NEUROPATHY-WORKUP
SUMMARY
GENERAL
1. BSL: fasting
2. HbA1c; or OGTT (more sensitive)
3. Vit B12: check homocystine & MMA if this is borderline
4. Folate
5. TFT (free T4 and TSH)
6. ESR
7. Creatinine, eGFR
8. FBC
9. CXR
10. EMG: for diseases of the muscle, NCS: for diseases of the nerves
DEMYELINATING NEUROPATHY
11. Serum immunoglobulin assay, serum protein electrophoresis, serum immunoglobulin electrophoresis
VASCULITIS
12. CRP, ANA, dsDNA, rheumatoid factor, proteinase-3/myeloperoxidase (ANCA), C3, C4, ACE, SS-A (anti-Ro, for Sjogren), SS-B (anti-La, for Sjogren), Hep B & C panels, cryoglobulin
SENSORY NEUROPATHY
13. Anti-Hu, coeliac screen, VASCULITIS panel
DYSAUTONOMIA
14. Abdominal fat pad aspiration (for amyloidosis), rectal biopsy (for amyloidosis), urinary porphyrins, paraneoplastic Ab panel (ganglionic Ach receptor Ab, anti-Hu Ab), genetic testing (for heriditary sensory neuropathies, Fabry disease)
MALIGNANCY
15. CSF (for infectious, autoimmune or neoplasia); protein-cell dissociation (for GBS/CIDP), pleosytosis (for infections, malignancy)
16. PET/pan-CT, bone marrow/skeletal survey, colonoscopy
IBD/COELIAC
17. Colonoscopy (IBD), duodenal biopsy (coeliac)
SJOGREN/SARCOID
18. CT chest (for sarcoid)
19. Salivary gland biopsy (for Sjogren)
Reference(s)
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].
