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How to work up a patient with polyneuropathy?
R Renganathan1, A Atkinson, B McNamara
1Department of Neurophysiology, Cork University Hospital, Wilton, Cork. howrurenga@yahoo.com
Irish Medical Journal
|March 17, 2009
Summary
Identifying the cause of polyneuropathy is crucial. A routine neuropathy screen using medical history, examination, nerve conduction studies, and blood tests can diagnose most cases efficiently.
Area of Science:
- Neurology
- Clinical Diagnostics
Background:
- Undiagnosed polyneuropathy can lead to significant disability and reduced quality of life.
- Extensive and varied diagnostic testing for polyneuropathy can be resource-intensive and time-consuming.
Purpose of the Study:
- To investigate a routine screening approach for diagnosing polyneuropathy.
- To identify the most effective diagnostic methods for identifying the cause of polyneuropathy.
Main Methods:
- Retrospective audit of 61 patient charts diagnosed with polyneuropathy via nerve conduction studies (November 2001 - November 2002).
- Documentation of demographics, medical history, neuropathy type, and investigations performed.
- Analysis of diagnostic yield from various investigations.
Main Results:
- A specific cause for polyneuropathy was identified in 79% of audited cases.
- Common contributing factors included diabetes mellitus (12 patients) and alcohol abuse (2 patients).
- Presenting symptoms included paresthesia (23 patients) and limb weakness (33 patients).
Conclusions:
- A focused diagnostic workup, including medical history, neurological examination, nerve conduction studies, and baseline blood tests, is effective in identifying the cause of most polyneuropathies.
- A suggested 3-step approach can streamline the diagnostic process for polyneuropathy.
- This approach aims to improve diagnostic efficiency and resource allocation in managing polyneuropathy.
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