Lumbar puncture and cerebrospinal fluid analysis may be helpful in the diagnosis of Guillain-Barré syndrome and chronic inflammatory demyelinating neuropathy. Initial blood tests should include a complete blood count, comprehensive metabolic profile, and measurement of erythrocyte sedimentation rate and fasting blood glucose, vitamin B 12, and thyroid-stimulating hormone levels specialized tests should be ordered if clinically indicated. A systematic approach begins with localization of the lesion to the peripheral nerves, identification of the underlying etiology, and exclusion of potentially treatable causes. The diagnosis requires careful clinical assessment, judicious laboratory testing, and electrodiagnostic studies or nerve biopsy if the diagnosis remains unclear. The most common treatable causes include diabetes mellitus, hypothyroidism, and nutritional deficiencies. Peripheral neuropathy has a variety of systemic, metabolic, and toxic causes.
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