Presentation
We have discussed the possibility of aluminium phosphide poisoning in view of the clinical presentation. [ncbi.nlm.nih.gov]
Entire Body System
- Pain
Treatment of painful neuropathy should be directed at removing the offending metabolic injury, if possible. [ncbi.nlm.nih.gov]
Diabetic neuropathy commonly causes painful tingling or burning sensations in the hands and feet—a condition called distal polyneuropathy. Pain is often worse at night and may be aggravated by touch or by a change in temperature. [msdmanuals.com]
During this visit, he reported having a burning chest pain which made it difficult to breathe. The pain was daily and continuous, although it improved when lying down, and became more intense in the evening. [archbronconeumol.org]
" 20 Mar. 2018 The spiky shoe inserts mimic peripheral neuropathy, the numbness and pain from nerve damage that often affects hands and feet. — Tara Bahrampour, The Seattle Times, "Loud banging, foot pain, flashes of light: a reporter’s 8 minutes as [merriam-webster.com]
Neuropathic Pain An estimated 10% of the population has neuropathic pain. [neuromodulation.com]
Respiratoric
- Aspiration
Bone marrow aspirate was usually normal. In seven patients definite reversibility of PPN was observed after irradiation of plasmacytoma. [ncbi.nlm.nih.gov]
Musculoskeletal
- Osteoporosis
Eleven patients had either osteoporosis or radiologically normal skeleton. The mean survival from the first symptom was about 28 months and from the diagnosis 20 months. The five-year survival was 21% and 20%, respectively. [ncbi.nlm.nih.gov]
During treatment, he suffered 2 vertebral fractures due to secondary osteoporosis and showed reactivation of hepatitis B and iatrogenic Cushing syndrome. He is currently treated with azathioprine; dysaesthesia and ataxic gait persist. [elsevier.es]
- Muscle Spasm
[…] are affected you may have: Muscle weakness (trouble turning a knob) Muscle cramping Muscle spasms Problems with balance It may not be possible to prevent nerve damage. [uihc.org]
Skin
- Ulcer
Loss of sensation increases risk for foot injury, delays treatment and can lead to foot and leg ulceration and infections. Ulcers and infections may eventually lead to amputation of the lower extremities. [effectivehealthcare.ahrq.gov]
Diabetic foot ulcer A diabetic foot ulcer is an open wound or sore on the skin that's slow to heal. These are common in people with diabetic polyneuropathy. If you have numb feet, it's easy to cut your foot by stepping on something sharp. [nhsinform.scot]
If the underlying cause of peripheral neuropathy is not treated, you may be at risk of developing potentially serious complications, such as a foot ulcer that becomes infected. [nhs.uk]
In the U.S., diabetic neuropathy is the main cause of foot problems and ulcers in people with diabetes. Around half of all people with diabetes are believed to have diabetic neuropathy. [medicalnewstoday.com]
Diabetic neuropathy often involves the feet and legs and is responsible for lack of sensation, foot ulcers, and infections. [jamanetwork.com]
- Hyperhidrosis
[…] vibration and proprioception Ataxia Clumsiness Areflexia Hypotonia "Tingling" "Pins and needles" Sensory (Small Fiber) Sensory loss to pain and temperature "Burning" "Stabbing" Autonomic Postural hypotension Anhidrosis Impotence Bowel or bladder disturbance Hyperhidrosis [casemed.case.edu]
[…] peripheral neuropathy may be treatable with medication, such as: erectile dysfunction constipation the slow movement of food through your stomach (gastroparesis) In some cases, you may need more invasive treatment, such as botulinum toxin injections for hyperhidrosis [nhsinform.scot]
This is most often secondary to anhidrosis in the limbs and thorax and reflects compensatory hyperhidrosis in the restricted areas that maintain normal sweating. [clevelandclinicmeded.com]
- Decreased Sweating
Decreased sweating. Problems with urination. Sexual dysfunction. Diarrhea. Weight loss (unintentional). Dizziness when standing up or fainting. Nausea or vomiting. Problems with digestion. Cleveland Clinic News & More [my.clevelandclinic.org]
