What is diagnostic testing?

A thorough neurological evaluation helps doctors to diagnose peripheral neuropathy. Your doctor will obtain your history and you will be asked questions about your symptoms and associated medical conditions. Then, the physician will perform a neurological examination by testing your neurological function in different domains including your cranial nerves, strength, sensation, and deep tendon reflexes. Depending on the results of your history and neurological examination, you may be referred for additional tests as outlined below.

Before diagnosing peripheral neuropathy, your physician will review your medical history and conduct a neurological examination and order additional tests.

A neurological examination, which consists of a number of simple and painless tests, is usually performed to diagnose peripheral neuropathy. Depending on your symptoms and outcome of the neurological examination, you may be referred to undergo other tests that can determine what type of peripheral neuropathy you have.

Neurology Exam Questions from Your Doctor

You should be prepared to discuss your symptoms in detail with your doctor. Your doctor will ask you to describe your symptoms, when you experience them, how long the episodes last and the amount of discomfort or pain you experience. The more specific you can be about the tingling, numbness, weakness or other symptoms you are experiencing, the easier it will be for your doctor to understand your condition.

Your doctor may also ask you general health questions that may seem unrelated to your symptoms, but are, in fact, important. These questions could be about whether or not you feel faint, nauseated or tired. The doctor may also ask if your bladder control and sexual function are normal. You will also be asked if you are suffering from any other illnesses and if you are taking medications.

Since some neuropathies are hereditary, your doctor will ask if other members of your family have suffered from any type of neuropathy or neurological disorder.

Evaluation & Tests

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Autonomic Testing

Evaluation of how the systems in the body controlled by the autonomic nerves respond to stimulation.

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Electrodiagnostic Testing

Evaluation of how the systems in the muscles and nerves react to electrical activity.

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Imaging

These tests create images of the body and its organs that may be used in the diagnosis or exclusion of disorders with similar symptoms.

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Lumbar Puncture

Method of collecting a sample of a patient’s spinal fluid to identify the presence of an autoimmune disorder or infection.

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Nerve, Skin, Muscle, Tissue Biopsy

Samples of nerves, skin, muscle or other tissues are examined to identify and diagnose various disorders.

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Quantitative Sensory Testing

Used to diagnose and assess the severity of nerve damage, especially in the small nerve endings.

Neurological Examination Tests

A neurological evaluation consists of a physical exam and a number of simple and painless tests. The purpose of these tests is to assess your neurological function, including your muscle strength, how your autonomic nerves are functioning, and your ability to feel different sensations.

Among the items your physician will evaluate to get relevant clues on your conditions, these are the commonly used ones:

  • Test for loss of vibratory sensation at limb extremities: a tuning fork will be place on some reference spots (usually a bony protuberance as at the ankle bone) and you will be asked to say if/when if you the instrument vibrate.
  • Test for skin sensation in the feet and hands: a pin or a cotton swab will be gently placed on the limb to examined and you will be asked to say what/if you fell it.
  • Test for muscle strength: you will be asked to perform some simple gestures, such as bending your forearm, and the examiner will rate your strength.
  • Deep tendon reflex testing: the physician will use a neurological hammer to gently tap over some specific tendons to see if an involuntary muscle twitch/movement can be obtained.

Blood Tests

Blood tests are commonly employed to check for infections, vitamin deficiencies, toxic elements and evidence of an abnormal immune response.

Depending on your individual situation, your doctor may request certain laboratory tests to identify potentially treatable causes of neuropathy. These include tests for:

  • Vitamin B12 and folate levels
  • Thyroid, liver and kidney functions
  • Vasculitis evaluation
  • Oral glucose tolerance test
  • Antibodies to nerve components (e.g., anti-MAG antibody)
  • Antibodies related to celiac disease
  • Lyme disease
  • HIV/AIDS
  • Hepatitis C and B

Other common tests

If your doctor suspects that you have a specific type of neuropathy, an advanced case of neuropathy, or an entirely different condition, it may be suggested that you undergo additional testing.

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