Evaluation of Sympathetic Skin Response for Early Diagnosis in Children with Diabetic Neuropathy

Objective To investigate the value of sympathetic skin response(SSR) for early diagnosis of childhood diabetic neuropathy. Methods Electrical SSR was performed in 35 patients with type 1 diabetes(T1DM) and 30 healthy controls.The onset latency and peak-to-peak amplitude(the baseline peak measurement of the first and second deflections) were measured and compared between 2 groups.Nerve conductive velocity(NCV) were detected in 35 patients with T1DM at the same time.And SSR was also assessed in the patients with or without diabetic ketoacidosis(DKA) history. Results The onset latencies were prolonged significantly in T1DM children compared with the controls(Pa0.05).All controls and 31 of the diabetic children demonstrated SSR in both feet and hands,but 4 patients(11.4%) had no responses in SSR in one of both feet and hands at least.Twenty-one patients(60%) demonstrated abnormal SSR in one lamb at least.Two patients(5.7%) had no responses in both feet and hands.Fifteen patients with abnormal SSR had DKA history,but there was no significant difference between the patients with or without DKA history(P0.05).Ten patients(28.6%) demonstrated NCV abnormal.There was no significant difference between the frequency of abnormality by SSR and NCV(P0.05). Conclusion The SSR can detect the early subcli-nical dysfunction of small sympathetic fibers in diabetes mellitus and is more sensitive than NCV.