Urogenital
- Female Sexual Dysfunction
INTRODUCTION: Female sexual dysfunction (FSD) in peripheral polyneuropathies besides diabetes mellitus is still a poorly studied subject. Little is known about sexual function in women with amyloidosis, Guillain-Barré syndrome, or porphyria. [ncbi.nlm.nih.gov]
Neurologic
- Hyporeflexia
Brisk reflexes point to a central cause, whereas hyporeflexia or areflexia suggest a peripheral problem. [rcemlearning.co.uk]
Hyporeflexia is also rare except in the ankles. In fact, tendon reflexes other than at the ankle are lost only if the femoral, musculocutaneous, or radial nerves are affected proximally [ 12, 18, 19 ]. [intechopen.com]
- Neurologic Manifestation
Conclusion 8.1 Final considerations PN is one of the possible neurologic manifestations encountered by physicians in CTD. Coexistence of both conditions is explained by immune-mediated factors particularly a vasculitis of peripheral nerve. [intechopen.com]
National Institute of Neurological Disorders and Stroke. 19 September 2012. ^ a b c d Zis P, Hadjivassiliou M (February 2019). "Treatment of Neurological Manifestations of Gluten Sensitivity and Coeliac Disease". [en.wikipedia.org]
Workup
An extensive workup for various infectious, autoimmune and other possible aetiologies was carried out to identify the underlying cause for his fulminant illness. [ncbi.nlm.nih.gov]
Clinical Algorithm: Athena Diagnostics offers CMT Advanced Evaluations organized by inheritance pattern (dominant, recessive, or unknown) and electrodiagnostic workup (demyelinating, axonal, or inconclusive). [athenadiagnostics.com]
When a hospitalist identifies this pattern and confirms the comorbid condition of diabetes or alcohol use, further workup may be needed (but, again, can be referred to an outpatient setting). [acphospitalist.org]
(See Workup.) Management of diabetic neuropathy should begin at the initial diagnosis of diabetes. [emedicine.medscape.com]
Urine
- Microalbuminuria
Subjects with the highest grade of PN were older and had significantly increased levels of creatinine, microalbuminuria, HbA1c, and plasma Hcy compared to the other two groups. [ncbi.nlm.nih.gov]
Treatment
Treatment of painful neuropathy should be directed at removing the offending metabolic injury, if possible. [ncbi.nlm.nih.gov]
He was started on remission induction treatment with prednisone dosed at 1 mg/kg/day and intravenous bolus cyclophosphamide as well as symptomatic treatment. After a few days, eosinophilia disappeared and respiratory symptoms improved progressively. [elsevier.es]
This treatment should be maintained during the subacute phase, and after 6 to 8 weeks, the treatment should be tapered progressively. [intechopen.com]
Epothilones are used in the treatment of advanced breast cancer. [onlinelibrary.wiley.com]
Other types of cancer treatments can also cause peripheral neuropathy. What Cancer Treatments Cause Peripheral Neuropathy? Drugs for cancer treatment are the most common cause of peripheral neuropathy. [nccn.org]
Prognosis
Prognosis The prognosis for patients suffering from peripheral neuropathy depends to a large extent on whether an underlying cause can be identified and treated. [brainfoundation.org.au]
More than 100 types of peripheral neuropathy have been identified, each with its own characteristic set of symptoms and prognosis. Impaired function and symptoms depend on the type of nerves that are damaged. [childneurologyfoundation.org]
What You Need to Know There are more than 100 types of peripheral neuropathy, each with its own set of symptoms and prognosis. Peripheral neuropathy has many different causes. [hopkinsmedicine.org]
More than 100 types of peripheral neuropathy have been identified, each with its own characteristic set of symptoms, pattern of development, and prognosis. [news-medical.net]
Cyclophosphamide would only be indicated as a first-line treatment if factors are present that indicate poor prognosis (proteinuria >1 g/day, creatinine >1.58 mg/dL, PNS involvement). [elsevier.es]
