How is toxic neuropathy diagnosed?

Updated: Dec 06, 2017
  • Author: Jonathan S Rutchik, MD, MPH, FACOEM; Chief Editor: Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS  more...
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Take a thorough medical history, including the patient’s occupational and environmental history, to consider all sources of exposure to all possible agents. List details of all jobs and specific tasks within these jobs, as well as when various symptoms and medical problems began for the patient.

Quantitative sensory testing in the diagnosis of neuropathy includes the following:

  • Vibration threshold

  • Thermal threshold

  • Portable motor and sensory latency

  • Current perception threshold (CPT)

Other studies that help to prove the presence of neuropathy include the following:

  • Intraepidermal nerve fiber density (IENF)

  • Sympathetic skin reflex

  • Electromyography (EMG)

  • Nerve conduction

Laboratory studies in patients with neuropathy can include the following:

  • Glucose tolerance

  • Serum, urine, or blood

  • Vitamin B-12

  • Monoclonal gammopathy of unknown significance

  • Axonal neuropathy

  • Cryoglobins and hepatitis C evaluation

  • Immunofixation (for paraneoplastic neuropathy)

  • Cerebrospinal fluid (CSF) protein level: Usually normal in toxic neuropathy

See Workup for more detail.

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