Peripheral Neuropathy
Refer to Neurology unless a neuropathy is expected as part of their disorder e.g. diabetes, where referral is not needed
GPs can request nerve conduction studies but unless the patient is known to Neurology, the report will not include clinical correlation. Nerve conduction studies are not required in a typical symmetrical sensory/motor neuropathy.
Consider restless legs if symptoms but no signs on examination.
For neuropathic pain see NICE CG 173
There is an order set on ICE for blood tests required for referrals:
- FBC
- ESR
- HBA1C
- TSH
- Renal, liver and bone profiles
- B12 and folate
- Plasma Electrophoresis/Ig levels
- Auto Antibody Screen (please specify for Peripheral Neuropathy on ICE)
- Coeliac screen
HIV + syphilis serology if high index of suspicion
CXR
NICE guidelines NG 127
Review Date 18/02/2020
Next Review Date 18/02/2021
Author Dr Andrew Sharp
Contributor Dr Brendan McLean Consultant Neurology RCHT
Version No. 2.0