Skip to main content
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1992 Jan;55(1):56–59. doi: 10.1136/jnnp.55.1.56

Weighted needle pinprick sensory thresholds: a simple test of sensory function in diabetic peripheral neuropathy.

A W Chan 1, I A MacFarlane 1, D Bowsher 1, J A Campbell 1
PMCID: PMC488935  PMID: 1312581

Abstract

A simple device is described, consisting of 12 weighted 23 gauge disposable needles (0.2 to 5.2 g), for testing sensation in busy diabetic clinics. The pinprick sensory threshold (PPT) is the lightest weighted needle which consistently elicits a sharp sensation. The subjects were 48 healthy controls (hospital staff), 44 diabetic patients without neuropathic symptoms, and 35 diabetic patients with chronic painful neuropathy. In the controls, the mean PPT from the right hand and foot obtained on two test occasions a week apart did not differ significantly. In diabetic patients without symptomatic neuropathy, the mean PPT in the right hand and right foot were significantly higher than in the controls. The diabetic patients with painful neuropathy had clearly increased mean PPT in the right hand and foot compared with controls. Marstock thermal limen in diabetic patients with painful neuropathy correlated significantly with PPT determinations. PPT and thermal thresholds probably give comparable information on small fibre dysfunction in diabetic patients with symptomatic neuropathy. Compared with thermal threshold determinations however, the weighted needle apparatus is inexpensive, simple, and rapid to use.

Full text

PDF
56

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bertelsmann F. W., Heimans J. J., Weber E. J., van der Veen E. A., Schouten J. A. Thermal discrimination thresholds in normal subjects and in patients with diabetic neuropathy. J Neurol Neurosurg Psychiatry. 1985 Jul;48(7):686–690. doi: 10.1136/jnnp.48.7.686. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Fagius J., Wahren L. K. Variability of sensory threshold determination in clinical use. J Neurol Sci. 1981 Jul;51(1):11–27. doi: 10.1016/0022-510x(81)90056-3. [DOI] [PubMed] [Google Scholar]
  3. Fruhstorfer H., Lindblom U., Schmidt W. C. Method for quantitative estimation of thermal thresholds in patients. J Neurol Neurosurg Psychiatry. 1976 Nov;39(11):1071–1075. doi: 10.1136/jnnp.39.11.1071. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Guy R. J., Clark C. A., Malcolm P. N., Watkins P. J. Evaluation of thermal and vibration sensation in diabetic neuropathy. Diabetologia. 1985 Mar;28(3):131–137. doi: 10.1007/BF00273859. [DOI] [PubMed] [Google Scholar]
  5. Jamal G. A., Hansen S., Weir A. I., Ballantyne J. P. An improved automated method for the measurement of thermal thresholds. 1. Normal subjects. J Neurol Neurosurg Psychiatry. 1985 Apr;48(4):354–360. doi: 10.1136/jnnp.48.4.354. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. KEELE K. D. Pain-sensitivity tests; the pressure algometer. Lancet. 1954 Mar 27;266(6813):636–639. doi: 10.1016/s0140-6736(54)92347-8. [DOI] [PubMed] [Google Scholar]
  7. Parkhouse N., Le Quesne P. M. Impaired neurogenic vascular response in patients with diabetes and neuropathic foot lesions. N Engl J Med. 1988 May 19;318(20):1306–1309. doi: 10.1056/NEJM198805193182005. [DOI] [PubMed] [Google Scholar]
  8. Tucker M. A., Andrew M. F., Ogle S. J., Davison J. G. Age-associated change in pain threshold measured by transcutaneous neuronal electrical stimulation. Age Ageing. 1989 Jul;18(4):241–246. doi: 10.1093/ageing/18.4.241. [DOI] [PubMed] [Google Scholar]
  9. Vital A., Vital C., Rigal B., Decamps A., Emeriau J. P., Galley P. Morphological study of the aging human peripheral nerve. Clin Neuropathol. 1990 Jan-Feb;9(1):10–15. [PubMed] [Google Scholar]
  10. Ward J. D. The diabetic leg. Diabetologia. 1982 Mar;22(3):141–147. doi: 10.1007/BF00283741. [DOI] [PubMed] [Google Scholar]
  11. Williams G., Gill J. S., Aber V., Mather H. M. Variability in vibration perception threshold among sites: a potential source of error in biothesiometry. Br Med J (Clin Res Ed) 1988 Jan 23;296(6617):233–235. doi: 10.1136/bmj.296.6617.233. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Young R. J., Zhou Y. Q., Rodriguez E., Prescott R. J., Ewing D. J., Clarke B. F. Variable relationship between peripheral somatic and autonomic neuropathy in patients with different syndromes of diabetic polyneuropathy. Diabetes. 1986 Feb;35(2):192–197. doi: 10.2337/diab.35.2.192. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES