Metabolic and toxic polyneuropathy

Abstract

Peripheral neuropathy has many types of systemic, metabolic, and toxic causes. The big selection of deficiencies and toxins that harm the peripheral nervous system highlight its vulnerability. Chemotherapy-induced peripheral neuropathies, even/especially newer agents continue to frequently cause this pathology been known for years. Peripheral neuropathies secondary to nutriment deficiencies, medications, or toxins are frequently discussed however may be troublesome to definitively diagnose. Precise identification of external nerves wreckers is very important since these conditions are typically curable. It is vital to contemplate these etiologies once approaching patients with a wide range of neuropathic presentations. In addition, etiologic measures are also provided by other or alternative general symptoms. A systematic approach begins with localization of the lesion to the peripheral nerves, identification of the underlying etiology, and exclusion of undoubtedly treatable causes. Initial blood tests ought to embrace a whole blood count, comprehensive metabolic profile, ESR and fast blood sugar, vitamin B, and endocrine levels (e.g. TSH); specialized tests ought to be ordered if clinically indicated. Spinal puncture and fluid analysis is also useful within the identification or exclusion of Guillain-Barre syndrome and chronic inflammatory demyelinating pathology. Electrodiagnostic studies, as well as nerve conductivity studies/ENMG will facilitate within the differentiation of axonopathy versus demyelinating or mixed pathology. Whereas most of those syndromes presented as a length-dependent sensorimotor pathology, some of the cases presented with asymmetry or radicular localization, especially in the onset, require that these causes to be thought of within the differential diagnosis of most cases of peripheral neuropathy. Treatment should to address the underlying disease process, correct any biological, horm [...]