Abstract Details

Title OSA and Worsening of Neuropathic Pain in Diabetic Neuropathy - A Retrospective Review

Topic Clinical Neurophysiology

Presentation(s) P07 - (-)

Poster/Presentation
Number 182

Objective

Background BACKGROUND: To see the association between DN and OSA.

Design/Methods DESIGN/METHODS: Retrospective chart review from 2005 to 2010 of patients with OSA (PSG AHI > 5) and DN(abnormal Nerve conduction study suggestive of peripheral neuropathy). Patients with other conditions that may cause or contribute to polyneuropathy (CRF,Chemotherapy, and Nutritional,vasculitic,paraproteinemia,infection and alcoholic) were excluded.

Results RESULTS: Out of 85 patients with DN, 44 patients had OSA as well. Patients with both DN and OSA have more severe pain rated as 8-10/10 at least 12 hours every day. This group has failed at least four pain modifiers alone or combination- Gabapentin, Cymbalta, Amitriptyline and Lyrica due to lack of effect. 43/44 patients were on disability and Chronic Opiates Treatment. Non- OSA diabetic Neuropathy group (41) rated there pain as more tolerable (3-8/10) with reasonable control with pain modifiers which has failed in other group. Only 29% of these patients were on narcotics or failed four commonly used medications (GBP, Lyrica, cymbalta and amitriptyline).

Conclusions CONCLUSIONS: Neuropathy is more painful and intractable to pain modifiers in patients with diabetic neuropathy who also have OSA. Presence of OSA may be used as a prognostic marker in these patients which already known to cause worsening of DM. This is a limited study as effect of OSA treatment with CPAP machine cannot be analyzed due to poor compliance with machine. The exact mechanism remains unknown and needs further prospective study.

Authors/Disclosures
Anupama Kale, MD (DENT Neurologic Institute) PRESENTER	No disclosure on file
Gulshan Uppal, MD, FAAN (Freeman Neurology and Headache Clinic)	Dr. Uppal has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie. Dr. Uppal has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Pfizer.
Tanuja Chitnis, MD, FAAN (Brigham and Women's Hospital)	Dr. Chitnis has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Chitnis has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche-Genentech. Dr. Chitnis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Octave Biosciences. Dr. Chitnis has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. The institution of Dr. Chitnis has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. The institution of Dr. Chitnis has received research support from Novartis. The institution of Dr. Chitnis has received research support from Sanofi. The institution of Dr. Chitnis has received research support from Octave. The institution of Dr. Chitnis has received research support from Genentech-Roche. The institution of Dr. Chitnis has received research support from Tiziana Life Sciences. The institution of Dr. Chitnis has received research support from Bristol-Myers Squibb. The institution of Dr. Chitnis has received research support from Wesley Clover.
Sharmila Suri Mohanram, MD (Capital Region Medical Center)	No disclosure on file
	No disclosure on file
Niranjan N. Singh, MD, FAAN	Dr. Singh has nothing to disclose.

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