Seminars in neurology
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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.
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The authors discuss the techniques and use of electrodiagnosis to help fully characterize peripheral neuropathies, including electrodiagnostic principles, normal findings, correlations between underlying nerve pathology that leads to abnormal electrodiagnostic findings, and how to detect and interpret electrodiagnostic findings.
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Seminars in neurology · Sep 2010
ReviewNerve conduction pitfalls and pearls in the diagnosis of peripheral neuropathies.
Nerve conduction studies are an integral component of the evaluation of a peripheral neuropathy. While routine in nature, they require attention to detail. This article focuses on operator and machine errors that can affect the correct interpretation of nerve conduction data and the nature of a neuropathy.
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Neuropathic pain is a common symptom associated with peripheral neuropathy and can be as or more disabling than the effects of nerve damage from the neuropathy. Though treatment of the underlying pathophysiology causing neuropathies may not be possible, treatment of neuropathic pain is. The author reviews the major medications used, dosing schedules, and data from randomized controlled trials.
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Laboratory testing to help determine the cause of a peripheral neuropathy can be challenging. A rational approach, as opposed to a shotgun approach, is advocated for efficiency and expense. The author reviews a spectrum of tests and provides a basis for when to order and not to order.