Real-world data back electrodiagnostic testing for suspected peripheral neuropathies

By Will Pass

Electrodiagnostic testing frequently provides important information when evaluating patients with suspected peripheral neuropathy, based on a retrospective look at real-world data.

At a tertiary care facility, electrodiagnostic testing (EDX) revealed that only one-third of patients had peripheral neuropathy, and more than half of those had additional neuromuscular diagnoses, reported lead author Matthew Ginsberg, MD, staff neurologist and assistant professor of pediatrics at Akron (Ohio) Children’s Hospital, and colleagues.

“Although we did not directly assess for changes in management as a result of EDX, the identification of alternate etiologies or superimposed pathology may change management by identifying treatable conditions such as carpal tunnel syndrome, or prompting other directed diagnostics, such as spine imaging for radiculopathies,” the investigators wrote (Muscle Nerve. 2020 Mar;61[3]:288-92).

Out of 162 patients who underwent EDX, 59 (36.4%) had normal results, 51 (31.5%) had an alternate diagnosis, 29 (17.9%) had peripheral neuropathy plus another neuromuscular diagnosis, and 23 (14.2%) had pure peripheral neuropathy.

The study results add “compelling evidence” to support the role of EDX when evaluating suspected peripheral neuropathy, according to Christopher D. Geiger, DO, and David C. Preston, MD, of University Hospitals Cleveland Medical Center, who wrote an accompanying editorial.

Dr. Geiger and Dr. Preston noted that the study did not include patients referred for mononeuritis multiplex, pure sensory polyneuropathy, and demyelinating polyneuropathy.

“As the confirmation of each of these conditions is associated with a limited differential diagnosis, and in many, specific treatment, the present study likely underestimated the value of EDX studies in suspected peripheral neuropathy,” they wrote.

The investigators reported no funding or conflicts of interest.