Peripheral Neuropathies


- See: neuropathic disorders and neuropathic ulceration

- Discussion:
    - neuropathies may be either acute or chronic;
    - acute:
          - Guillain Barre syndrome: best known acute neuropathy;
          - vasculitic neuropathy:
                - random involvement of individual nerves
                - vasculitis due to ischemic infarctions of the nerve fascicles;
                - ref: Primary and secondary vasculitic neuropathy.
    - chronic neuropathies:
          - acute intermittent porphyria
          - charcot marie tooth
          - metabolic diseases: diabetes and B12 deficiency (consider concomitant elevated homocysteine levels);
          - intoxications: lead
          - nutritional: ETOH, thiamine deficiency;
          - carcinomas: (esp of Lung);
          - immunological: amyloidosis, and plasma cell diseases;
    - sensory multiple mononeuropathy:
          - diff dx: sarcoidosis, malignant tumors, retroviruses, leprosy, hepatitis, and Lyme disease;
    - histology:
          - individual fiber atrophy progresses to small group and, in the more chronic forms, large group atrophy;


- Lab Findings:
    - thyroid-stimulating hormone
    - vitamin B12
    - folate
    - angiotensin-converting enzyme
    - lead
    - antibody labs:
         - antineutrophil cytoplasmic antibody; rapid plasma reagin; cryoprotein; serum immunofixation; Lyme antibody; hepatitis B and C antibody; HIV antibody;
                  anti-double-stranded DNA, anti-La, anti-Smith, anti-RNP, and anti–Scl-70 antibodies; and anticardiolipin antibodies;



- Electromyography Findings:
    - slowing of nerve conduction velocity
    - reduction in size of the electrical potential from muscle when nerve is stimulated, w/o marked reduction in conduction velocity

 Images in Clinical Medicine. Pseudoathetosis



Peripheral nerve injuries in the adult with traumatic brain injury

Weak Rules on Toxins and Safety



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Wednesday, May 30, 2012 10:04 am