Polyneuropathy
From IDWiki
Background
- Fairly common neurologic condition
- Categorized as sensory (large or small fibre), motor, or autonomic
- Distal symmetric polyneuropathy is the most common subtype
- Mimics of polyneuropathy include cervical myelopathy
Clinical Manifestations
- Large fibre sensory dysfunction can cause loss of proprioception and gait impairment
- Small fibre sensory dysfunction can cause pain, hyperesthesia, or allodynia
- Can also cause areas of redness and swelling
- Can also cause deep aching, postexertional malaise, and neuropathic itch
- Motor dysfunction can cause weakness, loss of dexterity, gait disturbance
- Autonomic dysfunction can cause orthostatic intolerance, gastroparesis, constipation, diarrhea, neurogenic bladder, sexual dysfunction, pupillomotor symptoms (including burry vision), and vasomotor symptoms (including dry eyes, mouth, and skin, and burning and flushing skin)
Causes
Distal Symmetric Polyneuropathy
- Diabetes mellitus
- Alcohol
- Chronic kidney disease
- Vitamin B12 deficiency
- Adverse effect of medications, including chemotherapy
- Amyloidosis
- MGUS
- HIV
Acute or Subacute Polyneuropathy
- Guillain-Barré syndrome
- Chronic inlammatory demyelinating polyradiculoneuropathy (CIDP) with acute onset
- Vasculitis
- Critical illness polyneuropathy
- Lymphoproliferative disease
- Sarcoidosis
- Organophosphate poisoning
- Diphtheria
- Porphyria
Motor-Predominant Polyneuropathy
- CIDP
- Multifocal motor neuropathy
- Hereditary motor sensory polyneuropathy (e.g. Charcot-Marie-Tooth disease)
- Hereditary motor neuropathy
- Porphyria
- Lead toxicity
- Diphtheria
- Adverse effect of medications, such as dapsone
Mononeuritis Multiplex
- Vasculitis
- Multifocal acquired demyelinating sensory and motor neuropathy (MADSAM)
- Multifocal motor neuropathy
- Amyloidosis
- Sarcoidosis
- Inflammatory bowel disease
- Celiac disease
- Hereditary neuropathy with liability to pressure palsies (HNPP)
- Diabetes mellitus
Autonomic Neuropathy
- Diabetes mellitus
- Alcohol
- Amyloidosis
- Autoimmune autonomic ganglionopathy
- Adverse effect of medications, including amiodarone, vincristine, cisplatin, and paclitaxel
- Sjögren syndrome
- HIV
- Vitamin B12 deficiency
- Heavy metal toxicity, including lead, thallium, mercury
- Hereditary sensory and autonomic neuropathy
