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GBS – Neuropathic Pain Management — SCE Neurology MCQ

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HardPeripheral Neuropathy & NeuromuscularGBS – Neuropathic Pain ManagementSCE Neurology

A 66-year-old has rapidly progressive painful foot drop followed by contralateral wrist drop. ESR is raised, ANCA is negative and systemic imaging is unrevealing. Neurophysiology shows multifocal axonal loss. Which sampling strategy offers the best diagnostic yield?

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Correct answer: B — Biopsy a clinically affected sensory nerve together with adjacent muscle

Suspected non-systemic vasculitic neuropathy requires tissue from a clinically and electrophysiologically involved, safely accessible sensory nerve; adding adjacent muscle can increase yield. Unaffected or contralateral tissue reduces sensitivity, skin–fat biopsy targets other disorders, lymph-node or salivary biopsy lacks a localising indication, and nerve-root biopsy is unnecessarily hazardous.

Reference: Diagnosis and therapeutic options for peripheral vasculitic neuropathy (Published March 2015): https://pmc.ncbi.nlm.nih.gov/articles/PMC4357592/