Neuropathy

Last updated: Friday, 21, January, 2011
CausesAppropriate Tests

Review clinical features, including distribution of sensory and/or motor abnormalities: it is important to distinguish peripheral neuropathy from spinal cord disease eg, subacute combined degeneration of the cord, tabes dorsalis.

Pathology tests may assist in defining underlying disorders.

Nerve biopsy if diagnosis uncertain, or confirmation required.

Mononeuritis multiplex

Diabetes mellitus

Polyarteritis nodosa

Systemic necrotising vasculitis

See under Vasculitis

Sarcoidosis

Amyloidosis

Leprosy

Polyneuropathy

Alcoholism

Drug reactions

  • Amiodarone
  • Cis-platinum
  • Didanosine (ddl)
  • Zalcitabine (ddC)
  • Stavudine (d4T)
  • Phenytoin
  • Vincristine

Guillain-Barré syndrome 

Cerebrospinal fluid examination - microscopy, protein, protein electrophoresis.

There is characteristically a marked increase in CSF protein, with oligoclonal bands and a normal, or only slightly increased, CSF cell count.

Chronic inflammatory demyelinating polyneuropathy

HIV infection

Syphilis (tabesdorsalis)

Systemic disease, especially

Associated with neoplasia, including

 


See Lung carcinoma

Paraproteinaemia

Cryoglobulinaemia

Toxins, especially

  • Lead
  • Organophosphates
  • Arsenic
  • Thallium

 

See Lead poisoning
See under Poisoning
See under Heavy metal exposure/toxicity
See under Heavy metal exposure/toxicity

Hereditary, including

  • Refsum disease
  • Charcot-Marie-Tooth disease
  • Acute neurological porphyria

 

Phytanate - plasma or serum.
Molecular genetics - individual genetic disorders.
See Charcot-Marie-Tooth disease testing