Diagnosing Peripheral Neuropathy

Most often, a doctor can diagnose peripheral neuropathy based on the description of your symptoms along with a neurological examination. Sometimes nerve conduction studies are performed and can support the diagnosis. We perform Epidermal Nerve Fiber Density (ENFD) biopsies which have been found to have 88.4% sensitivity in detection of peripheral neuropathy compared to 54.6% for a clinical exam alone. ENFD is widely considered to be the “Gold Standard” in the detection of peripheral neuropathy.

What is Peripheral Neuropathy?

Approximately 40 million Americans are affected by peripheral neuropathy. Neuropathy is a condition in which the peripheral nerves (the nerves in your body, aside from your spinal cord and brain) are damaged and/or not working correctly. Neuropathic pain is characterized by pain, tingling and numbness in the feet and lower legs, balance problems and a variety of uncomfortable feelings. It can be quite debilitating, and affects more than 10% of the population. Diabetes is the leading cause of peripheral neuropathy.

Here is a breakdown of  the causes of Peripheral Neuropathy:

  • Diabetes – an estimated 29.1 million Americans have Diabetes. 60-70% of those diabetics have PN (1) or 20 million diabetics have (DPN). Undermanaged DPN is the #1 cause of lower limb amputations. Nearly 54,000 diabetics have amputations each year. 75% of amputations are preventable. (1)
  • Idiopathic – 23% of patients have an unknown origin of PN (1) It occurs mostly in middle age and elderly patients.
  • Chemotherapy – 30-40% of all cancer patients have Chemotherapy-induced peripheral neuropathy (CIN)(3) or 10% of all PN. (1)
  • HIV/Aids – One third of HIV/AIDS suffer from PN (1). These people account for 2% of all PN.
  • Unknown causes- causes account for 5% of all PN (1).
  • Other: Immune System Disorders – Guillian-Barré, Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), Charcot-Marie Tooth disease, Celiac disease, Lupus, Rheumatoid Arthritis, Shingles (1)

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