Dyck’s Scoring methods for neuropathy
We were talking a while ago about the book by P. Dyck regarding measurement of degree of neuropathy. I finally made it through the chapter “Quantitating Severity of Neuropathy” which I sent you and actually found it quite interesting once I was able to grasp the terminology. I jotted down a few take-aways and I’ve listed them below.
• A change in the NDS score of 2 or more is considered significant. This seems important because there are so many measurements involved in the scoring and a 2 point movement found among all the measurements would seem quite possible (higher or lower depending on circumstances)
• VDT (vibration detection threshold) is a useful measurement, especially for repeatability for any given patient.
• NDS scoring is useful in the case of group studies due to the reproducibility and consistency between scorers.
• Nerve conduction (NC) can be effected by carpal tunnel syndrome, etc. and as a result, care should be exercised in evaluating results across a group (lack of consistency between scorers)
For me personally:
• Hypoactivity symptoms are much greater than hyperactivity symptoms. In other words, I have numbness and weakness as opposed to spasms, cramps, burning, prickling, etc. I think you are the same.
• NC test and VDT give a good quantitative evaluation – useful for measuring degree of change (progress/decline)
• Qualitative tests include reflexes, great toe joint position, cotton swab and pin *****. All show current neuropathy and a change in any one would be significant.
• Have Stage 2 – symptomatic neuropathy.