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Guidelines Issued for Distal Symmetric Polyneuropathy

Authors discuss roles of laboratory and genetic testing, autonomic testing, nerve and skin biopsy

THURSDAY, Dec. 4 (HealthDay News) -- Although the evaluation of distal symmetric polyneuropathy is not standardized, a growing body of research has produced evidence-based guidelines that may be useful for clinicians, according to two Practice Parameters released online Dec. 3 in advance of publication in the Jan. 13 issue of Neurology.

In one study, J.D. England, M.D., of the Louisiana State University Health Sciences Center in New Orleans, and colleagues reviewed 1980-2007 literature addressing the role of laboratory and genetic testing. They recommend that screening laboratory tests be considered for all patients with polyneuropathy. They also recommend that genetic testing should be conducted for the accurate diagnosis of hereditary neuropathies, but state that there is insufficient evidence to determine the usefulness of routine genetic testing in patients who do not exhibit a hereditary phenotype.

In a second study, England and colleagues reviewed 1980-2007 literature addressing the role of autonomic testing, nerve biopsy and skin biopsy. They recommend that autonomic testing be considered for all patients with polyneuropathy to document autonomic nervous system dysfunction. They also state that skin biopsy may be considered for the diagnosis of distal symmetric polyneuropathy, but that there is insufficient evidence to recommend nerve biopsy in the evaluation of the condition.

"There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyneuropathy," the authors write.

Several authors of both studies disclosed financial support from pharmaceutical companies.

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