSPN <\/strong><br \/>\nAn alternative approach to estimating severity is to indicate severity by grades:<\/p>\n<ul>\n<li>Grade 0 = no abnormality of NC, e.g., sum 5 nerve conduction (NC) normal deviates &lt;95th percentile or another suitable NC criterion<\/li>\n<li>Grade 1a = abnormality of NC, e.g., sum 5 NC normal deviates &gt;\/=95th percentile without symptoms or signs<\/li>\n<li>Grade 1b = NC abnormality of stage 1a plus neurologic signs typical of DSPN but without neuropathy symptoms<\/li>\n<li>Grade 2a = NC abnormality of stage 1a with or without signs (but if present, &lt;2b) and with typical neuropathic symptoms<\/li>\n<li>Grade 2b = NC abnormality of stage 1a, a moderate degree of weakness (i.e., 50%) of ankle dorsiflexion with or without neuropathy symptoms.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>References:<\/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>Created 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>Sorry, this entry is only available in Espa\u00f1ol.<\/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\/wp-json\/wp\/v2\/posts\/2399","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2399"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2399\/revisions"}],"predecessor-version":[{"id":8954,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2399\/revisions\/8954"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2399"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2399"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2399"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}