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Investigations

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The investigations of note in peripheral neuropathy include:

  • FBC
  • ESR, CRP
  • LFTs, GGT
  • TFTs
  • glucose
  • creatinine
  • plasma B12 and folate
  • serum protein electrophoresis and immunoelectrophoresis
  • urinalysis
  • CXR

Subsequently, EMG and peripheral nerve conduction; if these are normal and assuming symptoms and signs are confined to the legs, question whether there is a lesion in the cauda equina.

Notes:

  • other special investigations may include serum vitamin E concentrations, cryoglobulins, urinary heavy metals and porphyrins, antinuclear antibodies, rheumatoid factor, Sjogren's syndrome (SS) antibodies, (SS-A (anti-Ro) and SS-B (anti- La)), serology for Lyme disease and HIV, antiganglioside GM1 antibodies, Schirmer's test; if raised inflammatory markers and features of possible paraneoplastic peripheral neuropathy then further investigation for possible occult malignancy

Reference:

  • McLeod JG. Investigation of peripheral neuropathy. Journal of Neurology, Neurosurgery, and Psychiatry 1995;58:274-283.

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