Etiology
Treatment of DSP depends on the underlying etiology. Vitamin deficiencies should be corrected and metabolic or autoimmune etiologies addressed as appropriate. There are multiple pharmacologic options for treating persistent pain or discomfort. [mdedge.com]
Despite an extensive evaluation, in approximately half of patients no etiology is ever found; these patients typically have a predominately sensory polyneuropathy and have been labeled as having idiopathic or cryptogenic sensory polyneuropathy (CSPN). [accessmedicine.mhmedical.com]
An relapsing/remitting course suggests an autoimmune etiology or an intermittent exposure. A step-wise progression course suggest a mononeuropathy multiplex pattern. [casemed.case.edu]
With a systematic approach to the evaluation of these disorders, approximately 75% of patients have a specific etiologic diagnosis. [clevelandclinicmeded.com]
That said, when it comes to peripheral neuropathy, it is important to be aware of the array of potential etiologies beyond diabetes in order to ensure accurate diagnosis and effective treatment. [podiatrytoday.com]
Epidemiology
A blinded epidemiological survey was performed in 13 retired, long-term Cd-exposed workers and 19 age-matched controls. Historical Cd biomonitoring data were available over the last two decades. [ncbi.nlm.nih.gov]
This Primer summarizes the epidemiology, mechanisms, diagnosis and treatment of diabetic nephropathy and discusses the quality-of-life issues faced by patients. Eva L. Feldman, Brian C. Callaghan, Rodica Pop-Busui, Douglas W. Zochodne, Douglas E. [nature.com]
Epidemiology of peripheral neuropathy associated with connective tissue diseases and its topographic distribution PN is one of the clinical features of CTD with variable frequency and prognosis. It is often seen in the course of the disease. [intechopen.com]
Quantitative sensation testing in epidemiological and therapeutic studies of peripheral neuropathy. Muscle Nerve. 1999 Jun. 22(6):659-62. [Medline]. Pirart J. [emedicine.medscape.com]
Use of the Michigan Neuropathy Screening Instrument as a measure of distal symmetrical peripheral neuropathy in Type 1 diabetes: results from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications. [scielo.br]
Pathophysiology
Anti-GM1 IgM was significantly elevated in his serum during the acute phase, which suggested that it was related with the pathophysiology in this patient. [ncbi.nlm.nih.gov]
Churg–Strauss syndrome: update on pathophysiology and treatment. Curr Opin Rheumatol, 24 (2012), pp. 24-30 Please cite this article as: Bonaventura Ibars I, de Francisco Moure J, Pineda Barrero S, Rodriguez Carballeira M, Saura Salvado J. [elsevier.es]
Their presentation varies depending on the underlying pathophysiology. The speed of progression of the polyneuropathy coupled with its nature (axonal or demyelinating) can help identify its aetiology. [rcemlearning.co.uk]
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]
The evaluation of pain in response to thermal stimuli is best performed by using the thermotest which is recommended for pathophysiological research or treatment trials. [intechopen.com]
Prevention
Can Peripheral Neuropathy be Prevented? There is no proven way to prevent nerve damage in patients undergoing treatment. It probably helps to give less of the cancer drug. [nccn.org]
Peripheral Neuropathy Prevention Lifestyle choices can play a role in preventing peripheral neuropathy. [hopkinsmedicine.org]
Eat a healthy diet to prevent vitamin deficiency. Do not smoke as it reduces your circulation. Support Peripheral neuropathy can be hard to live with both physically and emotionally. It can reduce your mobility and prevent you from working. [cancer.ie]
such as foot care for prevention of foot ulcers, as well as exercise and balance training for the prevention of falls. [effectivehealthcare.ahrq.gov]
How Do I Prevent Neuropathy? Neuropathy is preventable only to the extent that the underlying condition or cause is preventable. [emedicinehealth.com]