cqvip:Although paresthesias of the distal lower limbs are characteristic features of polyneuropathy, they may also herald the presence of a focal neuropathy, polyra diculopathy, or myelopathy. Electromyography and nerve conduction studies (EMG/N CS) are widely used in the evaluation of such symptoms, but their utility has no t been subjected to vigorous scrutiny. We investigated the clinical impact of th e electrodiagnostic consultation in assessing suspected polyneuropathy. When com pared with the clinical impression, the result of the electrodiagnostic consulta tion was confirmatory in only 39%of all patients, and changed the diagnosis or uncovered an additional diagnosis in 43%. An alternative diagnosis was likely w hen either weakness was present (75%) or the Achilles stretch reflex was preser ved (48%). These data support the use of EMG/NCS in the diagnostic evaluation o f patients presenting with distal paresthesias, especially in those with preserv ed Achilles reflexes or motor deficits.
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