Introduction to the Management and Diagnosis of Peripheral Neuropathies

Abstract

The detailed descriptions about clinical features and management of the different types of peripheral neuropathy are beyond the scope of this article. It may be appropriate here to outline general aspects of clinical features and classification of peripheral neuropathies. The clinical history and the abnormalities revealed by physical examination may either suggest the diagnosis or narrow down the diagnostic possibilities, facilitating subsequent investigation. Nerve conduction studies can provide crucial information and are best performed at initial examination. In general, the first broad determination should be made whether the patient has symmetrical polyneuropathy or focal, or multifocal neuropathies. The range of diagnostic possibilities differs between symmetrical polymeuropathy and mutifocal neuropathy. For those patients with symmetrical polyneuropathy, the clinical pattern (that is, whether it is motor, sensory, or mixed, or whether it has proximal or distal distribution) can provide useful information, as well as the rapidity of onset and previous clinical course in established cases. Managements of peripheral neuropathy and planning of its treatment mostly depend on the confirmative diagnosis of peripheral neuropathy. Thus, the best knowledge and understanding of basic principles of peripheral neuropathies are required for facilitating the diagnosis of peripheral neuropathies.