Polyneuropathy

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Polyneuropathy Classification and external resources
ICD-10	G60.-G64.
ICD-9	356.4, 357.1-357.7
MeSH	D011115

Polyneuropathy is a neurological disorder that occurs when many peripheral nerves throughout the body malfunction simultaneously. It may be acute and appear without warning, or chronic and develop gradually over a longer period of time. Many polyneuropathies have both motor and sensory involvement and some have autonomic dysfunction. These disorders are often symmetric and frequently involve distal extremities. There is a very large differential for polyneuropathy.

Contents 1 Evaluation 2 Diagnosis/testing 3 Differential 4 See also 5 External links

[edit] Evaluation

Evaluation and classification of polyneuropathies begins with a history and physical exam in order to document what the pattern of the disease process is (arms, legs, distal, proximal, symmetric), when they started, how long they've lasted, if they fluctuate, and what deficits and pain are involved. If pain is a factor, and it often is, determining where and how long the pain has been present is important. The patient must be interviewed, and physical testing is often necessary to further delineate and document the pain.

One also needs to know what disorders are already present within the family and what diseases the patient may currently have. This is vital in forming a differential diagnosis.

[edit] Diagnosis/testing

Although often diseases are suggested by the physical exam and history alone, testing is still a large part of the diagnosis. Tests which may be employed include: electrodiagnostic testing using electromyography, muscle biopsy, serum creatine kinase (CK), antibody testing, . Nerve biopsy is not used much, but is helpful in determing small fiber neuropathy. Other tests may be used, especially tests for specific disorders associated with polyneuropathies.

[edit] Differential

There is a large differential for polyneuropathies: vitamin deficiency, cancer, toxins, infections (ex. Guillain-Barré Syndrome), liver disease, endocrine disease (inc. diabetes with diabetic and pre-diabetic neuropathy), amyloidosis, genetic disorders, motor neuron disorders, motor neuropathies, kidney failure[1],paraneoplastic, polio, porphyria (some types), spinal muscular atrophy, catecholamine disorders, and many others. This is not a complete list.

[edit] See also

• Neuropathy
• Mononeuropathy
• Polyneuropathy in dogs and cats
• Neuritis

[edit] External links

• Merck Manual overview
• Diagram Diagnosis page
• Wash U. Neuro website, very complete
• Discussion of diabetic polyneuropathy with Spanish translation

v • d • e Nervous system pathology, primarily PNS (G50-G99, 350-359) Nerve, nerve root and plexus disorders (neuropathy, radiculopathy, plexopathy) cranial nerve: V (Trigeminal neuralgia) - VII (Facial nerve paralysis, Bell's palsy, Melkersson-Rosenthal syndrome, Central seven) - XI (Accessory nerve disorder) nerve root and plexus: Brachial plexus lesion - Thoracic outlet syndrome - Phantom limb mononeuropathy: upper limb (Carpal tunnel syndrome, Ulnar nerve entrapment, Radial neuropathy) - Causalgia - lower limb (Meralgia paraesthetica, Tarsal tunnel syndrome, Morton's neuroma) - Mononeuritis multiplex Polyneuropathies and other disorders of the PNS hereditary motor and sensory neuropathy (Charcot-Marie-Tooth disease, Dejerine Sottas syndrome, Refsum's disease) Guillain-Barré syndrome - Alcoholic polyneuropathy Diseases of myoneural junction autoimmune: Myasthenia gravis - Lambert-Eaton myasthenic syndrome Diseases of muscle (myopathy)/ neuromuscular disease Muscular dystrophy myotonic (Myotonic dystrophy, Myotonia congenita, Thomsen disease, Neuromyotonia, Paramyotonia congenita) congenital myopathy (Centronuclear myopathy, Nemaline myopathy, Central core disease) Mitochondrial myopathy periodic paralysis: Hypokalemic - Hyperkalemic Dysautonomia/ Autonomic neuropathy Hereditary sensory and autonomic neuropathy (Familial dysautonomia) - Horner's syndrome - Multiple system atrophy (Shy-Drager syndrome, Olivopontocerebellar atrophy)