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2.1
Inherited Neuropathy
Inherited Neuropathies

Presentation

We describe a young woman who presented with postpartum foot drop diagnosed as an iatrogenic L5 root lesion after uncomplicated epidural anesthesia. [ncbi.nlm.nih.gov]

Case Presentation In August 2010, a 30-year-old male financial adviser presented to the hospital having awoken with painless weakness and patchy numbness of his left upper limb. [karger.com]

Power, bulk, gait, and coordination were intact, but distal hyporeflexia was present. Tinel signs were present at the wrists and elbows. No nerves could be palpated. Hammertoes and high arches were present. [emedicine.medscape.com]

Treatment

We now show reduced apoptosis after curcumin treatment of cells in tissue culture that express PMP22 mutants. [ncbi.nlm.nih.gov]

The supportive treatment is generally provided by a multidisciplinary team including neurologists, orthopedic surgeons, physical and occupational therapists; with treatment choices limited to physical therapy, the use of orthotics, surgical treatment [bcbst.com]

Depending on the particular type of neuropathy, the neurologist may provide treatment for neuropathic pain with a variety of drugs such as gabapentin, amitriptyline and analgesics. [hopkinsmedicine.org]

Treatment for Neuropathy There are many medications, and other remedies that can bring you relief, you can read about them in this article Neuropathy. Go to Neuropathy Treatment Section. [mcvitamins.com]

Prognosis

Genetic counseling is important to understand further details about the disease and prognosis. Prognosis The prognosis for individuals with hereditary neuropathies depends upon the type of neuropathy. [ninds.nih.gov]

Prognosis HNPP is not life threatening. Prognosis is good as half of patients recover fully after an episode and half with an incomplete recovery. Residual symptoms are usually relatively mild and do not result in severe disability. [orpha.net]

Prognosis for people with CMT The prognosis for people with hereditary neuropathy depends on the symptoms. Some types of hereditary neuropathy (CMT) progress (get worse) more slowly than other types. [ohsu.edu]

Parents should talk to their own or their children’s physician and medical team about their specific case, associated symptoms and overall prognosis. [rarediseases.org]

It is only by knowing the natural history that one understands the onset of clinical symptoms, the rate of progression, and the ultimate prognosis of these diseases. [clinicaltrials.gov]

Etiology

With a systematic approach to the evaluation of these disorders, approximately 75% of patients have a specific etiologic diagnosis. [clevelandclinicmeded.com]

The etiology may be known (e.g., arsenical, diabetic, ischemic, or traumatic neuropathy) or unknown. encephalopathy and myelopathy are corresponding terms relating to involvement of the brain and spinal cord. [medical-dictionary.thefreedictionary.com]

Etiology HNPP is due to a mutation in the PMP22 gene (17p12), encoding the peripheral myelin protein-22 (PMP22) that is predominantly expressed in the compact myelin of the peripheral nervous system. [orpha.net]

Several demyelinating etiologies can produce a “Dejerine-Sottas” phenotype with early onset, palpable nerves, and marked onion-bulb formation. [now.aapmr.org]

Epidemiology

Summary Epidemiology The actual prevalence is unknown due to under-diagnosis but estimates range between 1/50,000-1/20,000. In Finland, the prevalence is reported to be 1/6250. The disease affects males and females equally. [orpha.net]

Genetic epidemiology of Charcot-Marie-Tooth in the general population. Eur J Neurol 2011; 18: 39-48 51 Vallat JM, Mathis S, Funalot B. The various Charcot-Marie-Tooth diseases. Curr Opin Neurol 2013; 26: 473-480 52 Kleopa KA, Abrams CK, Scherer SS. [thieme-connect.com]

Epidemiology including risk factors and primary prevention HMSN is the most common inherited neuromuscular disease with overall prevalence of approximately 1/2500 and incidence 15/100,000 in the general population. [now.aapmr.org]

Overall prevalence of CMT is usually reported as 1 in 2,500, although several more recent epidemiological studies reported prevalences of CMT ranging from 1 in 1,214 (in Norway) to 1 in 6,500 (in the United Kingdom). [invitae.com]

Pathophysiology

Bersano A, Lanfranconi S, Valcarenghi C, Bresolin N, Micieli G, Baron P (2012) Neurological features of Fabry disease: clinical, pathophysiological aspects and therapy. Acta Neurol Scand 126:77–97 PubMed CrossRef Google Scholar 37. [link.springer.com]

Back to Top Pathophysiology and Natural History Despite the diverse array of medical disorders that cause peripheral neuropathies, peripheral nerves exhibit only a few distinct pathologic reactions to an insult or disease: wallerian degeneration, axonal [clevelandclinicmeded.com]

Importantly, CMT1A has one of the highest de novo mutation rates, similar to neurofibromatosis type 1, as discussed in Pathophysiology. Consequently, cases occur in which a family history is truly absent. [emedicine.medscape.com]

Prevention

We focus on all aspects of disease including diagnosis with genetic confirmation, genetic and family counseling, prevention and management of secondary symptoms and complications, access to clinical research studies and treatment trials and coordination [urmc.rochester.edu]

The prevention of HNPP manifestations can be accomplished by wearing protective padding (e.g., elbow or knee pads) to prevent trauma to nerves during activity. [bcbst.com]

This helps scientists look for better ways to prevent and treat this condition. You can opt out of the register at any time. Find out more about the register. Page last reviewed: 05/09/2017 Next review due: 05/09/2020 [nhs.uk]

Since foot disorders are common with neuropathy, precautions must be taken to strengthen these muscles and use preventative care and physical therapy to prevent injury and deformities. [en.wikipedia.org]

Leg braces prevent ankle sprains and improve walking ability. Surgery: For some people, surgery can help prevent or reverse foot and joint deformities. Pain management: Pain-killing drugs may be prescribed for people who have severe pain. [hnf-cure.org]

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