These nerve cells are known as motor neurons. In cases of polyradiculopathy, plexopathy, or radiculoplexus neuropathy, magnetic resonance imaging may help in localizing an atypical neuropathy.Electromyography (EMG) is a diagnostic procedure that evaluates the health condition of muscles and the nerve cells that control them.
Imaging should not be routinely ordered to aid in the diagnosis of peripheral neuropathy. Patients with peripheral neuropathy should be referred for electrodiagnostic studies if symptoms are worrisome (e.g., acute onset, asymmetrical, predominant motor or autonomic symptoms, rapidly progressive clinical course) or if initial workup is normal and symptoms persist. 1, 20, 21Įxpert opinion and consensus guideline in the absence of clinical trials Initial evaluation of a patient with suspected peripheral neuropathy should include a complete blood count comprehensive metabolic profile fasting blood glucose, thyroid-stimulating hormone, and vitamin B 12 levels and serum protein electrophoresis with immunofixation. Several classes of medications, including gabapentinoids and antidepressants, can help alleviate neuropathic pain. Treatment of peripheral neuropathy focuses on managing the underlying etiology. If the initial evaluation is inconclusive, referral to a neurologist for additional testing (e.g., electrodiagnostic studies, specific antibody assays, nerve biopsy) should be considered. Initial laboratory evaluation includes a complete blood count a comprehensive metabolic profile fasting blood glucose, vitamin B 12, and thyroid-stimulating hormone levels and serum protein electrophoresis with immunofixation. If the peripheral nervous system is identified as the likely source of the patient's symptoms, evaluation for potential underlying etiologies should initially focus on treatable causes.
Physical examination should include a comprehensive neurologic and musculoskeletal evaluation. Later stages may involve proximal numbness, distal weakness, or atrophy. Early peripheral neuropathy may present as sensory alterations that are often progressive, including sensory loss, numbness, pain, or burning sensations in a “stocking and glove” distribution of the extremities. Diagnosis requires a comprehensive history, physical examination, and judicious laboratory testing. Peripheral neuropathy is idiopathic in 25% to 46% of cases. Common identifiable causes include diabetes mellitus, nerve compression or injury, alcohol use, toxin exposure, hereditary diseases, and nutritional deficiencies.
The prevalence of peripheral neuropathy in the general population ranges from 1% to 7%, with higher rates among those older than 50 years. Peripheral neuropathy, a common neurologic problem encountered by family physicians, can be classified clinically by the anatomic pattern of presenting symptoms and, if indicated, by results of electrodiagnostic studies for axonal and demyelinating disease.
0 kommentar(er)
