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Neuropathy Testing

doi: 10.1097/01.NNN.0000345698.67558.10
Department: Neurology News

NEUROBIC ANSWERS FROM P. 9: Fifth wheel; sad sack; snake in the grass; wave of the future; four letter word.

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Do you have numbness, pain, or muscle weakness? New guidelines developed by the American Academy of Neurology identify the best tests for neuropathy. The authors published their results in Neurology® in December 2008.

Also known as neuritis or distal symmetric polyneuropathy, this common nerve problem affects people of all ages. Neuropathy affects one in 50 people in the general population and one in 12 over the age of 55. It usually causes numbness, tingling, or pain, often starting in the feet and moving to the hands. Muscle wasting and weakness can also occur. Neuropathy takes many forms and has many causes, the most common being diabetes. Other common causes are heredity, alcohol abuse, poor nutrition, autoimmune processes, and chemotherapy. Not all causes are known.

“There are many people with a neuropathy who have been walking around for years without having been diagnosed and treated,” says author John D. England, M.D, Grace Venson professor and chairman of the department of neurology at Louisiana State University Health Sciences Center in New Orleans.

“Both neurologists and people with neuropathy need to know that the appropriate choice of tests is critical to accurate diagnosis.” To develop the guidelines, the authors analyzed all available scientific studies on the topic.

The guidelines recommend that doctors obtain certain blood tests for all patients with numb, painful feet. “People with suspected nerve problems should talk to their doctors about screening tests, especially blood glucose, vitamin B12 level, and serum protein levels, since these tests can often point to common causes of neuropathy,” Dr. England says. The guidelines recommend genetic testing for diagnosing certain neuropathies that run in families.

The guidelines further recommend that doctors consider a combination of specialized tests to accurately evaluate neuropathies with autonomic dysfunction. These tests measure the action of the tiny nerves that control such functions as sweating, heart rate, and blood pressure. Skin biopsy may also be useful to diagnose loss of tiny nerve fibers in the skin.



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