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Intraepidermal Nerve Fiber Assessment
A New Window on Peripheral Neuropathy
Arch Neurol. 1998;55:1505-1506.
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NEUROLOGISTS ARE frequently asked to evaluate patients with numb, tingling, or painful feet thought to be caused by peripheral neuropathy. The 3 challenges that the neurologist faces in this situation are (1) to objectively determine whether there is a peripheral neuropathy, (2) to determine the cause of the peripheral neuropathy, and (3) to treat and monitor the peripheral neuropathy. In most instances, the diagnosis of a peripheral neuropathy can be easily established by careful neurologic examination, which is often supplemented by an electrophysiologic assessment with nerve conduction studies (NCS) and needle electromyography (EMG). The biopsy of a sensory peripheral nerve, such as a sural or superficial peroneal nerve, is not necessary in most cases of neuropathy. A nerve biopsy is seldom done to determine whether a peripheral neuropathy is present, but is usually done for the purpose of establishing the cause of a neuropathy resulting from vasculitis, sarcoidosis, or acquired . . . [Full Text of this Article]
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