TABLE 3.
Guidelines | Denmark (2022) | France (2007) | Germany (2019) | Netherlands (2019) | Norway (2022) | Spain d | Turkey (2006) | United States (2012) | United States (2017) |
---|---|---|---|---|---|---|---|---|---|
Indication NCS | Unclear cause or alarm symptoms. a | Not necessary in patients with a clinically distinct homogeneous symmetrical polyneuropathy with a known etiology. b | Every patient. | Unclear cause or alarm symptoms. c | Every patient. | Every patient. | Every patient. | No specific recommendations. | In patients with characteristics corresponding to high yield. e |
Recommended nerves | No specific recommendations. | Sensory: sural nerve bilaterally, peroneal nerve unilateral, median nerve bilaterally, two measurements of ulnar/radial nerve. Motor: peroneal nerve bilaterally (with F‐waves), H‐reflexes of tibial nerves bilaterally, median nerve bilaterally, ulnar nerve unilateral | Sensory: sural, peroneus superficialis, median, and ulnar nerve. Motor: peroneal, tibial, median and ulnar nerve. | Sensory: sural, radial, median, or ulnar nerve. Motor: peroneal and tibial, median, or ulnar nerve. | No specific recommendations. | No specific recommendations. | No specific recommendations. |
1. Sensory: sural, motor: peroneal 2. If sural or peroneal absent: sensory: ulnar and median, motor: ulnar. 3. If a response is absent for any of the nerve's studies, NCS of contralateral nerve should be performed. 4. If peroneal motor absent: ipsilateral tibial motor. |
No specific recommendations. |
Positive family history, acute onset, course relapsing, non‐length distribution, asymmetry, multiple nerves affected.
Diabetes, renal insufficiency, neurotoxic treatment.
Fast progression (4 weeks–6 months) leading to problems with walking or loss of motor function of arms, asymmetry, pure motor or motor dominant, ataxia, non‐length distribution, early autonomic symptoms, severe pain.
Year of publication unknown.
High yield: (1) the patient's history, physical and standard neuropathy blood tests do not indicate a likely etiology, (2) symptoms and/or physical findings are moderate to severe, (3) atypical presentation (predominantly motor symptoms or findings, proximal deficits or asymmetry), (4) rapid progression of symptoms or signs, (5) presence of symptoms or signs indicating another disorder, such as lumbar radiculopathy, (6) unknown duration or severity of the underlying cause, (7) family history suggesting hereditary neuropathy, (8) exposure to substances known to cause neuropathy, including medications, (9) discrepancy between symptoms and signs.