Predominantly axonal pathophysiology |
Initial tests: |
Serum glucose and glycohemoglobin |
Serum vitamin B12 level |
SPEP and UPEP with immunofixation |
Thyroid function tests |
Serum antinuclear antibodies |
Erythrocyte sedimentation rate |
Additional testing, if history suggestive: |
HIV serology |
Urine/blood for heavy metals |
Urine/blood for porphyrins |
Rheumatoid factor |
Sjögren's disease testing (anti-Ro, anti-La antibodies) |
Anti-Hu antibodies (in patients with sensory neuronopathy) |
Lyme testing |
Vitamin B1 (thiamine) erythrocyte transketolase activation assay or whole blood level |
Methylmalonic acid and homocysteine levels (in patients with borderline low serum vitamin B12 levels) |
Hepatitis screen (for types B and C) |
Predominantly demyelinating pathophysiology |
Initial tests: |
SPEP and UPEP with immunofixation |
Hepatitis screen (for types B and C) |
Lumbar puncture |
Additional testing, if history suggestive: |
Antimyelin associated glycoprotein (MAG) antibodies (in patients with predominantly sensory symptoms) |
Anti-GM1 antibodies (in patients with predominantly motor symptoms) |
HIV |
Genetic testing for Charcot-Marie-Tooth disease; generally, the electrophysiology is also suggestive of a hereditary condition |
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