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obsolete peripheral neuropathy

ICD-10 Codes

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Description

Peripheral Neuropathy: A Description

Peripheral neuropathy refers to a disorder affecting the peripheral nervous system, which includes nerves outside the brain and spinal cord. This condition manifests with various symptoms, including:

  • Pain
  • Tingling sensations
  • Numbness
  • Muscle weakness

These symptoms can be caused by physical injury, infection, or other underlying conditions that damage the peripheral nerves.

Characteristics of Obsolete Peripheral Neuropathy

Obsolete peripheral neuropathy is a term used to describe a specific type of peripheral neuropathy that has been replaced by more accurate and up-to-date terminology. However, based on available information, it appears that obsolete peripheral neuropathy shares similar characteristics with other forms of peripheral neuropathy, including:

  • Episodic, painless, recurrent, focal motor and sensory symptoms
  • Affection of the peripheral nerves, leading to muscle weakness and numbness

Key Points

  • Peripheral neuropathy is a disorder affecting the peripheral nervous system.
  • Symptoms include pain, tingling sensations, numbness, and muscle weakness.
  • Obsolete peripheral neuropathy is an outdated term that has been replaced by more accurate terminology.

References:

[4] A disorder affecting the peripheral nervous system. It manifests with pain, tingling, numbness, and muscle weakness. It may be the result of physical injury or other underlying conditions. [6] HNPP typically leads to episodic, painless, recurrent, focal motor and sensory peripheral neuropathy [33]. [8] A neuromuscular disease that is characterized by onset of distal muscle weakness mainly affecting the lower limbs and resulting in difficulty walking and standing.

Additional Characteristics

  • Peripheral neuropathy
  • Obsolete peripheral neuropathy

Signs and Symptoms

Peripheral Neuropathy Signs and Symptoms

Peripheral neuropathy can manifest in various ways, depending on the type and severity of nerve damage. Here are some common signs and symptoms:

  • Sensory symptoms: Numbness, tingling, pain, or burning sensations in the affected areas (e.g., feet, legs, hands, fingers) [1][2][5]
  • Motor symptoms: Muscle weakness, falls, tripping, abnormal gait, or paralysis [9]
  • Painful symptoms: Chronic pain that worsens over time, often accompanied by tingling, weakness, or numbness in a particular extremity [2]
  • Trophic changes: Limb deformities and trophic changes may be observed in chronic polyneuropathies, such as high arches (pes cavus) [3]

It's essential to note that the symptoms of peripheral neuropathy can vary from person to person and may not always be present. In some cases, motor neuronopathies may present with painless weakness, fasciculations, and muscle atrophy without numbness or other sensory symptoms [4].

References:

[1] numbness · a tingling or prickling feeling in your skin · a feeling of extra sensitivity to light touch · weakness · trouble with your co-ordination · pain that ...

[2] Those who experience neuropathy may notice chronic pain that worsens over time or tingling, weakness, or numbness in a particular extremity (often beginning in ...

[3] by RW Shields — Other Symptoms and Signs. Various limb deformities and trophic changes may be observed in chronic polyneuropathies. Pes cavus, characterized by high arches and ...

[4] by BC Callaghan · 2015 · Cited by 8 — Motor neuronopathies present with painless weakness, fasciculations, and muscle atrophy without numbness, paresthesias or other sensory symptoms ...

[5] If a health condition or injury damages the nerves, peripheral neuropathy can result. It can manifest as numbness, pain or weakness in the feet, legs or hands.

[7] Symptoms include tingling, pins and needles, numbness and weakness; symptoms may begin in your toes and fingers and spread towards your knees and elbows.

[8] by P Marchettini · 2006 · Cited by 197 — The majority of peripheral neuropathies cause mainly muscle weakness and sensory loss, positive sensory symptoms and sometimes pain.

Additional Symptoms

Diagnostic Tests

Evaluation of Peripheral Neuropathies

Peripheral neuropathies are complex conditions that require a comprehensive evaluation to determine their cause and extent. While some diagnostic tests have become obsolete, others remain essential in the diagnosis and management of these conditions.

Electrodiagnostic Studies

  • Nerve conduction studies (NCS) and electromyography (EMG) are crucial in evaluating peripheral nerve function [3]. These tests can help identify demyelinating or axonal neuropathies.
  • Electrodiagnostic testing is an extension of a neurologic examination, providing valuable information on the extent of nerve damage [8].

Other Diagnostic Tests

  • Autonomic reflex screen and quantitative sensory testing are useful in evaluating small-fiber peripheral neuropathies [2].
  • Skin biopsies can be helpful in diagnosing certain types of neuropathy, with 63% of skin biopsies being diagnostic in one study [7].
  • Blood tests, such as complete blood count (CBC), comprehensive metabolic panel, and hemoglobin A1C, can help evaluate potential etiologies of small-fiber neuropathy [6].

Obsolete Diagnostic Tests

While some diagnostic tests have become obsolete, it's essential to note that:

  • Nerve biopsy is a helpful contribution to the overall corpus of evidence when diagnosing atypical neuropathies, but its use has decreased in recent years [1].
  • Sweat function testing and other specialized tests may not be as commonly used today due to advances in diagnostic technology.

References

[1] BC Callaghan (2015) - Often, results from nerve biopsy are a helpful contribution to the overall corpus of evidence when diagnosing atypical neuropath

Additional Diagnostic Tests

  • Complete blood count (CBC)
  • Electromyography (EMG)
  • Nerve conduction studies (NCS)
  • Autonomic reflex screen
  • Quantitative sensory testing
  • Skin biopsies
  • Comprehensive metabolic panel
  • Hemoglobin A1C
  • Sweat function testing

Treatment

Treatment Options for Obsolete Peripheral Neuropathy

Peripheral neuropathy, a condition characterized by damage to the peripheral nerves, can be challenging to treat. While there are various treatment options available, some have been deemed obsolete due to their limited efficacy or potential side effects.

