Background
s and Objectives : In the length-dependent axonal polyneuropathy like diabetic polyneuropathy (DPN), the distal part of the longer axons are affected earlier. In cases of minimal distal axonal changes, nerve conduction studies (NCS) are frequently normal. If sural nerve is affected in the early stage of DPN, supportive parameters to detect the early axonal degeneration may be helpful. We investigated whether the sural/lunar SNAP amplitude ratio (SUAR) may be a more sensitive indicator than sural amplitude alone in the diagnosis of early diabetic polyneuropathy. Methods: We analyzed medical records and electrophysiological studies of 141 patients with DM and 30 healthy subject. The patients with early stage of DPN were defined as those having symptoms of neuropathy and normal NCS findings among the patients with DM. We compared SUAR between 57 patients with early stage of DPN and 71 age-matched control subjects. Results: Fifty seven patients had an average SUAR of 0.8, compared to that of 1,1 in the 71 normal controls. The SUAR of less than 0.9 was supplementary predictor of axonal polynerupathy, with the best balance of sensitivity and specificity (70%). The SUAR did not vary significantly with age, height or duration of DM. Conclusions: We conclude that the SUAR is a useful electrodiagnostic indicator to detect early stage of DPN.

The Lateral dorsal cutaneous branch of sural nerve (LDCB) is a terminal sensory branch of lower extremities. It canbe injured frequently in peripheral nerves. However, the normal data of each component of nerve conduction study(NCS) of were not studied at this time. The Nerve Conduction Study of LDCB adults were assessed for amplitude, area,duration and nerve conduction velocity (NCV) in normal fifty. We also evaluated how age, sex and dexterity affect thevarious components of NCS. The Mean amplitude of LDCB was 9.45

B a c k g r o u n d s: The pathway of the sural nerve (SN) is variable, but usually divided into medial and lateral suralbranches joining the posterior tibial nerve (PTN) and the peroneal nerve (PN). The sural nerve may be affected by PNpalsy. The frequency or the severity of SN involvement in peroneal palsy is not known. The purpose of the study is toinvestigate the frequency and the severity of the SN involvement by the peroneal nerve palsy.Methods: Total 85 patients were included with peroneal palsy. Amplitudes of distal peroneal, sural, and superficialperoneal nerves (SPN) were compared between normal and paralyzed sides. The frequency and severity of SN involvementby peroneal palsy were investigated.Results: Mean age was 48.4

Background
The most distal sensory fibers of the feet are often affected first in polyneuropathy. However, they are not evaluated in routine nerve conduction studies. Thus we evaluated the dorsal sural sensory nerve in patients with sensorimotor polyneuropathy with normal sural response, in order to assess the usefulness in electrodiagnostic practice.Methods: In this study, 53 healthy subjects and 27 patients with clinical evidence of sensorimotor polyneuropathy were included. In all subjects, peripheral motor and sensory nerve studies were performed on the upper and lower limbs including dorsal sural nerve conduction studies. On electrodiagnostic testing, all patients had normal sural responses.Results: The dorsal sural sensory nerve action potentials (SNAPs) mean amplitude was 13.12

Underlying neuropathies combined with amyotrophic lateral sclerosis (ALS) cast doubt on the diagnosis of ALS when present.Abnormal sural nerve conductions were found in 3 patients with clinically definite ALS. Pathologically demyelinating, axonal, or vasculitic neuropathy was suggested respectively. High dose oral corticosteroid had no effect and clinical courses were deteriorating in all the patients.The causes of combined neuropathies were unclear. Possibility of direct consequence of ALS, concomitant neuropathies, or rare variants of ALS should be considered in these cases.