Peripheral Neuropathy

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
Subcategory^a	Age <49	Age >50	Overall population
Mononeuropathy
	35%	50%	30%
Generalized neuropathies
Toxic/metabolic	60%	55%	69%^a
Hereditary	5%	<1%	30%^a
Malignancy	2%	10%	5%
Idiopathic	8%	5%	5%
^a Categories coexist in up to one-third of cases.

Table 4. Age-Related Changes in the Peripheral Nervous System
Type	Changes
Clinical	Decreased vibratory sense Decreased threshold response to tactile stimuli, but normal threshold response to pain No change in position sense Decreased muscle bulk and strength
Histologic	Reduction 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
Physiologic	Decline 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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Peripheral neuropathy types cidpusa.org

Peripheral Neuropathy guidelines