Additional tests to investigate neuropathic pain. The value of electroneuromyography for neuropathic pain

Abstract

BACKGROUND AND OBJECTIVES: Neuropathic pain is defined as pain induced by injury or disease involving the somatosensory system. Dysfunctions in anatomic regions responsible for the processing of pain may involve peripheral and central nervous system components. A careful history and clinical evaluation with special attention to neurologic propaedeutics are critical for the syndromic, anatomic and etiologic diagnosis of neuropathic pain. However, diagnosis is not always simple and often depends on additional tests. This chapter aimed at reviewing most commonly used additional tests in the clinical practice to help diagnosing neuropathic pain. CONTENTS: Electroneuromyography is primarily indicated for topographic, etiologic and prognostic diagnosis of peripheral nervous system diseases and for the differential diagnosis between neurogenic, myopathic and neuromuscular junction diseases. It gives real time information on what is going on in the nerve and the muscle, being fundamentally important for differential neuromuscular disease diagnosis. Some imaging methods, such as computerized tomography and magnetic resonance, for their spatial resolution, give details of anatomic structures. Other methods, such as positron emission tomography scan and functional magnetic resonance, in addition to anatomic details, also provide data on metabolic and functional measurements. In addition, imaging techniques such as spectroscopy and diffusion tensor magnetic resonance, allow the study of brain biochemical changes and conectivities with different temporal and spatial resolutions. Other additional tests, such as sensory quantification test and microneurography are seldom used in the clinical practice. CONCLUSION: Additional tests, together with careful history and neurological evaluation focused on neurologic propaedeutics, may provide important data for the diagnosis of neuropathic pain and are often used in the clinical practice.

The Primary Motor Cortex Stimulation Attenuates Cold Allodynia in a Chronic Peripheral Neuropathic Pain Condition in <i>Rattus norvegicus</i>

“…It is known that the sensory dysfunction detected in patients with chronic neuropathic pain involves both mechanical and thermal dysfunctions and, as shown in the present study, rodents with neuropathic pain present markedly cold allodynia. Some studies using fRMI approaches before and after the injury demonstrated that the mechanical stimulation of the skin produced increased pain in the area of secondary hyperalgesia leading to greater activation in areas of the brain associated with pain signalling [41] [42].…”

Investigation of concordance between referral diagnosis and electroneuromyographic diagnosis

“…Concordance between preliminary diagnosis and post-ENMG diagnosis of patients has been discussed in many studies. Different consistency rates were determined in these studies [3,9]. It is thought that the present study will contribute to the existing literature.…”

“…Although an important diagnostic tool such as genetic examination and fast-growing imaging techniques nowadays, ENMG has frequently been used examination and treatment response of entrapment neuropathies, anterior horn motor neuron disease, neuropathy, polyneuropathy, radiculopathy, nerve muscle junction disease and muscle diseases since the year 1940 [1,2]. ENMG still maintains its importance despite advanced diagnostic tools also it is considered as the gold-standard tool to evaluate the nerve function [3,4]. Main parameters of the electrophysiological studies are latency, amplitude and conduction velocity.…”

Complicações Do Diabetes Mellitus Em Idosos Diabéticos: Neuropatia E Vasculopatia

“…Exames clínicos, testes de sensibilidade, estudos eletrofisiológicos e estudos de condução nervosa, são comuns para avaliar o comprometimento dos nervos. Além disso, a monitorização regular dos pés e a identificação precoce de qualquer lesão ou anormalidade são cruciais para prevenir complicações mais graves, como úlceras ou infecções (Porto;Porto;Britto, 2016) Os pacientes com neuropatia, podem beneficiar-se de medidas específicas para proteger os pés. Isso inclui o uso de calçados adequados, inspeção regular dos pés, maneiras corretas de cortar de unhas.…”

“…O ultrassom com Doppler é comumente empregado para avaliar o fluxo sanguíneo em artérias e veias, identificando possíveis obstruções ou estreitamentos. Exames avançados, como a Angiografia por Ressonância Magnética (ARM) e a Angiografia por Tomografia Computadorizada (CTA),proporcionam imagens detalhadas das artérias em diferentes partes do corpo(Porto;Porto; Britto., 2016).…”