How to detect nerve damage – details of all the tests required

Nerve damage, which in scientific terminology is known as peripheral neuropathy, is essentially a series of damages happening to the nervous system. This damage usually happens to the peripheral nervous system, which along with the central nervous system (including brain and spinal cord) for the entire nervous system of a human body.

The peripheral nervous system involves the connections of the brain to the various body parts of the human body, such as hands, legs, mouth, nose, ears, internal organs, and joints. If any damage happens to this nervous system, the brain is unable to receive and send messages to the aforementioned body parts as well as muscles and skin. This can lead to numbness or pain in the affected point of the nerve damage.

However, there are a series of examinations and tests which are conducted to detect the root cause and carry further with the required treatment of the nerve damage. Following are those tests in the required order:-

1. Preliminary examination – Whatever discomfort or symptoms you might be feeling, you must tell your doctor about it in detail. This includes all the minute details, such as the frequency, time intervals, and the magnitude of pain you are suffering. The more specific you will be about the symptoms to the doctor, the more clearly the doctor will be able to go ahead with the further checkup. After this initial further discussion and examination, the doctor might ask further questions related to your normal health, regarding if you are suffering from other chronic ailments or hereditary diseases and the medications you are taking for them.

2. Neurological examination tests – After all the initial one-to-one discussion with the doctor regarding symptoms and the health condition of yours, he will proceed further with various general neurological tests. These tests generally include a series of various tests, such as testing the sensation of your contact points such as hands and feet with the help of a pin. With this test, the doctor usually tests the various kinds of neurological functions, such as the strength of muscles, the functioning of autonomic nerves, the ability to feel different kinds of sensations, including coolness and hotness.

3. Diagnostic testing – Based on the aforementioned kinds of preliminary neurological examinations, the doctor will then pursue some diagnostic tests. These tests are based on the patient’s medical history and the magnitude and kind of symptoms he/she is facing. The main objective of diagnostic tests is to figure out the kind and frequency of activity of muscles and nerves. The various kinds of tests included in the diagnostic testing include magnetic resonance imaging (MRI), nerve biopsy, and spinal tap. However, the root cause might not be detected for the patients with longstanding neuropathy.

4. Electro-diagnostic testing – If no clear results are obtained from the various diagnostic tests, further detailed examination can be done using more advanced electro-diagnostic tests. These tests are also usually done to measure the activity of nerves and muscles, based on the response of electrical inputs. Based on these tests, the actual magnitude of nerve damage and its root cause is determined. The main electro-diagnostic tests which a neurologist generally recommends are non-invasive neurological ones, such as nerve conduction velocity (NCV) and electromyography (EMG). These tests can also be done along with diagnostic testing in order to have a clearer and elaborative idea of all the aspects related to the concerned nerve damage.

5. Various blood tests – For testing various kinds of side effects such as the presence of toxic elements in blood, abnormality in immune response, and vitamin deficiencies, blood tests are conducted. These blood tests are very beneficial in finding the root causes of neuropathy. These tests include checking the levels of vitamin B12 and folate, as well as the condition of thyroid, liver, and kidney. It also includes tests for oral glucose tolerance, antibodies related to nerve components and celiac disease, hepatitis C and B, and vasculitis evaluation.

6. Advanced additional testing – These tests are considered if the doctor finds the concerned neuropathy is of a specific type when the magnitude and responses are of different types to what the usual suspects are. In such cases, the various kinds of tests included are quantitative sensory testing (QST) and autonomic testing, which are recommended upfront by the doctor.