Case Definition for Polyneuropathy Developed to Standardize Research

January 20, 2005

ST. PAUL, Minn. – A new case definition for distal symmetrical polyneuropathy

has been developed by the American Academy of Neurology, the American

Association of Electrodiagnostic Medicine, and the American Academy of Physical

Medicine and Rehabilitation. The definition is published in the January 25 issue

of Neurology, the scientific journal of the American Academy of Neurology. This

represents a new effort to standardize and facilitate clinical research.

The three organizations initially intended to develop a practice guideline about

treatment for polyneuropathy, a noninflammatory nerve disease. The definition of

polyneuropathy was inconsistent in available studies, making it impossible to

compare the studies and make recommendations for practice. This led to the

decision to write a case definition.

“Where case definitions have been developed, they have improved clinical

research,” said co-author D. England, MD, of Deaconess Billings Clinic in

Billings, Mont.

The author panel evaluated the diagnostic accuracy of the predictors of

polyneuropathy and used an extensive literature review and a formal consensus

process to develop an approach ranked by the likelihood of disease.

According to the definition, the combination of neuropathic symptoms, signs, and

abnormal electrodiagnostic studies provides the most accurate diagnosis of

distal symmetrical polyneuropathy. Electrodiagnostic studies are recommended,

since they are objective and validate tests of peripheral nerve function.

Electrodiagnostic studies should not be used alone to make the diagnosis because

their sensitivity and specificity are not perfect.

The case definition will be available for downloading on January 25 at

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