Promotional Communication. The medical devices SUDOSCAN & EZSCAN are regulated health products under the CE certification, Class IIa, according to the European Medical Device directive – SGS Belgium, notified body 1639. The test allows screening and monitoring of peripheral autonomic neuropathies. It can be performed in diabetic patients or in patients suffering from neurological diseases involving small fibers damage. As with any diagnostic test, its results must be interpreted in a global context including the clinic and other examinations performed. Please read the user manual instructions carefully. Contact our office for more information. Last update: 2021/01/12
Early detection is key
What is peripheral neuropathy?
Peripheral neuropathy is the result of damage to peripheral nerves, including small fiber neuropathy involving small and myelinated nerves (Aδ), as well as unmyelinated nerves (unmyelinated C fibers). In peripheral neuropathy, small somatic and autonomic fibers can be affected. Small fibers control thermal perception, pain perception, and autonomic functions such as cardiac, pulmonary or enteric functions .
Peripheral neuropathy can be a complication of several diseases such as diabetes, neurological or metabolic disorders, and infections. It can also result from certain drugs or alcohol consumption.
Figure: The peripheral nervous system is made of large and small fibers. The small, un-myelinated C-fibers are in charge of autonomic functions such as sweating
Why neuropathy testing?
Peripheral neuropathy can occur in the very early stages of the underlying causative disease. Its detection may help physicians better manage their patients and avoid advanced complications. Diabetic peripheral neuropathy is a serious and common complication that occurs in more than half of the patients . It can involve the entire autonomic nervous system. It can precede other complications and manifests as dysfunction in one or more organ systems, for example cardiovascular. Its early detection is important to avoid diabetic foot, a key initiating factor of amputation.
What are possible complications or symptoms?
Patients with peripheral neuropathy can present with either autonomic or somatic symptoms, or both. Symptoms are potentially numerous and can include allodynia, burning, impaired thermal sensation, hyperesthesia, paresthesia, numbness in the lower extremities with potential to affect limbs and the trunk, restless leg syndrome, dry eyes and mouth, abnormal sweating, bladder control issues, gastrointesnial dysfunction, skin discoloration, and cardiac symptoms. Cardiac symptoms include syncope, palpitations, and orthostatic hypotension, and – at its most serious – sudden death syndrome .
How can neuropathy be detected?
Testing the function of sweat glands, which are innervated by the autonomic system, is considered a fast and accurate method for detecting early stages of neuropathies. Sweat gland nerve fibers (sudomotors nerves) are thin, long and susceptible to damage at a very early stage of disease.
Figure: Activation of sudomotor small nerve fibers causes chloride ions to be secreted by sweat glands and released on the surface of the skin.
How does it work?
SUDOSCAN evaluates sudomotor function on the palms of the hands and soles of the feet. It uses a very low DC voltage (<4V) to activate the sweat glands and measures the current of chloride ions that flow out of the sweat glands in response to the electrical impulse. The test is painless, very quick (about 3 minutes), and easy to perform.
How is the test performed?
You will be asked to take your shoes and socks off; then you will stand on the sensor plates for the feet and place your hands on the hand sensor plates. If you are unable to stand still for 3 minutes on the plates, your physician will ask you to sit for the test.
How can the physician use this information to help me?
Physicians get simple and immediate information about the status of small autonomic nerves and can use it to:
• Confirm whether your symptoms may be due to a neuropathy
• Assess a change in your medical status
• Evaluate why your treatment may or may not be working.
What is SUDOSCAN?
SUDOSCAN is a quick and non-invasive test that provides an accurate evaluation of sweat gland function reflecting the status of the autonomic nervous system.
With quantitative and reproducible results, SUDOSCAN allows physicians to detect early and follow-up peripheral neuropathy to monitor disease progression and assess treatment efficacy for better patient management.
SUDOSCAN efficacy has been evaluated in the assessment of small fiber neuropathies in several diseases and compared to reference tests recommended in guidelines.
 Levine TD. Small Fiber Neuropathy: Disease Classification Beyond Pain and Burning. J Cent Nerv Syst Dis. 2018;10:1179573518771703. Published 2018 Apr 18.
 Selvarajah D, Kar D, Khunti K, Davies MJ, Scott AR, Walker J, Tesfaye S. “Diabetic peripheral neuropathy: advances in diagnosis and strategies for screening and early intervention”. The Lancet Diabetes Endocrinol 2019. Volume 7, Issue 12, p938-948, December 01, 2019.onomic neuropathy assessed by Sudoscan® in transthyretin wild-type cardiac amyloidosis. ESC Heart Fail. 2021 Apr;8(2):1656-1665.
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Ask your Doctor
If you suspect peripheral neuropathy ask your doctor about the non-invasive SUDOSCAN test.