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Peripheral neuropathy types cidpusa.org

 

Autoimmune diseases

Peripheral Neuropathy guidelines

Neuropathy means diseases of the nerve. the symptoms of numbness in feet and burning  pains are usually termed neuropathy its very common in diabetics, the modern name has changed to the very cause of neuropathy. A type of inflammatory neuropathy currently labeled as CIDP., this is usually the cause of daiabetic neuropathy. Please see the links on the left for detailed info on CIDP the real cause of neuropathy and its immediate treatment with IVIg. For a simple discussion see our home page.The following are neuropathies according to location.

Table 1.  Mono- and Generalized Neuropathies Commonly Encountered in Clinical Practice
Mononeuropathies Generalized neuropathies
Cranial neuropathies:
  • Trigeminal neuralgia
  • Bells palsy
  • Diabetic cranial neuropathies

Carpal tunnel syndrome (median nerve)
Cubital tunnel syndrome (ulnar nerve) Sciatic nerve damage following hip replacement
Diabetic mononeuropathy/mononeuropathy multiplex
Amyloidosis
Diabetic neuropathies:
  • Generalized sensorimotor polyneuropathy
  • Autonomic neuropathy
  • Polyradiculopathy

Hereditary neuropathies:
  • Charcot-Marie-Tooth disease
  • Amyloid polyneuropathy
  • Dejerine-Sottas disease
  • Refsums disease
Inflammatory/autoimmune neuropathies:
  • Guillain-Barre syndrome (GBS)
  • Chronic inflammatory demyelinating polyneuropathy (CIDP)
Toxic/metabolic/infectious diseases:
  • Various toxin-induced neuropathies
  • Alcoholic neuropathy
  • HIV neuropathy
  • Lyme neuropathy
  • Uremia
  • Porphyria
Systemic/malignancy-related neuropathies:
  • Paraneoplastic
  • Dysproteinemia
Table 3. Distribution of Neuropathies by Age and in General Population
SubcategoryaAge <49Age >50Overall population
Mononeuropathy
 35%50%30%
Generalized neuropathies
Toxic/metabolic60%55%69%a
Hereditary5%<1%30%a
Malignancy2%10%5%
Idiopathic8%5%5%
a Categories coexist in up to one-third of cases.
Table 4.  Age-Related Changes in the Peripheral Nervous System
TypeChanges
ClinicalDecreased vibratory sense
Decreased threshold response to tactile stimuli, but normal threshold response to pain
No change in position sense
Decreased muscle bulk and strength
HistologicReduction in number of nerve fibers
Preferential loss of large-diameter fibers
Reduction in muscle-fiber size
Decline in number of motor units (distal muscles)
Evidence of denervation and reinnervation with advancing age
PhysiologicDecline in motor- and sensory-nerve conduction velocity (MCV)
Decreased amplitude in sensory-nerve action potential (SNAP)
Increased amplitude and duration of voluntary motor units suggesting denervation and reinnervation

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