The Experts below are selected from a list of 1098 Experts worldwide ranked by ideXlab platform

James R Lupski - One of the best experts on this subject based on the ideXlab platform.

  • practice parameter evaluation of distal symmetric polyNeuropathy role of autonomic testing nerve biopsy and skin biopsy an evidence based review report of the american academy of neurology american association of neuromuscular and electrodiagnostic m
    Neurology, 2009
    Co-Authors: Jeffrey A. Cohen, John D England, Gary S Gronseth, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski
    Abstract:

    Background: Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyNeuropathy. Methods: A literature review using MEDLINE, EMBASE, and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based upon the level of evidence. Results and Recommendations: 1) Autonomic testing should be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). 2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). 3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy. AAN = American Academy of Neurology; AANEM = American Academy of Neuromuscular and Electrodiagnostic Medicine; AAPMR ART = autonomic reflex testing; BRSI = baroreflex sensitivity index; CASS = composite autonomic scoring scale; CIDP = chronic inflammatory demyelinating polyNeuropathy; DSFN = distal small fiber Neuropathy; DSP = distal symmetric polyNeuropathy; EDx = electrodiagnosis; EFNS = European Federation of Neurological Societies; HRV = heart rate variability; IAN = idiopathic autonomic Neuropathy; IENF = intraepidermal nerve fibers; MSNA = muscle sympathetic nerve activity; NCSs = nerve conduction studies; PGP 9.5 = protein-gene-product 9.5; PN = peripheral Neuropathy; PRT = blood pressure recovery time; QAE = quantitative autonomic examination; QSART = quantitative sudomotor axon reflex test; QSS = Quality Standards Subcommittee; QST = quantitative sensory testing; SFSN = small fiber sensory polyNeuropathy; TST = thermoregulatory sweat testing.

  • practice parameter evaluation of distal symmetric polyNeuropathy role of autonomic testing nerve biopsy and skin biopsy an evidence based review report of the american academy of neurology american association of neuromuscular and electrodiagnostic m
    Neurology, 2009
    Co-Authors: John D England, Jeffrey A. Cohen, Gary S Gronseth, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski
    Abstract:

    Background: Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyNeuropathy. Methods: A literature review using MEDLINE, EMBASE, and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based upon the level of evidence. Results and Recommendations: 1) Autonomic testing should be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). 2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). 3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy. Neurology ® 2009;72:177–184

  • practice parameter the evaluation of distal symmetric polyNeuropathy the role of autonomic testing nerve biopsy and skin biopsy an evidence based review report of the american academy of neurology the american association of neuromuscular and electro
    Pm&r, 2009
    Co-Authors: Gary S Gronseth, Jeffrey A. Cohen, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski, Norman Latov
    Abstract:

    Background Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy and skin biopsy for the assessment of polyNeuropathy. Methods A literature review using MEDLINE, EMBASE, Science Citation Index and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based upon the level of evidence. Results and Conclusions 1. Autonomic testing may be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). 2. Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). 3. Skin biopsy is a validated technique for determining intraepidermal nerve fiber (IENF) density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy.

  • evaluation of distal symmetric polyNeuropathy the role of autonomic testing nerve biopsy and skin biopsy an evidence based review
    Muscle & Nerve, 2009
    Co-Authors: Gary S Gronseth, Jeffrey A. Cohen, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski, Norman Latov
    Abstract:

    Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyNeuropathy. A literature review using MEDLINE, EMBASE, Science Citation Index, and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based on the level of evidence. (1) Autonomic testing may be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). (2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). (3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber (IENF) density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy.

  • practice parameter the evaluation of distal symmetric polyNeuropathy the role of autonomic testing nerve biopsy and skin biopsy an evidence based review report of the american academy of neurology the american association of neuromuscular and electro
    Pm&r, 2009
    Co-Authors: John D England, Jeffrey A. Cohen, Gary S Gronseth, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski, Norman Latov
    Abstract:

    Background: Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyNeuropathy. Methods: A literature review using MEDLINE, EMBASE, and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based upon the level of evidence. Results and Recommendations: 1) Autonomic testing should be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). 2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). 3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy. Neurology ® 2009;72:177–184

John D England - One of the best experts on this subject based on the ideXlab platform.

