Diagnosing Neuropathy in Chicago: The 5 Essential Tests Your Neurologist Should Order

If you are experiencing tingling, numbness, or burning sensations in your extremities, finding the root cause is the first step toward relief. At CNS Brain Center, located in Chicago and River Forest, we often see patients who have been told they have "idiopathic neuropathy" simply because standard testing didn't dig deep enough. To effectively treat neuropathy in Chicago, you need a comprehensive diagnostic approach that goes beyond basic reflexes.

A precise diagnosis changes everything. It moves you from symptom management to root-cause treatment. Whether you are visiting our clinic near Roscoe Village or our new facility in River Forest, Dr. Lenny Cohen and our team believe that thorough testing is the bedrock of neurological recovery.

Unlike many practices that refer patients out to hospitals or third-party labs for diagnostics, CNS Brain Center performs the majority of these advanced tests in-house. We value your time and comfort, which is why we have equipped our clinics with state-of-the-art technology to perform the following evaluations right here in our office.

1. Comprehensive Metabolic & Autoimmune Blood Panels

Before looking at the nerves themselves, we must look at the environment in which they live. Your blood provides the fuel and oxygen your nervous system needs to survive.

Why This Matters for Chicago Patients

Many cases of neuropathy are secondary to systemic issues. While diabetes is the most common cause (Diabetic Polyneuropathy), it is far from the only one. A standard "check-up" blood panel is often insufficient.

What We Look For

A specialized neurologist will order an expanded panel that includes:

• Vitamin B12 and Folate levels: Deficiencies here directly strip the myelin sheath (protective coating) from nerves.
• HbA1c: To detect undiagnosed pre-diabetes or diabetes.
• Autoimmune Markers (ANA, SSA/SSB): To check for Sjogren’s syndrome, Lupus, or Rheumatoid Arthritis which can attack nerve fibers.
• Serum Protein Electrophoresis (SPEP): To rule out paraproteinemia or blood cancers affecting nerve function.

By identifying these metabolic markers, CNS Brain Center can often reverse the neuropathy simply by correcting the underlying chemical imbalance.

2. Nerve Conduction Studies (NCS)

When searching for the best neurologist in Chicago, you will likely encounter Nerve Conduction Studies (NCS). This is the "gold standard" for evaluating large nerve fibers.

The "In-House" Advantage

At many clinics, you are given a referral slip and forced to wait weeks for an appointment at a hospital for this test. At CNS Brain Center, we perform Nerve Conduction Studies in-house. Our expert team conducts the testing in the comfort of our private treatment rooms, ensuring faster results and a less stressful experience.

The Science Behind NCS

NCS measures how fast and how strong the electrical signals are moving through your peripheral nerves.

• Velocity: Slow speeds often indicate damage to the myelin sheath (demyelination).
• Amplitude: Low signal strength often indicates damage to the nerve fiber itself (axonal loss).

This test is critical for differentiating between conditions like Carpal Tunnel Syndrome and generalized peripheral neuropathy.

3. Electromyography (EMG)

An EMG is almost always performed alongside an NCS. While the NCS tests the nerve, the EMG tests how the muscle responds to the nerve.

Performed by Experts On-Site

Just like the NCS, we perform EMG testing directly in our Chicago and River Forest offices. Dr. Cohen and our specialized providers handle this delicate procedure personally, ensuring the highest level of accuracy and patient comfort.

Why It Is Essential

• Pinpointing the Damage: EMG helps determine if the weakness is caused by the muscle itself (myopathy) or the nerve controlling it (neuropathy).
• Active vs. Chronic: It can tell the doctor if the nerve damage is actively happening right now, or if it is an old injury that has healed.

For patients seeking neuropathy treatment in River Forest, having an EMG done on-site means we can discuss the findings with you immediately, rather than waiting for a report from a third-party facility.

4. Epidermal Nerve Fiber Density (ENFD) Skin Biopsy

This is the test that sets an expert Chicago neurology clinic apart from a general practitioner.

The "Normal EMG" Paradox

We frequently see patients who have severe burning pain in their feet, yet their EMG and NCS results are "normal." This is because standard tests only measure large nerve fibers. Pain and temperature are transmitted by small nerve fibers.

The Solution: In-House Skin Biopsy

A skin biopsy is the definitive test for Small Fiber Neuropathy. While this sounds complex, it is actually a simple procedure that we perform right here in our office.

• The Procedure: It is a minimally invasive 3mm punch biopsy usually taken from the ankle and thigh. No stitches are required, and you walk out immediately after.
• The Result: If the density of nerve fibers is lower than the age-adjusted norm, Small Fiber Neuropathy is confirmed.

Without this test, many patients are misdiagnosed with Fibromyalgia. At CNS Brain Center, we have the capability to perform this biopsy on-site to validate your pain with objective data.

5. Autonomic Function Testing (QSART or TST)

Neuropathy doesn't just affect how you feel; it affects how your body functions. The autonomic nervous system controls involuntary actions like heart rate, digestion, and sweating.

Testing the "Invisible" Nerves

If you have neuropathy that affects the autonomic nerves, you might experience dizziness when standing (POTS), digestive issues, or abnormal sweating.

• QSART (Quantitative Sudomotor Axon Reflex Test): Measures the nerves that control sweating.
• Thermoregulatory Sweat Test (TST): Evaluates the body’s ability to regulate temperature.

CNS Brain Center is one of the few private practices in the Chicago area equipped to perform these specialized autonomic tests in-house. You do not need to travel to a large university research center to analyze your autonomic nervous system; our team has the technology and expertise to do it locally.

Why Accurate Diagnosis Leads to Better Outcomes

The "wait and see" approach is dangerous when it comes to nerve health. Nerves heal slowly, and once a nerve cell dies, it is difficult to regenerate.

By utilizing these five tests, four of which are performed conveniently in our office, we can classify your condition correctly. Whether you require Medical Hyperbaric Therapy, nutritional infusions, or immune-modulating therapies, the correct diagnosis is the key that unlocks the door to recovery.

Visit CNS Brain Center in Chicago & River Forest

Don’t settle for a diagnosis of "unknown cause." If you are suffering from nerve pain, you deserve a Chicago neurologist who has the tools to dig deeper right at their fingertips.

Call to Action: Take control of your nerve health today. Schedule a comprehensive consultation with Dr. Lenny Cohen at CNS Brain Center. We are accepting new patients at our River Forest and Chicago locations.

Contact CNS Brain Center Today