Contribution and Limitations of Electroneuromyography in the Evaluation of Neuropathic Pain: A Single-Center Retrospective Study of 315 Patients

Abstract

Introduction: Neuropathic pain is a common reason for consultation in neurology. Electroneuromyography (ENMG) is widely used in the assessment of peripheral nervous system disorders; however, its role in the diagnosis of neuropathic pain remains debated, particularly due to its limitations in evaluating small fiber involvement. Objective: To assess the contribution and limitations of ENMG in patients presenting with symptoms suggestive of neuropathic pain. Methods: We conducted a retrospective descriptive study over a 10-month period (January–October 2025), including 315 patients referred for ENMG. Clinical, demographic, and electrophysiological data were analyzed. Results: The study population was predominantly female (77.8%), with a mean age of 42 years (range: 9–76 years). Sensory symptoms were the main reason for referral (58%). Diabetes was present in 46% of patients. ENMG findings were normal in 44% of cases. Among abnormal findings, carpal tunnel syndrome was the most frequent (21%), followed by length-dependent polyneuropathies (17%) and radiculopathies (9%). Conclusion: ENMG is an essential tool in the evaluation of peripheral neuropathies. However, the high rate of normal findings highlights its limitations, particularly in small fiber involvement, emphasizing the need for complementary diagnostic approaches.