  • practice parameter evaluation of distal symmetric polyNeuropathy role of autonomic testing nerve biopsy and skin biopsy an evidence based review report of the american academy of neurology american association of neuromuscular and electrodiagnostic m
    Neurology, 2009
    Co-Authors: Jeffrey A. Cohen, John D England, Gary S Gronseth, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski
    Abstract:

    Background: Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyNeuropathy. Methods: A literature review using MEDLINE, EMBASE, and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based upon the level of evidence. Results and Recommendations: 1) Autonomic testing should be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). 2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). 3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy. AAN = American Academy of Neurology; AANEM = American Academy of Neuromuscular and Electrodiagnostic Medicine; AAPMR ART = autonomic reflex testing; BRSI = baroreflex sensitivity index; CASS = composite autonomic scoring scale; CIDP = chronic inflammatory demyelinating polyNeuropathy; DSFN = distal small fiber Neuropathy; DSP = distal symmetric polyNeuropathy; EDx = electrodiagnosis; EFNS = European Federation of Neurological Societies; HRV = heart rate variability; IAN = idiopathic autonomic Neuropathy; IENF = intraepidermal nerve fibers; MSNA = muscle sympathetic nerve activity; NCSs = nerve conduction studies; PGP 9.5 = protein-gene-product 9.5; PN = peripheral Neuropathy; PRT = blood pressure recovery time; QAE = quantitative autonomic examination; QSART = quantitative sudomotor axon reflex test; QSS = Quality Standards Subcommittee; QST = quantitative sensory testing; SFSN = small fiber sensory polyNeuropathy; TST = thermoregulatory sweat testing.

  • practice parameter evaluation of distal symmetric polyNeuropathy role of autonomic testing nerve biopsy and skin biopsy an evidence based review report of the american academy of neurology american association of neuromuscular and electrodiagnostic m
    Neurology, 2009
    Co-Authors: John D England, Jeffrey A. Cohen, Gary S Gronseth, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski
    Abstract:

    Background: Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyNeuropathy. Methods: A literature review using MEDLINE, EMBASE, and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based upon the level of evidence. Results and Recommendations: 1) Autonomic testing should be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). 2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). 3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy. Neurology ® 2009;72:177–184

  • practice parameter the evaluation of distal symmetric polyNeuropathy the role of autonomic testing nerve biopsy and skin biopsy an evidence based review report of the american academy of neurology the american association of neuromuscular and electro
    Pm&r, 2009
    Co-Authors: John D England, Jeffrey A. Cohen, Gary S Gronseth, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski, Norman Latov
    Abstract:

    Background: Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyNeuropathy. Methods: A literature review using MEDLINE, EMBASE, and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based upon the level of evidence. Results and Recommendations: 1) Autonomic testing should be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). 2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). 3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy. Neurology ® 2009;72:177–184

  • Practice Parameter: Evaluation of distal symmetric polyNeuropathy: Role of autonomic testing, nerve biopsy, and skin biopsy (an evidence-based review): Report of the American Academy of Neurology, American Association of Neuromuscular and Electrodiag
    'Ovid Technologies (Wolters Kluwer Health)', 2009
    Co-Authors: John D England, Jeffrey A. Cohen, Gary S Gronseth, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski, G. Franklin, Norman Latov
    Abstract:

    Background:: Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyNeuropathy. METHODS:: A literature review using MEDLINE, EMBASE, and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based upon the level of evidence. RESULTS AND RECOMMENDATIONS:: 1) Autonomic testing should be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). 2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). 3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy. GLOSSARY: AAN = American Academy of Neurology; AANEM = American Academy of Neuromuscular and Electrodiagnostic Medicine; AAPM&R = American Academy of Physical Medicine and Rehabilitation; ART = autonomic reflex testing; BRSI = baroreflex sensitivity index; CASS = composite autonomic scoring scale; CIDP = chronic inflammatory demyelinating polyNeuropathy; DSFN = distal small fiber Neuropathy; DSP = distal symmetric polyNeuropathy; EDx = electrodiagnosis; EFNS = European Federation of Neurological Societies; HRV = heart rate variability; IAN = idiopathic autonomic Neuropathy; IENF = intraepidermal nerve fibers; MSNA = muscle sympathetic nerve activity; NCSs = nerve conduction studies; PGP 9.5 = protein-gene-product 9.5; PN = peripheral Neuropathy; PRT = blood pressure recovery time; QAE = quantitative autonomic examination; QSART = quantitative sudomotor axon reflex test; QSS = Quality Standards Subcommittee; QST = quantitative sensory testing; SFSN = small fiber sensory polyNeuropathy; TST = thermoregulatory sweat testing

Gary S Gronseth - One of the best experts on this subject based on the ideXlab platform.

