An Approach to the Evaluation of Peripheral Neuropathies

ABSTRACT

Requests for an evaluation for a peripheral neuropathy are common in the clinic and electrodiagnostic laboratory. Lists of types of neuropathies are long as are diagnostic tests. An approach to the evaluation of peripheral neuropathies is valuable as it permits full characterization of the neuropathy after which the lists of possible types and tests becomes much shorter and manageable. In this article, the author presents such an approach, focusing on the clinical aspects.

KEYWORDS

Peripheral neuropathy - evaluation

REFERENCES

• 1 Barohn R J, Kissel J T, Warmolts J R, Mendell J R. Chronic inflammatory demyelinating polyradiculoneuropathy. Clinical characteristics, course, and recommendations for diagnostic criteria.  Arch Neurol. 1989;  46(8) 878-884
• 2 Dyck P J, Dyck P J, Grant I A, Fealey R D. Ten steps in characterizing and diagnosing patients with peripheral neuropathy.  Neurology. 1996;  47(1) 10-17
• 3 Sabin T D. Classification of peripheral neuropathy: the long and the short of it.  Muscle Nerve. 1986;  9(8) 711-719
• 4 Sivak M, Ochoa J, Fernández J. Positive manifestations of nerve fiber dysfunction: Clinical, electrophysiologic, and pathologic correlations. In: Brown W, Boulton C Clinical Electromyography. 2nd ed. Boston, MA; Butterworth-Heinemann 1993: 117-147
• 5 Apfel S C, Asbury A K, Bril V Ad Hoc Panel on Endpoints for Diabetic Neuropathy Trials et al. Positive neuropathic sensory symptoms as endpoints in diabetic neuropathy trials.  J Neurol Sci. 2001;  189(1-2) 3-5
• 6 Dyck P, Karnes J, O'Brien P, Zimmerman I. Detection thresholds of cutaneous sensation in humans. In: Dyck P, Thomas P, Griffin J, Low P, Poduslo J Peripheral Neuropathy. 3rd ed. Philadelphia, PA; WB Saunders Company 1993: 706-728
• 7 Dyck P J, Oviatt K F, Lambert E H. Intensive evaluation of referred unclassified neuropathies yields improved diagnosis.  Ann Neurol. 1981;  10(3) 222-226
• 8 Bennett C L, Lawson V H, Brickell K L et al.. Late-onset hereditary axonal neuropathies.  Neurology. 2008;  71(1) 14-20
• 9 Donofrio P D, Albers J W. AAEM minimonograph #34: polyneuropathy: classification by nerve conduction studies and electromyography.  Muscle Nerve. 1990;  13(10) 889-903