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Tests and diagnosis

By Mayo Clinic staff

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Peripheral neuropathy isn't a single disease, but rather a symptom with many potential causes. For that reason it can be difficult to diagnose. Your doctor will need to determine where the nerve damage is and what's causing it.

Diagnosis usually requires:

  • A full medical history. This includes your symptoms, your lifestyle, exposure to toxins, drinking habits and a family history of neurological disease.
  • Neurological exam. This may include checking your tendon reflexes, your muscle strength and tone, your ability to feel certain sensations, and your posture and coordination.
  • Physical exam. Your doctor will likely do a complete physical exam.

Your doctor may order tests, including:

  • Blood tests. These measure various levels, such as vitamin and blood sugar levels; and bodily functions, such as thyroid, liver and kidney.
  • Imaging tests. Your doctor may request a CT scan or MRI to look for herniated disks, tumors or other abnormalities.
  • Nerve function tests. These may include electromyography — which reads electrical activity in your muscles to determine if your weakness is caused by muscle damage or nerve damage — and nerve conduction studies — which assess how your nerves and muscles respond to small electrical stimuli, generated by a probe and measured by an electrode placed along the nerve's pathway.
  • Nerve biopsy. Your doctor may recommend this procedure to try to determine what's damaging your nerves. A small portion of a nerve is removed and examined for abnormalities.
References
  1. Peripheral neuropathy fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/peripheralneuropathy/detail_peripheralneuropathy.htm. Accessed Aug. 22, 2011.
  2. Peripheral neuropathy. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/sec17/ch234/ch234h.html?qt=peripheral%20neuropathy&alt=sh#v1046209. Accessed Aug. 22, 2011.
  3. Pai S. Peripheral neuropathy. In: Rakel D. Integrative Medicine. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/156944782-3/0/1494/62.html#4-u1.0-B978-1-4160-2954-0..50019-3--cesec2_528. Accessed Aug. 25, 2011.
  4. Dietary supplement fact sheet: Vitamin B12. Office of Dietary Supplements. http://ods.od.nih.gov/factsheets/vitaminb12.asp. Accessed Aug. 25, 2011.
  5. Bril V, et al. Evidence-based guideline: Treatment of painful diabetic neuropathy. Neurology. 2011;76:1758.
  6. Ropper AH, et al. Diseases of the peripheral nerves. In: Ropper AH, et al. Adams and Victor's Principles of Neurology. 9th ed. New York, N.Y.: McGraw-Hill Companies; 2009. http://www.accessmedicine.com/content.aspx?aID=3641268. Accessed Aug. 25, 2011.
  7. Amato AA, et al. Peripheral neuropathy. In: Fauci AS, et al. Harrison's Principals of Internal Medicine. 18th ed. New York, N.Y.: McGraw-Hill Companies; 2010. http://www.accessmedicine.com/content.aspx?aID=9148461. Accessed Aug. 25, 2011.
DS00131 Nov. 2, 2011

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