  • practice parameter evaluation of distal symmetric polyNeuropathy role of autonomic testing nerve biopsy and skin biopsy an evidence based review report of the american academy of neurology american association of neuromuscular and electrodiagnostic m
    Neurology, 2009
    Co-Authors: Jeffrey A. Cohen, John D England, Gary S Gronseth, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski
    Abstract:

    Background: Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyNeuropathy. Methods: A literature review using MEDLINE, EMBASE, and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based upon the level of evidence. Results and Recommendations: 1) Autonomic testing should be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). 2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). 3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy. AAN = American Academy of Neurology; AANEM = American Academy of Neuromuscular and Electrodiagnostic Medicine; AAPMR ART = autonomic reflex testing; BRSI = baroreflex sensitivity index; CASS = composite autonomic scoring scale; CIDP = chronic inflammatory demyelinating polyNeuropathy; DSFN = distal small fiber Neuropathy; DSP = distal symmetric polyNeuropathy; EDx = electrodiagnosis; EFNS = European Federation of Neurological Societies; HRV = heart rate variability; IAN = idiopathic autonomic Neuropathy; IENF = intraepidermal nerve fibers; MSNA = muscle sympathetic nerve activity; NCSs = nerve conduction studies; PGP 9.5 = protein-gene-product 9.5; PN = peripheral Neuropathy; PRT = blood pressure recovery time; QAE = quantitative autonomic examination; QSART = quantitative sudomotor axon reflex test; QSS = Quality Standards Subcommittee; QST = quantitative sensory testing; SFSN = small fiber sensory polyNeuropathy; TST = thermoregulatory sweat testing.

  • practice parameter evaluation of distal symmetric polyNeuropathy role of autonomic testing nerve biopsy and skin biopsy an evidence based review report of the american academy of neurology american association of neuromuscular and electrodiagnostic m
    Neurology, 2009
    Co-Authors: John D England, Jeffrey A. Cohen, Gary S Gronseth, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski
    Abstract:

    Background: Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyNeuropathy. Methods: A literature review using MEDLINE, EMBASE, and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based upon the level of evidence. Results and Recommendations: 1) Autonomic testing should be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). 2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). 3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy. Neurology ® 2009;72:177–184

  • practice parameter the evaluation of distal symmetric polyNeuropathy the role of autonomic testing nerve biopsy and skin biopsy an evidence based review report of the american academy of neurology the american association of neuromuscular and electro
    Pm&r, 2009
    Co-Authors: Gary S Gronseth, Jeffrey A. Cohen, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski, Norman Latov
    Abstract:

    Background Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy and skin biopsy for the assessment of polyNeuropathy. Methods A literature review using MEDLINE, EMBASE, Science Citation Index and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based upon the level of evidence. Results and Conclusions 1. Autonomic testing may be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). 2. Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). 3. Skin biopsy is a validated technique for determining intraepidermal nerve fiber (IENF) density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy.

  • evaluation of distal symmetric polyNeuropathy the role of autonomic testing nerve biopsy and skin biopsy an evidence based review
    Muscle & Nerve, 2009
    Co-Authors: Gary S Gronseth, Jeffrey A. Cohen, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski, Norman Latov
    Abstract:

    Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyNeuropathy. A literature review using MEDLINE, EMBASE, Science Citation Index, and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based on the level of evidence. (1) Autonomic testing may be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). (2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). (3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber (IENF) density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy.

  • practice parameter the evaluation of distal symmetric polyNeuropathy the role of autonomic testing nerve biopsy and skin biopsy an evidence based review report of the american academy of neurology the american association of neuromuscular and electro
    Pm&r, 2009
    Co-Authors: John D England, Jeffrey A. Cohen, Gary S Gronseth, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski, Norman Latov
    Abstract:

    Background: Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyNeuropathy. Methods: A literature review using MEDLINE, EMBASE, and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based upon the level of evidence. Results and Recommendations: 1) Autonomic testing should be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). 2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). 3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy. Neurology ® 2009;72:177–184

Arthur K Asbury - One of the best experts on this subject based on the ideXlab platform.

