New Triad Defines Distal Symmetrical Polyneuropathy : The combined case definition should be particularly useful for clinical and epidemiologic research design.

Clinical Findings Most Predictive of Distal Symmetrical Polyneuropathy

Protocol for Nerve Conduction Studies

The Polyneuropathy Task Force recommended the following protocol for a nerve conduction study (NCS):

▸ Sural sensory and peroneal motor NCSs should be performed in one lower extremity. Normal results from both studies preclude a diagnosis of distal symmetric polyneuropathy.

▸ Abnormal sural sensory or peroneal motor NCS results warrant an NCS of at least the ulnar sensory, median sensory, and ulnar motor nerves in one upper extremity and, if desired, a contralateral sural sensory and one tibial motor NCS. Examiners should be cognizant of the possibility of abnormal median and ulnar studies because of nerve compression at the wrist or ulnar neuropathy at the elbow.

▸ An absent response for any of the sensory or motor nerves studied warrants an NCS of the contralateral nerve.

▸ An absent peroneal motor response calls for an ipsilateral tibial motor NCS.

Minimal criteria for electrodiagnostics confirmation of distal symmetric polyneuropathy is an abnormality of any attribute of nerve conduction in two separate nerves, one of which must be the sural nerve.