CLINICAL AND ETIOLOGICAL STUDY OF PERIPHERAL NEUROPATHY WITH SPECIAL REFERENCE TO NERVE CONDUCTION STUDY

Abstract

Background: Peripheral neuropathy refers to any disorder of the peripheral nervous system. It is
a common neurological disorder with variable presentations and numerous etiologies. Nerve
conduction studies are an extension of clinical history and examination. NCS are less invasive,
and are sensitive to both myelin sheath and axonal changes. It is an excellent measure of the
function of the PNS and provides a reliable index of measurement in the diagnosis, treatment,
and prognosis of the patient.
Objectives: To study the clinical parameters and etiologies in suspected cases of peripheral
neuropathy, and its association with nerve conduction study.
Methods: 100 patients of both genders above the age of 18 years, with clinical features
suggestive of peripheral neuropathy, were observed to study the etiology and correlate clinical
parameters with nerve conduction study to assess the severity of peripheral neuropathy.
Results: Out of 100 subjects, 57 were male and 43 were females (M:F = 1.3:1). Most common
clinical presentation in our study was burning/ tingling/ pricking sensation in the limbs, followed
by numbness/ loss of sensation. Most common etiology was observed to be diabetes mellitus,
followed by chronic ethanol abuse. Majority of patients presenting with burning/ tingling/
pricking sensation revealed mixed sensory motor lesions on the NCS with demyelinating nerve
injury.
Conclusion: NCS is a reliable investigation in diagnosis, treatment, and prognosis of peripheral
neuropathy. Most frequent presenting symptom was burning/ tingling sensation, followed by
numbness. Most common etiology was diabetes, followed by chronic ethanol abuse. We inferred
that patients with multiple etiologies of peripheral neuropathy had more severe findings on NCS
as compared to those presenting with single etiologies. Majority of patients with mild symptoms
were found to have pure sensory demyelinating lesions on NCS, whereas severe neuropathic
symptoms revealed mixed sensory motor lesions with axonal and demyelinating injury on NCS.
Hence, clinical examination and NCS will guide the clinician to assess the severity of peripheral
neuropathy, its prognosis, and promote better management of patients.