  • practice parameter evaluation of distal symmetric polyNeuropathy role of autonomic testing nerve biopsy and skin biopsy an evidence based review report of the american academy of neurology american association of neuromuscular and electrodiagnostic m
    Neurology, 2009
    Co-Authors: Jeffrey A. Cohen, John D England, Gary S Gronseth, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski
    Abstract:

    Background: Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyNeuropathy. Methods: A literature review using MEDLINE, EMBASE, and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based upon the level of evidence. Results and Recommendations: 1) Autonomic testing should be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). 2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). 3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy. AAN = American Academy of Neurology; AANEM = American Academy of Neuromuscular and Electrodiagnostic Medicine; AAPMR ART = autonomic reflex testing; BRSI = baroreflex sensitivity index; CASS = composite autonomic scoring scale; CIDP = chronic inflammatory demyelinating polyNeuropathy; DSFN = distal small fiber Neuropathy; DSP = distal symmetric polyNeuropathy; EDx = electrodiagnosis; EFNS = European Federation of Neurological Societies; HRV = heart rate variability; IAN = idiopathic autonomic Neuropathy; IENF = intraepidermal nerve fibers; MSNA = muscle sympathetic nerve activity; NCSs = nerve conduction studies; PGP 9.5 = protein-gene-product 9.5; PN = peripheral Neuropathy; PRT = blood pressure recovery time; QAE = quantitative autonomic examination; QSART = quantitative sudomotor axon reflex test; QSS = Quality Standards Subcommittee; QST = quantitative sensory testing; SFSN = small fiber sensory polyNeuropathy; TST = thermoregulatory sweat testing.

  • practice parameter evaluation of distal symmetric polyNeuropathy role of autonomic testing nerve biopsy and skin biopsy an evidence based review report of the american academy of neurology american association of neuromuscular and electrodiagnostic m
    Neurology, 2009
    Co-Authors: John D England, Jeffrey A. Cohen, Gary S Gronseth, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski
    Abstract:

    Background: Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyNeuropathy. Methods: A literature review using MEDLINE, EMBASE, and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based upon the level of evidence. Results and Recommendations: 1) Autonomic testing should be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). 2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). 3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy. Neurology ® 2009;72:177–184

  • practice parameter the evaluation of distal symmetric polyNeuropathy the role of autonomic testing nerve biopsy and skin biopsy an evidence based review report of the american academy of neurology the american association of neuromuscular and electro
    Pm&r, 2009
    Co-Authors: Gary S Gronseth, Jeffrey A. Cohen, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski, Norman Latov
    Abstract:

    Background Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy and skin biopsy for the assessment of polyNeuropathy. Methods A literature review using MEDLINE, EMBASE, Science Citation Index and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based upon the level of evidence. Results and Conclusions 1. Autonomic testing may be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). 2. Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). 3. Skin biopsy is a validated technique for determining intraepidermal nerve fiber (IENF) density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy.

  • evaluation of distal symmetric polyNeuropathy the role of autonomic testing nerve biopsy and skin biopsy an evidence based review
    Muscle & Nerve, 2009
    Co-Authors: Gary S Gronseth, Jeffrey A. Cohen, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski, Norman Latov
    Abstract:

    Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyNeuropathy. A literature review using MEDLINE, EMBASE, Science Citation Index, and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based on the level of evidence. (1) Autonomic testing may be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). (2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). (3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber (IENF) density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy.

  • practice parameter the evaluation of distal symmetric polyNeuropathy the role of autonomic testing nerve biopsy and skin biopsy an evidence based review report of the american academy of neurology the american association of neuromuscular and electro
    Pm&r, 2009
    Co-Authors: John D England, Jeffrey A. Cohen, Gary S Gronseth, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski, Norman Latov
    Abstract:

    Background: Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyNeuropathy. Methods: A literature review using MEDLINE, EMBASE, and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based upon the level of evidence. Results and Recommendations: 1) Autonomic testing should be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). 2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). 3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy. Neurology ® 2009;72:177–184

Jeffrey A. Cohen - One of the best experts on this subject based on the ideXlab platform.

