Investigations

Question 1

Investigation of peripheral neuropathy

Answer 1

Bloods: including ESR, LFTs (alcoholic neuropathy), glucose (diabetic neuropathy), B12, TFTs (hypothyroidism can cause primarily motor neuropathy)

ANCA (vasculitis)

ANA (SLE, Sjrogen’s, scleroderma, RA)

Urinalysis (glucose)

+/- LP if suspecting GBS or CIDP

Nerve conduction studies

Question 2

Investigations in suspected encephalitis?

Answer 2

Bloods: cultures, serum viral PCR, toxoplasma IgM titre, malaria film
Contrast CT head (detects HSV encephalitis)
LP and urgent viral PCR on CSF
EEG

Question 3

Investigations in possible GCS?

Answer 3

LP
Nerve conduction studies (can be normal however)
Serology (campylobacter, EBV/CMV/HIV)
Auto-antibodies (anti-glycosides)
FVC

Question 4

Investigations in meningitis?

Answer 4

Blood cultures, throat swabs, serology (EBV, HIV)
Bloods: FBC for WBC (if low, get help as immunocompromised), LFTs, glucose, coagulation screen
CT head if GCS <15, raised ICP symptoms, or focal neurology
LP if no CI - send CSF for MC&S, Gram stain, protein, glucose, virology/PCR, lactate
CXR if suspect TB