Evaluation of Patients With Symptoms Suggestive of Chronic Polyneuropathy

Johannsen, Lis; Smith, Torben; Havsager, Anne‐Mette; Madsen, Claus; Kjeldsen, Marianne Juel; Dalsgaard, Niels Jørn; Garcı́a-Dorado, David; Schrøder, Henrik Daa; Sindrup, Søren Hein

doi:10.1097/00131402-200112000-00001

Cited by 53 publications

(42 citation statements)

References 17 publications

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“…Such a comprehensive investigation yields an etiologic diagnosis in 74 to 82% of patients with polyneuropathy. [4][5][6][7][8][9][10][11][12][13] Laboratory test results must be interpreted in the context of other clinical information since the etiologic yield of laboratory testing alone is limited by the low specificity of many of the tests. For example, one study of idiopathic polyneuropathy found that laboratory tests alone had only a 37% diagnostic yield (Class III).…”

Section: Analysis Of Evidencementioning

confidence: 99%

“…10 The majority of studies indicated that screening laboratory tests comprised of a complete blood count, erythrocyte sedimentation rate, comprehensive metabolic panel (blood glucose, renal function, liver function), thyroid function tests, serum B12, and serum protein immunofixation electrophoresis are indicated for most patients with polyneuropathy. [4][5][6][7][8][9][10][11][12][13] Five Class III studies indicated that the highest yield of abnormality was seen with screening for blood glucose, serum B12, and serum protein immunofixation electrophoresis. 4,6,10,13,14 The test with the highest yield was the blood glucose, consistent with the well-known fact that diabetes mellitus is the most common cause of DSP.…”

Section: Analysis Of Evidencementioning

confidence: 99%

“…[4][5][6][7][8][9][10][11][12][13] Five Class III studies indicated that the highest yield of abnormality was seen with screening for blood glucose, serum B12, and serum protein immunofixation electrophoresis. 4,6,10,13,14 The test with the highest yield was the blood glucose, consistent with the well-known fact that diabetes mellitus is the most common cause of DSP. In patients with DSP, blood glucose was elevated in approximately 11%, serum protein electrophoresis or immunofixation was abnormal in 9%, and serum B12 was low in approximately 3.6%.…”

Section: Analysis Of Evidencementioning

confidence: 99%

See 2 more Smart Citations

Practice Parameter: Evaluation of distal symmetric polyneuropathy: Role of laboratory and genetic testing (an evidence-based review)

England¹,

Gronseth²,

Franklin³

et al. 2009

Neurology

226

188

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Section: Analysis Of Evidencementioning

confidence: 99%

Section: Analysis Of Evidencementioning

confidence: 99%

Section: Analysis Of Evidencementioning

confidence: 99%

See 1 more Smart Citation

Practice Parameter: Evaluation of distal symmetric polyneuropathy: Role of laboratory and genetic testing (an evidence-based review)

England¹,

Gronseth²,

Franklin³

et al. 2009

Neurology

226

188

View full text Add to dashboard Cite

show abstract

“…The electromyographic findings in patients with vasculitic neuropathy show an axonal neuropathy of all fibres type, with the feature either of a symmetric polyneuropathy or asymmetric in patients with multiple mononeuropathy. A selective involvement of small fibres is rare and reflects the incidence of small fibres neuropathy in polyneuropathies in general, about 8% [26]. Pain in inflammatory neuropathy may be the heralding symptom of vasculitis anticipating sensory motor symptoms and signs.…”

Section: Neuropathic Pain In Connective Tissue Autoimmune Diseasesmentioning

confidence: 99%

Painful Peripheral Neuropathies

Marchettini¹,

Lacerenza²,

Mauri³

et al. 2006

134

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Peripheral neuropathies are a heterogeneous group of diseases affecting peripheral nerves. The causes are multiple: hereditary, metabolic, infectious, inflammatory, toxic, traumatic. The temporal profile includes acute, subacute and chronic conditions. The majority of peripheral neuropathies cause mainly muscle weakness and sensory loss, positive sensory symptoms and sometimes pain. When pain is present, however, it is usually extremely intense and among the most disabling symptoms for the patients. In addition, the neurological origin of the pain is often missed and patients receive inadequate or delayed specific treatment. Independently of the disease causing the peripheral nerve injury, pain originating from axonal pathology or ganglionopathy privileges neuropathies affecting smaller fibres, a clinical observation that points towards abnormal activity within nociceptive afferents as a main generator of pain. Natural activation of blood vessels or perineurial nociceptive network by pathology also causes intense pain. Pain of this kind, i.e. nerve trunk pain, is among the heralding symptoms of inflammatory or ischemic mononeuropathy and for its intensity represents itself a medical emergency. Neuropathic pain quality rekindles the psychophysical experience of peripheral nerves intraneural microstimulation i.e. a combination of large and small fibres sensation temporally distorted compared to physiological perception evoked by natural stimuli. Pins and needles, burning, cramping mixed with numbness, and tingling are the wording most used by patients. Nociceptive pain instead is most often described as aching, deep and dull. Good command of peripheral nerve anatomy and pathophysiology allows timely recognition of the different pain components and targeted treatment, selected according to intensity, type and temporal profile of the pain.

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“…The most common cause of neuropathy worldwide is diabetes mellitus [1]. Prevalence of neuropathy in patients with diabetes is 30% and it is estimated that more than 50% may develop during the course of the disease [2].…”

Section: Introductionmentioning

confidence: 99%

Comparative Clinical Trail Of Safety And Tolerability Of Gabapentin Plus Vitamin B1/B12 Versus Pregabalin In The Treatment Of Painful Peripheral Diabetic Neuropathy

A¹

2014

J Pain Relief

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Introduction: The B complex vitamins (B1 and B12) have been shown to have antiallodynic, antihyperalgesic and antinociceptive effect. Neuromodulators as gabapentin (GBP) and pregabalin (PGB) are effective in the treatment of painful peripheral diabetic neuropathy, but are related to occurrence of adverse events at high doses (sleepiness, vertigo and dizziness). The aim of this study was to evaluate the efficacy and safety on pain intensity reduces of GBP + B1/B12 versus PGB in patients with painful diabetic peripheral neuropathy of moderate to severe intensity.

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Evaluation of Patients With Symptoms Suggestive of Chronic Polyneuropathy

Cited by 53 publications

References 17 publications

Practice Parameter: Evaluation of distal symmetric polyneuropathy: Role of laboratory and genetic testing (an evidence-based review)

Practice Parameter: Evaluation of distal symmetric polyneuropathy: Role of laboratory and genetic testing (an evidence-based review)

Painful Peripheral Neuropathies

Comparative Clinical Trail Of Safety And Tolerability Of Gabapentin Plus Vitamin B1/B12 Versus Pregabalin In The Treatment Of Painful Peripheral Diabetic Neuropathy

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