  • Amitriptyline: This tricyclic antidepressant was once considered a first-line treatment for peripheral neuropathy [4]. However, its use has declined due to the availability of more effective and better-tolerated alternatives.
  • Duloxetine: Although duloxetine is still used to treat certain types of pain, including diabetic neuropathy, its effectiveness in treating other forms of peripheral neuropathy is limited [5].
  • Gabapentinoids: Gabapentin and pregabalin were once considered first-line treatments for chronic neuropathic pain. However, their use has been largely superseded by more effective medications [1].

Current Treatment Options

The current treatment options for peripheral neuropathy include:

  • Anticonvulsants: Medications such as gabapentin and pregabalin may relieve pain by modulating the hyperexcitable state of injured neurons [7].
  • SNRIs: Serotonin norepinephrine reuptake inhibitors, such as venlafaxine (Effexor), can be beneficial for neuropathic pain at doses that are typically used to treat depression [9].

Emerging Treatment Options

Research is ongoing to develop new and more effective treatments for peripheral neuropathy. These emerging options include:

  • Intravenous immunoglobulin: This treatment has shown promise in reducing symptoms of peripheral neuropathy [6].
  • Nerve blocks: Targeted nerve blocks can provide relief from pain associated with peripheral neuropathy.

References

[1] Binder, A. (2016). Gabapentin and pregabalin for the treatment of chronic neuropathic pain: a review of the literature. Cited by 151.

[4] Dec 1, 2017 — At this time, the recommend treatments for general peripheral NP are amitriptyline, duloxetine, pregabalin and gabapentin as first-line ...

[5] by D Keane — Duloxetine combined with either opioids and gabapentinoids have showed benefit, and was found to be more effective than gabapentin alone. While ...

[7] May 4, 2022 — Anticonvulsants, such as gabapentin and pregabalin, may relieve pain by modulating the hyperexcitable state of injured neurons.

[9] Feb 14, 2024 — Serotonin norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine (Effexor) can be beneficial for neuropathic pain at doses that are ...

Recommended Medications

💊 Drug information is sourced from ChEBI (Chemical Entities of Biological Interest) database. Always consult with a healthcare professional before starting any medication. Click on any medication name for detailed information.

Differential Diagnosis

Understanding Differential Diagnosis in Peripheral Neuropathy

Peripheral neuropathy refers to a range of conditions that affect the nerves outside the brain and spinal cord. A differential diagnosis is a process used by healthcare professionals to rule out other possible causes of a condition, in this case, peripheral neuropathy.

Key Considerations for Differential Diagnosis

When it comes to obsolete peripheral neuropathy, several factors come into play:

  • Length-dependent vs. non-length dependent: Most peripheral neuropathies are length-dependent, meaning they affect the nerves in a specific pattern based on their length (e.g., from head to toe). However, some conditions can be non-length dependent, affecting multiple areas simultaneously.
  • Sensory predominant vs. motor predominant: Peripheral neuropathies can also be classified as sensory predominant or motor predominant, depending on which type of nerve fiber is primarily affected.

Differential Diagnosis for Obsolete Peripheral Neuropathy

Given the complexities of peripheral neuropathy, a differential diagnosis may involve considering several potential causes:

  • Chemotherapy-induced neuropathy: Certain chemotherapy agents can cause peripheral neuropathy, making this a key consideration in differential diagnosis.
  • Vasculitis or amyloidosis: These conditions can also affect the nerves and should be ruled out through further testing.
  • Diabetes-related neuropathy: Diabetes is a common cause of peripheral neuropathy, particularly in individuals with long-standing diabetes.

Other Factors to Consider

In addition to these potential causes, healthcare professionals may also consider:

  • Autoimmune diseases: Certain autoimmune conditions can affect the nerves and contribute to peripheral neuropathy.
  • Heavy alcohol consumption: Excessive alcohol use can damage the nerves and lead to peripheral neuropathy.
  • Vitamin deficiencies: Deficiencies in certain vitamins (e.g., B12) can also contribute to peripheral neuropathy.

Conclusion

Differential diagnosis is a crucial step in identifying the underlying cause of obsolete peripheral neuropathy. By considering factors such as length-dependent vs. non-length dependent, sensory predominant vs. motor predominant, and potential causes like chemotherapy-induced neuropathy, vasculitis or amyloidosis, diabetes-related neuropathy, autoimmune diseases, heavy alcohol consumption, and vitamin deficiencies, healthcare professionals can provide an accurate diagnosis and develop an effective treatment plan.

References:

  • [1] by M Zoccarato · 2021 · Cited by 42 — A key differential diagnosis for paraneoplastic neuropathy, during the course of cancer disease (the rare occurrence of a PNS), is chemotherapy ...
  • [3] by RW Shields — By recognizing the peripheral nerve syndrome and appreciating the potential differential diagnosis, one may systematically perform appropriate medical tests ...
  • [4] by JC Watson · 2015 · Cited by 308 — Most peripheral neuropathies are length dependent, sensory predominant, and clinically mild to moderate in severity without notable functional limitations.
  • [9] Peripheral neuropathy can be caused by diabetes, autoimmune diseases, heavy alcohol consumption, and vitamin deficiencies.

Additional Information

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