The Diabetic Companion on Neuropathy Primer - Part 6a Neuropathy Tests and Diagnosis_1
Neuropathy tests and diagnosis_1 may require more procedures to arrive at a more definitive answer to what is wrong. Along with checking the activity in the muscles through electromyography, a test can also find how fast the signals travel along the nerves through nerve conduction velocity or NCV.
The nerve conduction velocity will check the flow of the electric current through a nerve. The result is shown on the screen and the doctor will be able to assess the condition. The electromyography is often done at the same time as the NCV. This procedure is sometimes needed along with the other neuropathy tests and diagnosis_1.
To do the NCV, surface electrodes or patches like they use for ECG are placed on the skin over nerves. Each of these patches emits a mild electrical impulse that stimulates the nerve. This is recorded by the other electrodes which then determines the speed of the nerve signals which is based on the distance between the electrodes and the time it takes for the electrical impulses to travel between the electrodes.
To prepare for the test, since low body temperature slows down nerve conduction, it is best to maintain normal body temperature. Also if you have a pacemaker or a cardiac defibrillator, tell your doctor as there may be a need for some precautions. The impulse may feel like an electric shock and it can be uncomfortable but you should feel no pain when the test is over.
The doctor may also request for imaging tests like the CT scan and MRI to look for tumours, herniated disks and other abnormalities. The CT scan (Computed Tomography) a painless non-invasive process is used to produce two dimensional images of the bones, organs and tissues. X-rays go through the body and are identified by a computerized scanner.
MRI or Magnetic Resonance Imaging can examine the size and quality of the muscles and find out whether a nerve fibre has damage and how well the parts are functioning. The MRI creates a magnetic field around the body and radio waves passing through the body. This triggers a signal that can be detected at different angles in the body.
Nerve biopsy can provide important information on the degree of the nerve damage and other abnormalities by removing and examining a small sample of the nerve tissue to examine but it is invasive and difficult to do. In addition it can lead to neuropathic side effects so experts are of the opinion that this is not always necessary for diagnosis especially a nerve biopsy may not always reveal what is damaging the nerves.
Skin biopsy is easier to do, has fewer side effects and is less invasive. It has an advantage over the NCV tests and nerve biopsy. On top of this, it can disclose damage present in smaller fibres. How do they do this? The doctors remove a thin skin sample and then examine the fibre endings of the nerves. This may be needed over and above the other neuropathy tests and diagnosis_1.
Once the diagnosis is made, we will have to manage our condition to make sure we can avoid the complications. One way is to monitor the blood glucose level. The health care provider at this time may already have your A1C test which shows the average amount of glucose in the blood during the last two to three months. Ask the doctor what your target level is so when you test for glucose the result is within the target range. If not, an adjustment on the treatment plan may have to be made.
There we have all the information needed to uncover the condition pertaining to nerve damage. Hopefully, the condition will be revealed early enough to avoid permanent damage and more invasive procedure to correct the situation. That’s why we need this information on neuropathy tests and diagnosis_1.
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