Multiple consensus panels recommend the inclusion of electrophysiologic testing in the evaluation of diabetic neuropathy. An appropriate array of electrodiagnostic tests includes both nerve conduction testing and needle EMG of the most distal muscles usually affected.
Imaging studies rarely help the physician diagnose or manage diabetic neuropathy. However, in the appropriate clinical setting, MRI of the cervical, thoracic, and/or lumbar regions may help exclude another cause for symptoms mimicking diabetic neuropathy.
Scintigraphic techniques are used to detect and quantify cardiac autonomic neuropathy (for research purposes). Techniques include radiolabeled analogs of norepinephrine, 123I-metaiodobenzylguanidine (MIBG), and 11C-hydroxyephedrine. Adrenergic nerve terminals of the heart actively take up these compounds. Combining this technique with single-photon emission computed tomography (SPECT) scanning allows detection of decreased innervation of the heart.
For more on the workup of diabetic neuropathy, read here.
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Cite this: Dianna Quan, Romesh Khardori. Fast Five Quiz: How Much Do You Know About Diabetic Neuropathy? - Medscape - Jul 13, 2016.