[Peripheral neuropathies: the rational diagnostic process].
OBJECTIVE
Neuropathies are defined as dysfunction of peripheral nerves, which may show motor, sensory and autonomic symptoms. Although most neuropathies are symmetric, it is important to distinguish a polyneuropathy from a mononeuropathy, a multiple mononeuropathy or a polyradiculoneuropathy. Electrophysiological procedures are helpful in determining the pathological process which may be either an axonopathy, a myelinopathy or a neuronopathy.


RESULTS
Major progresses have been made in the ten past years in the management and diagnostic approaches of peripheral neuropathy. The history and the physical examination are the first steps to the evaluation of patients with peripheral neuropathy. Electrodiagnostic studies and then laboratory tests are the next step in the diagnostic procedures of peripheral neuropathies. These will lead to a proper identification of the cause of neuropathy, allowing to develop a specific treatment for the patient. However, even after a careful work-up of a patient with neuropathy, 25 to 40% of patients with polyneuropathies remain undiagnosed.


CONCLUSIONS
Further development are focused in better understanding the pathogenesis and molecular mechanisms of peripheral nerve diseases in order to provide a specific and adequate treatment for each neuropathy.
Stojkovic
T
T
Clinique Neurologique, Service du Professeur Vermersch, Hôpital Roger-Salengro, CHRU de Lille, 59037 Lille cedex, France. t-stojkovic@chru-lille.fr
D001706:Biopsy; D003937:Diagnosis, Differential; D004568:Electrodiagnosis; D004594:Electrophysiology; D005544:Forecasting; D006801:Humans; D008854:Microscopy, Electron; D020422:Mononeuropathies / Q000175:diagnosis / Q000503:physiopathology; D009460:Neurologic Examination; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D011115:Polyneuropathies / Q000175:diagnosis / Q000503:physiopathology