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© 1996 British Society for Rheumatology

research-article

QUANTIFIED NEUROLOGICAL EXAMINATION WITH EMPHASIS ON MOTOR AND SENSORY FUNCTIONS IN PATIENTS WITH RHEUMATOID ARTHRITIS AND CONTROLS

S. I. BEKKELUND, S. I. MELLGREN, A. PRØVEN* and G. HUSBY{dagger}

Department of Neurology, University Hospital Tromsö
*Department of Rheumatology, Central Hospital of Bodö Tromsö, Norway
{dagger}Department of Rheumatology, University Hospital Tromsö, Norway

Correspondence to: Correspondence to: S. I. Bekkelund, Department of Neurology, University Hospital, N-9038 Tromsø, Norway

A controlled study of quantified clinical neurological examination, including psychophysical assessment of sensory thresholds, in patients with rheumatoid arthritis (RA) was carried out. Fifty-five women with seropositive RA living in North Norway and 83 healthy controls underwent clinical neurological examination quantified by neurological symptom score (NSS) and neurological deficit score (NDS). Vibration threshold (VT), warm-cold detection threshold (limen) as well as heat pain detection threshold (HPDT) were performed to evaluate afferent myelinated and unmyelinated fibre functions. Higher scores on NSS and NDS were seen in RA patients compared with the controls. Higher index finger and big toe VT was demonstrated in the patients, while results from warm-cold limen and HPDT were not significantly different in the two groups. Among the disease-related variables, the most prominent finding was a positive association of index finger VT with disease duration in the patients (P = 0.01). Maximum walking time (15 m) was a significant predictor of big toe VT in the patient group (P = 0.0001). This study suggests impaired peripheral nerve function in afferent myelinated fibres. However, involvement of dorsal column fibres cannot be excluded, although patients with radiological atlantoaxial subluxation were not included in this study.

KEY WORDS: Rheumatoid arthritis, Peripheral neuropathy, Vibratory detection threshold, Thermal and pain sensation thresholds


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