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 Information on Peripheral Neuropathy

 alternatives treatment of disease  read our e-book 

Peripheral Neuropathy guidelines                      most of neuropathy is really CIDP.

Numbness is feet and pain is usually termed neuropathy its very common in diabetics, the modern name has changed to the very cause of neuropathy. Its currently labeled CIDP. 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.

This is a more scientific page for doctors and medical students.

Figure 5. Pes cavus

High-arched foot results from a chronic imbalance of intrinsic foot muscles in Charcot-Marie-Tooth disease.

 
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-Barré 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