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Choosing Wisely®

American Association of Neuromuscular & Electrodiagnostic Medicine

Genetic testing is now widely available and can be ordered directly by patients from home. Due to the potential implications of test results and the complexity of testing, patients are advised to speak with their physician or genetic counselor prior to having testing performed. Pre-testing counseling will help patients select appropriate testing, understand the limitations of testing, potential out-of-pocket costs and the effect that positive test results may have on the patient and their ...

Choosing Wisely®

American Association of Neuromuscular & Electrodiagnostic Medicine

Opioids and narcotics include drugs such as hydrocodone, oxycodone, fentanyl and others. Risks related to the use of these drugs include uncontrollable sleepiness and slow or stopped breathing. They are a leading cause of addiction and avoidable death. Opioids may be less risky when used for a short time after some surgeries or when used for pain related to deadly cancers. There are many effective, safer options for neuropathic pain.

Choosing Wisely®

American Association of Neuromuscular & Electrodiagnostic Medicine

Muscle pain or myalgias are common. The likelihood of finding a muscle disease in an individual with muscle pain who has a normal neurologic exam and laboratory tests is quite low.

Choosing Wisely®

American Association of Neuromuscular & Electrodiagnostic Medicine

There is no indication for supplementing with B vitamins in patients with polyneuropathy unless a deficiency has been detected or is highly likely secondary to other medical factors (e.g., gastric bypass surgery). In addition to being an unnecessary expense, excessive vitamin B-6 can lead to toxicity and cause worsening neuropathy.

Choosing Wisely®

American Association of Neuromuscular & Electrodiagnostic Medicine

IVIG is an expensive therapy with side effects that may include severe allergic reactions, headaches and blood clots. It is recommended for use in Guillain-Barre Syndrome, chronic inflammatory demyelinating polyradiculoneuropathy and multifocal motor neuropathy, but not other polyneuropathies.