Does Your Bedside Neurological Examination for Suspected Peripheral Neuropathies Measure Up?

SYNOPSIS: Neurological testing is essential for screening and diagnosing suspected peripheral neuropathies. Detecting changes in somatosensory and motor nerve function can also have direct implications for management decisions. Neverthe-less, there is considerable variation in what is in-cluded in a bedside neurological examination and how it is performed. Neurological examinations are often used as screening tools to detect neurologi-cal deficits but not used to their full potential for monitoring progress or deterioration. Here, we advocate for better use of the neurological exami-nation within a clinical reasoning framework. Con-strained by the lack of research in this field, our Viewpoint is based on neuroscientific principles. We highlight 6 challenges for clinicians when conducting neurological examinations and propose ways to overcome these challenges in clinical prac-tice. We challenge widely held ideas about how the results of neurological examinations for peripheral neuropathies are interpreted and how the examina-tions are performed in practice.

Automated summary

Neurological testing is crucial for screening and diagnosing suspected peripheral neuropathies, and detecting changes in nerve function can directly impact treatment decisions. However, there is significant inconsistency in the content and methods of bedside neurological examinations. These examinations are often used as screening tools but not fully utilized for monitoring progress or deterioration. This viewpoint advocates for better integration of neurological examinations within a clinical reasoning framework, highlighting challenges faced by clinicians and proposing ways to overcome them in practice.