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Dec 4, 2008 - 10:44:32 AM

Doctors Recommend Certain Tests To Detect Common Nerve Disease

(HealthNewsDigest.com) - ST. LOUIS - New guidelines for diagnosing neuropathy, a common nerve condition that affects about one in 50 Americans, suggest a combination of blood and nerve tests works best to find the root cause of the disease.

The condition, which may involve muscle wasting and weakness, frequently begins with a tingling sensation or numbness in the feet or hands and can spread slowly to the legs and arms. It affects one in 12 people over the age of 55.

"Because there are many diseases or conditions that cause neuropathy, it's important to find the underlying reason for the condition," said Laurence Kinsella, M.D., professor of neurology at Saint Louis University and a member of the research team that studied which tests should be ordered for patients who have symptoms of neuropathy.

"Once you know the cause, in some cases you have exceptionally good therapies. And even when there aren't good treatments for the cause of neuropathy, a physician can always treat symptoms of pain and discomfort and make it easier for a patient to function."

The guidelines for diagnosing neuropathy were developed by the American Academy of Neurology and are published in the Dec. 3 issue of Neurology®, the medical journal of the American Academy of Neurology. The findings were based on a study of all scientific research on neuropathy.

As the population ages and as more people develop diabetes, the most common cause of neuropathy, the prevalence of neuropathy is rising, Kinsella said.

For years, doctors have not known the best tests to determine if a patient is suffering from neuropathy, which also can be caused by heredity, alcohol abuse, poor nutrition, autoimmune disorders and other factors.

"A large proportion of all neuropathies are hereditary," Kinsella said. "In some cases, people with neuropathy never realize they have the condition. They may chalk up their difficulty with rolling ankles or finding comfortable shoes as 'one of those things,' particularly if their parents had the same difficulty."

All patients who have numb or painful feet should have certain blood tests to screen for neuropathy, according to the new guidelines.

Blood tests for levels of glucose, vitamin B12 and serum protein can point to common causes of neuropathy, Kinsella said.

Other specialized tests – known as "autonomic tests" – that measure the action of tiny nerves that control body functions such as sweating, heart rate and blood pressure also can be helpful, he added.

The American Association of Neuromuscular and Electrodiagnostic Medicine and the American Academy of Physical Medicine and Rehabilitation collaborated on the new guidelines.

"Doctors need to know what tests are critical to accurately diagnose neuropathy," Kinsella said. "These guidelines are designed to improve the quality of life for patients who suffer a treatable problem."

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