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Constipation or diarrhea, emesis, anorexia, early satiety, and abdominal pain are common symptoms of gastrointestinal dysmotility, which affects 70% of patients. [1] Although about a quarter of patients report neuropathic symptoms such as tingling in the distal extremities, sensory examination and nerve conduction studies are normal. [1]
The nerve conduction study is often combined with needle electromyography. The Department of Health and Human Services Inspector General recently identified the use of NCSs without a needle electromyography at the same time a sign of questionable billing. [9] The nerve conduction study consists of the following components:
However, nerve conduction studies poorly identify hypersensitivity, QST can identify both loss and gain of function. [9] Psychophysical tests are generally affected by other difficult to control factors, such as stress, the experience of the tester, the room the test is in, the novelty of the environment and the person's temperament.
Peripheral neuropathy may be classified according to the number and distribution of nerves affected (mononeuropathy, mononeuritis multiplex, or polyneuropathy), the type of nerve fiber predominantly affected (motor, sensory, autonomic), or the process affecting the nerves; e.g., inflammation (), compression (compression neuropathy), chemotherapy (chemotherapy-induced peripheral neuropathy).
Nerve conduction studies will show absent or reduced sensory nerve conduction action potentials in the upper and lower limbs with preserved conduction velocity. [4] Motor nerve action potentials and conduction are usually unaffected, but in a subset of cases may have limited dysfunction. [ 2 ]
Causes: Chronic vitamin B 6 supplementation, or acute parenteral or oral over‐dosages of vitamin B 6. [5] [4] [6] [7] [8] Risk factors: Impaired kidney function, parenteral nutrition [9] Diagnostic method: Serum testing for elevated levels of vitamin B 6, testing of tendon reflexes, nerve conduction studies and electrodiagnostic testing. [10 ...
Although diseases often are suggested by the physical examination and history alone, tests that may be employed include electrodiagnostic testing, serum protein electrophoresis, nerve conduction studies, urinalysis, serum creatine kinase (CK) and antibody testing; nerve biopsy is done sometimes. [1] [3]
Electrodiagnostics – electromyography (EMG) and nerve conduction study (NCS). In usual CIDP, the nerve conduction studies show demyelination. These findings include: [citation needed] a reduction in nerve conduction velocities; the presence of conduction block or abnormal temporal dispersion in at least one motor nerve;