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Laboratory testing in peripheral nerve disease

J W Griffin1, S T Hsieh, J C McArthur

  • 1Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Neurologic Clinics
|February 1, 1996
PubMed
Summary
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Choosing the right lab tests for peripheral neuropathy diagnosis improves accuracy and saves costs. This guide helps select the best tests, including electrodiagnostic studies and antibody assays, for specific clinical situations.

Area of Science:

  • Neurology
  • Clinical Diagnostics

Background:

  • Peripheral neuropathies encompass a wide range of disorders affecting the peripheral nervous system.
  • Accurate diagnosis is crucial for effective management and patient outcomes.
  • A broad array of laboratory tests are available, necessitating a structured approach to selection.

Purpose of the Study:

  • To provide a comprehensive guide for selecting appropriate laboratory tests in the diagnosis of peripheral neuropathies.
  • To review clinical scenarios that indicate the utility of specific diagnostic tests.
  • To enhance diagnostic yield and cost-effectiveness in managing peripheral neuropathies.

Main Methods:

  • Review of current literature and clinical guidelines on diagnostic testing for peripheral neuropathies.
  • Discussion of the roles of electrodiagnostic testing, quantitative sensory testing, routine blood tests, antibody assays, and nerve/skin biopsies.

Related Experiment Videos

  • Emphasis on judicious test selection based on clinical presentation.

    • Main Results:

    • Electrodiagnostic testing is a valuable tool for nearly all patients with peripheral neuropathy.
    • Quantitative sensory testing offers additional insights, particularly for small fiber neuropathies.
    • Routine blood tests can identify underlying metabolic disorders.
    • Specific antibody assays (anti-MAG, anti-GM1, anti-GQ1b, anti-Hu, anticalcium channel) are useful in select cases, not for general screening.
    • Nerve and skin biopsies have a role in diagnosing specific disorders.

    Conclusions:

    • Appropriate selection of laboratory tests is essential for accurate and cost-effective diagnosis of peripheral neuropathies.
    • A stepwise approach integrating electrodiagnostic studies, targeted blood tests, and specific assays based on clinical suspicion is recommended.
    • The judicious use of advanced testing modalities like biopsies ensures optimal diagnostic yield.