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Polyneuropathies

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Electrodiagnostic Medicine

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Abstract

Polyneuropathy (often also referred to as peripheral neuropathy) is a broad term that encompasses conditions characterized by a generalized disorder of peripheral nerves. Most commonly, patients present with sensory symptoms such as numbness or paresthesia starting in the toes/feet (i.e. following a length-dependent pattern). Common causes of polyneuropathy are diabetes mellitus, chronic alcoholism, nutritional deficiencies such as vitamin B12 and immune-mediated conditions (with leprosy or Hansen’s disease still considered among the leading causes of polyneuropathy worldwide, albeit rare in most developed countries). Each of these have distinct clinical and electrophysiological features. Hence a systematic and practical approach is needed for cost-effective diagnosis and early recognition of treatable forms of polyneuropathy.

The goal of electrodiagnostic studies is to confirm the presence of a polyneuropathy, assess the type of nerve fibers involved (sensory and/or motor), pattern, chronicity (and possibly tempo), pathophysiology (primarily axonal vs demyelinating) and its severity.

Nerve conduction studies (NCS) and needle electrode examination (NEE) aid in the classification and differentiation of peripheral neuropathies. The distinction between axonal and demyelinating neuropathies has diagnostic and prognostic implications. The routine electrodiagnostic evaluation of patients with suspected polyneuropathy includes sensory NCS, motor NCS, F-wave studies, H-wave studies and NEE. A wide variably exists amongst neurophysiologists regarding the use of electrodiagnostic examination techniques, reference values, interpretation of individual tests, and criteria for diagnosis and classification of peripheral neuropathy. However, the basic approaches are similar in most laboratories.

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Author information

Authors and Affiliations

  1. Department of Neurology, Dr. L H Hiranandani Hospital, Mumbai, Maharashtra, India

    Megha Chetan Dhamne

  2. Neuromuscular Center, Neurological Institute, Cleveland Clinic, and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA

    John A. Morren

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  1. Megha Chetan Dhamne
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Correspondence to Megha Chetan Dhamne .

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Editors and Affiliations

  1. Braathen Neurological Center, Cleveland Clinic Florida, Weston, FL, USA

    Nestor Galvez-Jimenez

  2. Braathen Neurological Center, Cleveland Clinic Florida, Weston, FL, USA

    Alexandra Soriano

  3. Neuromuscular Center Neurological Institute, Cleveland Clinic, and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA

    John A. Morren

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Dhamne, M.C., Morren, J.A. (2021). Polyneuropathies. In: Galvez-Jimenez, N., Soriano, A., Morren, J.A. (eds) Electrodiagnostic Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-74997-2_6

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  • DOI: https://doi.org/10.1007/978-3-030-74997-2_6

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