Obligatory medical device diagnostics.
- Electromyography (EMG; measurement of electrical muscle activity) of affected nerves (to determine type of damage (axonal versus demyelinating) or to detect specific patterns of damage (e.g., conduction blocks)) – 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.
- MR neurography (neuroradiological examination using magnetic resonance imaging or magnetic resonance imaging for precise diagnosis of nerve diseases).
- 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-based cross-sectional imaging method (using magnetic fields, i.e., without X-rays); particularly well suited for changes in the spinal cord and brain); indications:
- For assessment of nerve cross-sectional area by neurosonography or MRI: may be helpful in the diagnosis of CIDP (chronic inflammatory demyelinating polyradiculoneuropathy) or CMT (Charcot-Marie-Tooth disease).
- When malignant diseases are suspected for extended tumor search.
- 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) – if diabetic cystopathy (urinary bladder disease) is suspected.
