Laboratory Evaluation of Peripheral Neuropathy - 27/10/25

Doi : 10.1016/j.ncl.2025.05.009

David S. Saperstein, MD ^a,^b,^⁎ , Todd D. Levine, MD ^c, Richard J. Barohn, MD ^d, Jonathan S. Katz, MD ^e, Mazen M. Dimachkie, MD ^f,^g
^a University of Arizona College of Medicine, Phoenix, AZ, USA
^b Center for Complex Neurology, EDS & POTS, Phoenix, AZ, USA
^c CND Life Sciences Medical Laboratory, Scottsdale, AZ, USA
^d Department of Neurology, School of Medicine, University of Missouri, Columbia, USA
^e Forbes Norris ALS Research and Treatment Center, Sutter Health, San Francisco, CA, USA
^f Neuromuscular Division, Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
^g Institute for Neurological Discoveries, School of Medicine

^∗Corresponding author. Center for Complex Neurology, EDS & POTS, 1010 E McDowell Road, Suite 101, Phoenix, AZ 85006.Center for Complex NeurologyEDS & POTS1010 E McDowell RoadSuite 101PhoenixAZ85006

Résumé

This comprehensive review provides a practical, pattern-based framework for the laboratory evaluation of peripheral neuropathy, aimed at improving diagnostic efficiency and therapeutic outcomes. The authors advocate for a structured approach that tailors testing to specific clinical patterns rather than employing a broad, undirected testing strategy. By focusing on high-yield, low-cost investigations and deemphasizing unnecessary or bundled antibody panels, this methodology aims to reduce patient burden and health care costs, while prioritizing the identification of treatable conditions. The review integrates expert consensus with current evidence to offer diagnostic algorithms and commentary on test utility for each neuropathy subtype.

Le texte complet de cet article est disponible en PDF.

Keywords : Peripheral neuropathy, Laboratory evaluation, Small fiber neuropathy, Sensory ataxia, Motor neuropathy, Autonomic neuropathy