Test Utilization and Value in the Evaluation of Peripheral Neuropathies

Autor:	Brian C. Callaghan
Rok vydání:	2020
Předmět:	Pediatrics medicine.medical_specialty business.industry Diagnostic evaluation medicine.disease Laboratory testing Distal symmetric polyneuropathy Peripheral Test (assessment) Peripheral neuropathy Electrodiagnostic testing medicine Neurology (clinical) business Genetics (clinical) Subacute onset
Zdroj:	CONTINUUM: Lifelong Learning in Neurology. 26:1384-1391
ISSN:	1538-6899 1080-2371
DOI:	10.1212/con.0000000000000910
Popis:	Peripheral neuropathies can be classified as typical or atypical. Patients with atypical neuropathy have one or more of the following features: acute/subacute onset, non-length dependence, motor predominance, or asymmetry. This classification is important because it informs the appropriate diagnostic evaluation of this highly prevalent condition. The evaluation of a typical peripheral neuropathy, also known as distal symmetric polyneuropathy, requires a thorough history, neurologic examination, and focused laboratory testing. Electrodiagnostic testing and MRI account for the majority of costs but rarely lead to changes in diagnosis or management. These costs are increasingly being passed on to patients, especially those with high-deductible health plans. In contrast, patients with atypical neuropathy require more extensive testing, including electrodiagnostic tests. These tests are much more likely to lead to the use of disease-modifying therapies in these patients compared to in those with typical peripheral neuropathy. This article describes two cases to illustrate the appropriate diagnostic workup of those with typical or atypical neuropathy.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::eddb3b8ba2013af4560758e07ce5859f https://doi.org/10.1212/con.0000000000000910 Zobrazit plný text záznamu