Chaudhry et al developed a score for grading the severity of a peripheral neuropathy induced by suramin. It can be used to describe peripheral neuropathies from other causes. The authors are from the Johns Hopkins University in Baltimore.
Parameters:
(1) sensory symptoms
(2) motor symptoms
(3) pin sensibility
(4) vibration sensibility
(5) strength
(6) tendon reflexes
(7) thermal (cooling) threshold
(8) vibration threshold
(9) sural amplitude in nerve conduction studies
(10) peroneal amplitude in nerve conduction studies
|
Parameter |
Finding |
Points |
|---|---|---|
|
sensory symptoms |
none |
0 |
|
|
limited to fingers and toes |
1 |
|
|
extend to ankle or wrist |
2 |
|
|
extend to knee or elbow |
3 |
|
|
extend above knee or elbow |
4 |
|
|
disabling |
4 |
|
motor symptoms |
none |
0 |
|
|
slight problem |
1 |
|
|
moderate problem |
2 |
|
|
requires assistance |
3 |
|
|
paralysis |
4 |
|
pin sensibility |
normal |
0 |
|
|
reduced in finger and toes |
1 |
|
|
reduced up to wrist/ankle |
2 |
|
|
reduced up to elbow/knee |
3 |
|
|
reduced above elbow/knee |
4 |
|
vibration sensibility |
normal |
0 |
|
|
reduced in finger and toes |
1 |
|
|
reduced up to wrist/ankle |
2 |
|
|
reduced up to elbow/knee |
3 |
|
|
reduced above elbow/knee |
4 |
|
strength |
normal |
0 |
|
|
mild weakness |
1 |
|
|
moderate weakness |
2 |
|
|
severe weakness |
3 |
|
|
paralysis |
4 |
|
tendon reflexes |
normal |
0 |
|
|
ankle reflex reduced |
1 |
|
|
ankle reflex absent |
2 |
|
|
ankle reflex absent and other reflexes reduced |
3 |
|
|
all reflexes absent |
4 |
|
thermal threshold |
normal (< 95%ile) |
0 |
|
|
95-96%ile |
1 |
|
|
97%ile |
2 |
|
|
98%ile |
3 |
|
|
>= 99%ile |
4 |
|
vibration threshold |
normal (< 95%ile) |
0 |
|
|
95-96%ile |
1 |
|
|
97%ile |
2 |
|
|
98%ile |
3 |
|
|
>= 99%ile |
4 |
|
sural amplitude |
normal to reduced < 5% (> 95% of LLN) |
0 |
|
|
76-95% of LLN (mild reduction) |
1 |
|
|
51-75% of LLN (moderate reduction) |
2 |
|
|
26-50% of LLN (moderate to marked reduction) |
3 |
|
|
<= 25% of LLN (severe reduction) |
4 |
|
peroneal amplitude |
normal to reduced < 5% (> 95% of LLN) |
0 |
|
|
76-95% of LLN |
1 |
|
|
51-75% of LLN |
2 |
|
|
26-50% of LLN |
3 |
|
|
<= 25% of LLN |
4 |
where:
• The original table lists vibration sensibility with reduced in elbow/knee as worth 2 and 3 points, while there is no listing for reduced in fingers and toes. I changed these to match pin sensibility.
• It appears as if changes are assumed to be symmetric.
total score =
= SUM(points for all 10 parameters)
Interpretation:
• minimum score: 0
• maximum score: 40
• The higher the score the worse the peripheral neuropathy.
adjusted total score to 100% severity =
= (total score) / 40 * 100%
Specialty: Neurology
