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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