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New Testing Guidelines for Common Nerve Disorder

December 8, 2008

It’s now easier to know who should be tested for a common nerve disorder, when they should be tested, and how.

Two new studies from Louisiana State University recommend new testing guidelines for neuropathy — a degenerative nerve disorder. Researchers say a combination of certain screening blood tests and other specialized testing brings definitive information for certain forms of the disorder, while nerve biopsies may not be as useful in certain cases.

“There are many people with a neuropathy who have been walking around for years without having been diagnosed and treated,” lead author John D. England, M.D., Louisiana State University, was quoted as saying. “Both neurologists and people with neuropathy need to know that the appropriate choice of tests is critical to accurate diagnosis.”

There are more than a hundred types of neuropathy. Different nerves can be involved making the symptoms and levels of damage vary. In the most common forms where multiple nerves are involved, the nerve fibers farthest from the brain and the spinal cord malfunction first — for example, the hands and feet. Some patients may have temporary numbness, tingling, and pricking sensations, sensitivity to touch, or muscle weakness. Others may have more severe symptoms, including burning pain, muscle wasting, paralysis, or organ failure. Diabetes is the most common cause of neuropathy.

If you think you have nerve problems, researchers recommend you talk to your doctor about screenings, especially tests for blood glucose, vitamin B12 level and serum protein levels, since they can often point to common causes of neuropathy.

The guidelines recommend doctors get certain blood tests for all patients with numb, painful feet, as well as tailored genetic testing to accurately diagnose certain neuropathies that run in families. They also recommend doctors consider a combination of specialized tests to evaluate neuropathies with autonomic dysfunction — autonomic nerves regulate biological activities that people do not control consciously, such as breathing, digesting food, blood pressure and heart rate. A skin biopsy may also help to diagnose the loss of tiny nerve fibers in the skin.

SOURCE: Neurology, published online December 3, 2008

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