A Simplified Screening Protocol Predicts Pathological Electroneurographic Results in Patients with Suspected Polyneuropathy

ABSTRACT

Electroneurographic testing is one of the standard instruments to detect polyneuropathy (PNP). The objective of this study was to develop a screening tool with optimized sensitivity and specificity, consisting of a short questionnaire and a short standardized neurological examination. One hundred one patients with a suspected PNP were prospectively selected from the neurological outpatient clinic. We used a short questionnaire and a short neurological examination derived from the Michigan Neuropathy Screening Instrument (MNSI). Based on electroneurographic results, patients were classified in three groups of different severity. The diagnostic power of the MNSI was optimized by constructing a score based on two combined discrimination functions. The optimized screening tool was able to detect patients suffering from PNP at a sensitivity of 88%%. In particular, a severe form of PNP was recognized at a sensitivity of 97%%. The specificity to detect healthy subjects was 74%%. This new tool is a fast and easy to use instrument which can give a decision support for general practitioners for patients with a suspected PNP as to whether a subsequent electroneurographical examination (ENG) testing will show pathological results.

KEYWORDS: :

• polyneuropathy
• screening
• tool