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In the 10-step approach,the history and neurologic examination place the patient's disorder into one of perhaps 21 anatomic-pathologic patterns. Next,electrophysiologic and other tests confirm the correctness of this anatomic-pathologic pattern.Finally,a series of evaluations exclude or include an increasingly shorter list of diagnoses until only one remains or the disorder remains undiagnosed.We advocate the 10-step over the shotgun or or gestalt approach,because it emphasizes careful initial characterization of neuropathy and emphasizes use of a logical step-by- step inclusion or exclusion to arrive at a short list of diagnostic possibilities.The approach depends ultimately on the judgment of adequately trained and experienced physicians,not on the results of single tests.the 10-step approach is not a mindless algorithm,leading inevitably to the correct diagnosis,but depends on judgment based on extensive background and neurobiologic and clinical knowledge and training. |
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algorithm
cost effectiveness
electromyogram
nerve biopsy
nerve biopsy,indication
nerve conduction studies
neurologic disease,diagnoses of
neurologic history
neuropathy
neuropathy,classification of
neuropathy,work up for
review article
sensory testing,quantitative
treatment of neurologic disorder
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