Obligatory medical device diagnostics.
- Electromyography (EMG; measurement of electrical muscle activity) of affected nerves – if proximal nerve damage is suspected.
- Electroneurography (ENG; method for measuring nerve conduction velocity) of affected muscles [impaired nerve conduction velocity without symptoms or clinical findings = subclinical diabetic polyneuropathy].
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnostic clarification.
- Neurosonography (synonym: nerve sonography; nerve ultrasound); neurologic ultrasound diagnosis; procedure for imaging the peripheral nerve and its surrounding structures.
- Assessment of the cross-sectional area (CSA) of the entire nerve and individual fascicles.
- Somatosensory evoked potentials (SEP or SSEP; electrical stimulus response to electrostimulation of peripheral nerves of the somatosensory system) – for objectification of sensory deficits.
- Electrocardiogram (ECG; recording of electrical activity of the heart muscle) – to exclude autonomic neuropathy.
- X-ray of the thorax (X-ray thorax/chest) and lungs, in two planes – as an additional examination.
- Computed tomography (CT; sectional imaging method (X-ray images from different directions with computer-based evaluation)); high radiation exposure; often contrast agent required – in suspected malignant (malignant) diseases for extended tumor search.
- Magnetic resonance imaging (MRI; computer-assisted cross-sectional imaging method (using magnetic fields, that is, without X-rays); particularly well suited for changes in the spinal cord and brain) – in suspected malignant diseases for extended tumor search.
- Measurement of heart rate variability (HRV) (synonym: heart rate variability (HRV)): Standard procedure of autonomic nervous function diagnostics – in suspected cardiovascular autonomic neuropathy (CAN)testing of HRV.
- Under deep respiration/breathing (over 1-2 min with a frequency of 6 breaths/minute).
- After change of position
- Orthostasis test – to detect orthostatic hypotension (occurrence of abnormally low blood pressure in a person when standing up from a sitting or lying position)Test procedure: Blood pressure measurement twice within 1 minute while lying down; remeasurement of blood pressure immediately after actively standing up and then every 30 seconds for 3 minutes.Interpretation:Normal value for systolic blood pressure drop: ≤ 27 mmHg.
- Urodynamic diagnostics (including measurement of bladder function during filling via a catheter and subsequent emptying (pressure-flow analysis) to differentiate the various forms of urinary incontinence (stress, urge incontinence also mixed forms, neurogenic bladder) – on suspicion of diabetic cystopathy (urinary bladder disease).
