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Polyneuropathy
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==Diagnosis== [[File:Ragged red fibres - gtc - very high mag.jpg|thumb|left|170 px|Micrograph of a muscle biopsy]] The diagnosis of polyneuropathy begins with a history (anamnesis) and [[physical examination]] to ascertain the pattern of the disease process (such as arms, legs, distal, proximal), if they fluctuate, and what deficits and pain are involved. If pain is a factor, determining where and how long it has been present is important; one also needs to know what disorders are present within the family and what diseases the person may have. 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.<ref name=pat/><ref name="neur">{{cite journal|last1=Burns|first1=Ted M.|last2=Mauermann|first2=Michelle L.|title=The Evaluation of Polyneuropathies|journal=Neurology|date=15 February 2011|volume=76|issue=7 Supplement 2|pages=S6–S13|doi=10.1212/WNL.0b013e31820c3622|pmid=21321354|language=en|issn=0028-3878|pmc=5766173}}</ref> Other tests may be used, especially tests for specific disorders associated with polyneuropathies; quality measures have been developed to diagnose patients with distal symmetrical polyneuropathy (DSP).<ref>{{cite journal|last1=England|first1=John D.|last2=Franklin|first2=Gary|last3=Gjorvad|first3=Gina|last4=Swain-Eng|first4=Rebecca|last5=Brannagan|first5=Thomas H.|last6=David|first6=William S.|last7=Dubinsky|first7=Richard M.|last8=Smith|first8=Benn E.|title=Quality improvement in neurology|journal=Neurology|date=13 May 2014|volume=82|issue=19|pages=1745–1748|doi=10.1212/WNL.0000000000000397|pmc=4032209|issn=0028-3878|pmid=24696504}}</ref> ===Differential diagnosis=== In terms of the differential diagnosis for polyneuropathy, the following must be considered: {{columns-list|colwidth=30em| * [[Vitamin deficiency]]<ref name=bmj/> * [[Diabetes mellitus]]<ref name=bmj/> * Toxins<ref name=bmj/> * [[Guillain–Barré syndrome]]<ref name="bmj">{{cite web|title=Polyneuropathy/differential diagnosis|url=http://bestpractice.bmj.com/best-practice/monograph/158/diagnosis/differential-diagnosis.html|website=BMJ.com|publisher=BMJ Best Practices|access-date=26 August 2016|archive-date=22 October 2023|archive-url=https://web.archive.org/web/20231022225050/https://bestpractice.bmj.com/topics/en-us/158/differentials|url-status=live}}</ref> * [[Lyme disease]]<ref name=bmj/> * Hepatitis C<ref name=bmj/> * [[Amyloidosis]]<ref name=bmj/> * [[Acromegaly]]<ref name=bmj/> * [[Kidney failure]]<ref>[https://www.nlm.nih.gov/medlineplus/ency/article/000471.htm Chronic renal failure] {{Webarchive|url=https://web.archive.org/web/20160705050214/https://www.nlm.nih.gov/medlineplus/ency/article/000471.htm |date=2016-07-05 }}, ''Medline Plus''</ref> * [[Friedreich's Ataxia]]<ref>{{cite journal | url=https://doi.org/10.1097/NEN.0b013e31827e5762 | doi=10.1097/NEN.0b013e31827e5762 | title=Friedreich Ataxia: Neuropathology Revised | year=2013 | last1=Koeppen | first1=Arnulf H. | last2=Mazurkiewicz | first2=Joseph E. | journal=Journal of Neuropathology & Experimental Neurology | volume=72 | issue=2 | pages=78–90 | pmid=23334592 | pmc=3817014 | access-date=2019-06-28 | archive-date=2023-10-22 | archive-url=https://web.archive.org/web/20231022225126/https://academic.oup.com/jnen/article/72/2/78/2917588 | url-status=live }}</ref> }}
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