Diagnostic work-up in peripheral neuropathy: an analysis of 171 cases

This study was set up to evaluate retrospectively the efficacy of a standar d diagnostic procedure, including noninvasive and invasive (spinal tap, ner ve/muscle biopsy) investigations, in the diagnosis of peripheral neuropathy . The medical records of 171 in-patients with the final diagnosis of periph eral neuropathy of determined or undetermined cause were reviewed and each individual diagnostic work-up was analysed. Basic investigations included t he patient's history, a clinical examination and basic laboratory tests. De pending on the individual presentation, course, and severity, further nonin vasive and invasive examinations were added according to the department's s tandard diagnostic procedure. The aetiology could be clarified in 124 patie nts (73%) and remained unclear in 47 cases. Excluding cases with acute and chronic inflammatory polyneuropathy (n=14), the number of idiopathic periph eral neuropathies dropped to 33. Non-invasive investigations were sufficien t to reveal the underlying aetiology in 114 cases (83 %). It is concluded t hat, with the application of a standard procedure for the diagnosis of peri pheral neuropathy, the aetiology can be clarified in 81% of patients. In th e other 19% of patients the aetiology remains idiopathic. In the majority o f cases, noninvasive investigations were sufficient for diagnosis.