2 Dimensional Guidelines for Investigations and Management of Polyneuropathy


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Nerve Conduction Study
(Last Updated On: April 27, 2017)

A. Investigations

Baseline Tests for Polyneuropathy
Lab Investigations for Polyneuropathy

Polyneuropathy is the disease of the nerves, which can be diagnosed by various investigations and it becomes even more important to determine the underlying cause of polyneuropathy once the diagnosis of polyneuropathy has been made. Following are the investigations that are usually carried out to diagnose and determine the underlying cause of polyneuropathy:

1. Routine Blood Investigations:

Blood Screening in Polyneuropathy
Baseline Blood Tests in a Case of Polyneuropathy

These investigations give a wild guess about the type and cause of polyneuropathy:

These include following investigations:

I. Full Blood Count

II. Erythrocyte Sedimentation Rate

III. C-Reactive Protein

IV. Serum urea, creatinine and electrolytes

V. Liver Function Tests

VI. Thyroid Function Tests

VII. S. Glucose level

VIII. Vitamin B12 level

2. Specialized Blood Tests:

Advanced Blood Tests to Diagnose The Underlying Cause of Polyneuropathy
Blood Investigations Diagnostic of Underlying Cause of Polyneuropathy

Specialized blood tests for polyneuropathy include:

I. Antinuclear Antibody

II. Extractable Nuclear Antigen.

III. Antineutrophil Cytoplasmic Antibodies.

IV. Heavy Metals

V. Porphyrins

VI. Genetic Testing

3. Nerve Conduction Studies (NCS) and Electromyography (EMG):

Nerve Conduction Study and Electromyography can Diagnose Polyneuropathy, Determine Its Type, Pattern of Its Recovery or Deterioration and Pattern of Nerve Involvement.
NCS and EMG for The Diagnosis of Polyneuropathy.

This investigation helps differentiate focal/multifocal neuropathy, sensory and/or motor neuropathy and axonal or sensory neuropathy.

4. Cerebrospinal Fluid (CSF) Examination:

Cerebrospinsal Fluid Examination Reveals Important Information Regarding Origin of Polyneuropathies.
Cerebrospinal Fluid Collection.

CSF examination can yield very important information especially regarding inflammatory neuropathies with proximal origin. Elevated proteins could be a hint towards paraneoplastic neuropathies while an elevated white cell count in a patient of inflammatory neuropathy could be pointing towards HIV associated neuropathy.

5. Nerve Biopsy:

Nerve Biopsy Has Very Low Diagnostic Yield Due To Patchy Involvement of Nerves.
Nerve Biopsy

Nerve biopsy does not have very high diagnostic yield and should only be attempted if it is expected to affect the decisions regarding management.

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2 Dimensional Guidelines for Investigations and Management of Polyneuropathy

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