Micrograph of a muscle biopsy The diagnosis of<unk> es begins with a history and physical examination to ascertain the pattern of the disease process (such as-arms, legs, distal, proximal) if they fluctuate, and what deficits and pain are involved. If pain is a factor, determining where and how long the pain has been present is important, one also needs to know what disorders are present within the family and what diseases the person may have. Although diseases often are suggested by the physical examination and history alone, tests that may be employed include: electrodiagnostic testing, serum protein electrophoresis, nerve conduction studies, urinalysis, serum creatine kinase (CK) and antibody testing (nerve biopsy is sometimes done). Other tests may be used, especially tests for specific disorders associated with<unk> es, quality measures have been developed to diagnose patients with distal symmetrical<unk>  (DSP). Differential diagnosis In terms of the differential diagnosis for<unk>  one must look at the following:
Polyneuropathy
Lead poisoning
Tropical neuropathy
Polyradiculoneuropathy
Peripheral mononeuropathy
Giant axonal neuropathy
Vasculitic neuropathy
Diabetic neuropathy