- See:
neuropathic disorders
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;
Peripheral nerve injuries in the adult with traumatic brain injury.
