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Diagnostic yield by testing small fiber function in patients examined for polyneuropathy
S H Sindrup1, D Gaist, L Johannsen
1Department of Neurology, Odense University Hospital, Denmark. s.sindrup@dadlnet.dk
Journal of the Peripheral Nervous System : JPNS
|January 22, 2002
Summary
Adding quantitative sensory testing significantly improves the diagnosis of chronic polyneuropathy. This method enhances detection rates when standard nerve conduction studies are inconclusive, aiding in identifying nerve damage.
Area of Science:
- Neurology
- Clinical Neurophysiology
- Sensory Neuroscience
Background:
- Polyneuropathy diagnosis relies on standard electrodiagnostic tests.
- Unselected patients often present diagnostic challenges.
- Quantitative sensory testing (QST) may enhance diagnostic yield.
Purpose of the Study:
- To evaluate the diagnostic utility of QST in addition to standard work-up for polyneuropathy.
- To assess the diagnostic yield of QST in unselected patients with suspected polyneuropathy.
Main Methods:
- Included 198 patients (18-70 years) with suspected polyneuropathy.
- Performed nerve conduction studies (NCS) and QST (heat/cold detection thresholds).
- Utilized somatosensory-evoked potentials (SSEPs) for CNS disease investigation.
Main Results:
- 149 patients had polyneuropathy; 25 remained undiagnosed.
- 86% of patients showed abnormalities in NCS and/or QST.
- QST identified sensory deficits in patients with normal NCS.
Conclusions:
- Quantitative testing of temperature sensation improves diagnostic yield in chronic polyneuropathy evaluation.
- QST is a valuable adjunct to NCS for diagnosing polyneuropathy.
- Enhanced diagnostic accuracy aids in patient management and understanding of neuropathic conditions.