Diagnosis

Peripheral neuropathy can be diagnosed on the basis of the symptoms, especially abnormal sensations in the feet and reduced or absent ankle reflexes, and the results of standard neurological tests. Electromyography (EMG), in which the electrical activity of a muscle is measured through electrodes, and nerve conduction studies may also be used to detect nerve problems.

In resource-limited settings a symptom questionnaire and reflex tests will be sufficient to accurately diagnose the vast majority of cases of moderate to severe neuropathy (see HIV & AIDS Treatment in Practice, March 2009, for further information on the various symptom questionnaires).

Testing lactate levels in the blood has been proposed a way of determining whether neuropathy is caused by HIV itself or by the nucleoside class of drugs.1 High lactate has been associated with NRTI-mediated neuropathy.

References

  1. Brew B et al. Lactate concentrations distinguish between nucleoside neuropathy and HIV distal symmetrical sensory polyneuropathy. Eighth Conference on Retroviruses and Opportunistic Infections, Chicago, abstract 9, 2001
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