  • practice parameter evaluation of distal symmetric polyNeuropathy role of autonomic testing nerve biopsy and skin biopsy an evidence based review report of the american academy of neurology american association of neuromuscular and electrodiagnostic m
    Neurology, 2009
    Co-Authors: Jeffrey A. Cohen, John D England, Gary S Gronseth, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski
    Abstract:

    Background: Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyNeuropathy. Methods: A literature review using MEDLINE, EMBASE, and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based upon the level of evidence. Results and Recommendations: 1) Autonomic testing should be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). 2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). 3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy. AAN = American Academy of Neurology; AANEM = American Academy of Neuromuscular and Electrodiagnostic Medicine; AAPMR ART = autonomic reflex testing; BRSI = baroreflex sensitivity index; CASS = composite autonomic scoring scale; CIDP = chronic inflammatory demyelinating polyNeuropathy; DSFN = distal small fiber Neuropathy; DSP = distal symmetric polyNeuropathy; EDx = electrodiagnosis; EFNS = European Federation of Neurological Societies; HRV = heart rate variability; IAN = idiopathic autonomic Neuropathy; IENF = intraepidermal nerve fibers; MSNA = muscle sympathetic nerve activity; NCSs = nerve conduction studies; PGP 9.5 = protein-gene-product 9.5; PN = peripheral Neuropathy; PRT = blood pressure recovery time; QAE = quantitative autonomic examination; QSART = quantitative sudomotor axon reflex test; QSS = Quality Standards Subcommittee; QST = quantitative sensory testing; SFSN = small fiber sensory polyNeuropathy; TST = thermoregulatory sweat testing.

  • practice parameter evaluation of distal symmetric polyNeuropathy role of autonomic testing nerve biopsy and skin biopsy an evidence based review report of the american academy of neurology american association of neuromuscular and electrodiagnostic m
    Neurology, 2009
    Co-Authors: John D England, Jeffrey A. Cohen, Gary S Gronseth, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski
    Abstract:

    Background: Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyNeuropathy. Methods: A literature review using MEDLINE, EMBASE, and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based upon the level of evidence. Results and Recommendations: 1) Autonomic testing should be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). 2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). 3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy. Neurology ® 2009;72:177–184

  • practice parameter the evaluation of distal symmetric polyNeuropathy the role of autonomic testing nerve biopsy and skin biopsy an evidence based review report of the american academy of neurology the american association of neuromuscular and electro
    Pm&r, 2009
    Co-Authors: Gary S Gronseth, Jeffrey A. Cohen, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski, Norman Latov
    Abstract:

    Background Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy and skin biopsy for the assessment of polyNeuropathy. Methods A literature review using MEDLINE, EMBASE, Science Citation Index and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based upon the level of evidence. Results and Conclusions 1. Autonomic testing may be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). 2. Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). 3. Skin biopsy is a validated technique for determining intraepidermal nerve fiber (IENF) density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy.

  • evaluation of distal symmetric polyNeuropathy the role of autonomic testing nerve biopsy and skin biopsy an evidence based review
    Muscle & Nerve, 2009
    Co-Authors: Gary S Gronseth, Jeffrey A. Cohen, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski, Norman Latov
    Abstract:

    Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyNeuropathy. A literature review using MEDLINE, EMBASE, Science Citation Index, and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based on the level of evidence. (1) Autonomic testing may be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). (2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). (3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber (IENF) density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy.

  • practice parameter the evaluation of distal symmetric polyNeuropathy the role of autonomic testing nerve biopsy and skin biopsy an evidence based review report of the american academy of neurology the american association of neuromuscular and electro
    Pm&r, 2009
    Co-Authors: John D England, Jeffrey A. Cohen, Gary S Gronseth, Gary M Franklin, Arthur K Asbury, Gregory T Carter, Laurence J Kinsella, Kinga Szigeti, James R Lupski, Norman Latov
    Abstract:

    Background: Distal symmetric polyNeuropathy (DSP) is the most common variety of Neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyNeuropathy. Methods: A literature review using MEDLINE, EMBASE, and Current Contents was performed to identify the best evidence regarding the evaluation of polyNeuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based upon the level of evidence. Results and Recommendations: 1) Autonomic testing should be considered in the evaluation of patients with polyNeuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic Neuropathy (Level B) and distal small fiber sensory polyNeuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). 2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected Amyloid Neuropathy, monoNeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyNeuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). 3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyNeuropathy. Neurology ® 2009;72:177–184