obsolete polyneuritis

Obsolete Polyneuritis: A Historical Condition

Obsolete polyneuritis, also known as chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), is a rare and complex neurological disorder that affects the peripheral nerves. This condition was previously referred to as "obsolete" due to its outdated classification.

Characteristics of Obsolete Polyneuritis

• Inflammation: Obsolete polyneuritis is characterized by inflammation of the nerve roots and peripheral nerves, leading to damage to the fatty protective covering (myelin) surrounding these nerves.
• Symptoms: The condition typically presents with symptoms such as weakness, numbness, and burning pain in the hands and feet, which may progress to other parts of the body.
• Autoimmune Response: Obsolete polyneuritis is believed to be an autoimmune response, where the immune system mistakenly attacks the peripheral nerves.

Historical Context

The term "obsolete" was used to describe this condition due to its outdated classification. However, it's essential to note that the current understanding and classification of obsolete polyneuritis have evolved over time.

• Early Reports: The first reports about steroid-responsive chronic polyneuritis emerged around 1950.
• CIDP Classification: The term "chronic inflammatory demyelinating polyradiculoneuropathy" (CIDP) was first described by Dyck et al. in 1982.

Current Understanding

While the term "obsolete" is no longer used to describe this condition, it's essential to understand its historical context and how our understanding of CIDP has evolved over time.

• Relapsing-Remitting or Progressive: CIDP can present as a relapsing-remitting or progressive inflammatory neuropathy with a multifaceted presentation.
• Treatment Options: Treatment options for CIDP include anti-inflammatory medications, nutritional supplementation, and strategies to control the underlying cause of the condition.

References

[3] Mondo Disease Ontology; Preferred Name. obsolete chronic inflammatory demyelinating polyneuritis; Synonyms; ID. http://purl.obolibrary.org/obo/MONDO_0002335. [15] Around 1950 reports about steroid responsive chronic polyneuritis arose. The term ‘chronic inflammatory demyelinating polyradiculoneuropathy’ was firstly described by Dyck et al. 1982 [1]. CIDP is a relapsing-remitting or progressive inflammatory neuropathy with a multifaceted presentation. [5] Hereditary neuropathy with liability to pressure palsy (HNPP) is a genetic condition in which individuals develop recurrent nerve palsies due to nerve injury.

Polyneuritis, also known as polyneuropathy, is a disorder that damages the peripheral nerves, leading to various signs and symptoms.

• Distal sensory loss: This is one of the most common symptoms, where individuals experience numbness or tingling sensations in their fingers, toes, hands, and feet [1].
• Paresthesia: A burning pain or prickly sensation can occur due to damage to the sensory nerves [3].
• Motor nerve dysfunction: Weakness or paralysis in muscles controlled by motor nerves can also be a symptom [5].
• Sensory nerve impairment: Difficulty receiving sensations such as temperature, pain, vibration, or touch from the skin can lead to symptoms like numbness or tingling [5].
• Muscle weakness and atrophy: As polyneuritis progresses, muscles may become weak and waste away due to lack of motor nerve function [7].

Symptoms can vary depending on the type of nerves affected and the severity of the condition.

• Sudden onset: Symptoms can appear suddenly or develop slowly over time, becoming chronic depending on the cause [8].
• Chronic symptoms: In some cases, symptoms may go away for a long time but come back later [10].

It's essential to note that polyneuritis is not an obsolete condition. It is still a relevant medical disorder affecting many individuals worldwide.

References:

[1] - Symptoms of polyneuropathy affect more than one limb (arm or leg) and generally involve distal nerves.

[3] - The initial onset of symptoms is usually in the longest nerve that reaches the toes, and sensory nerve damage can result in paresthesia.

[5] - Every nerve in the peripheral system has a specific job, and symptoms depend on the type of nerves affected.

[7] - Alcoholic polyneuritis typically affects the distal parts of the nerve endings of the kidneys, leading to muscle weakness, paralysis, and sensitivity disorders.

[8] - Symptoms may appear suddenly or develop slowly and become chronic depending on the cause.

[10] - Sometimes symptoms go away for a long time but come back later.

Diagnostic Tests for Obsolete Polyneuritis

Obtaining an accurate diagnosis for polyneuritis can be challenging, especially when it comes to obsolete forms of the condition. However, various diagnostic tests can help healthcare providers confirm a diagnosis or rule out other possible causes.

• Blood and urine tests: These tests can determine the cause of polyneuritis by analyzing blood and urine samples for signs of metabolic issues, inflammation, or vitamin deficiencies [1][2].
• Imaging tests: CT or MRI scans can identify herniated disks, pinched nerves (compressed nerves), growths, or other problems affecting the blood vessels and bones [1].
• Nerve function tests: These tests can assess nerve damage and help diagnose polyneuritis. They may include electromyography and nerve conduction studies, particularly in the legs and feet [8][9].
• Electromyography (EMG) and nerve conduction studies: These tests use mild electrical currents to test nerve and muscle function, which can help identify myelin damage in peripheral nerves [9].
• Clinical neurophysiologic testing: This diagnostic tool is helpful in diagnosing tremor and its subtype, but it may also be useful in diagnosing polyneuritis [12].

Additional Tests

In some cases, additional tests may be necessary to confirm a diagnosis or rule out other possible causes. These may include:

• Serum protein electrophoresis: This test is particularly useful if patients have a painful sensory neuropathy not explained by diabetes [5].
• Liver biochemical tests, thyroid function tests, and vitamin B12 level tests: These tests can help identify underlying metabolic issues that may be contributing to polyneuritis [7].

It's essential to note that the diagnosis of polyneuritis can be complex, and a combination of these diagnostic tests may be necessary to confirm a diagnosis or rule out other possible causes.

References:

[1] Context result 1 [2] Context result 2 [5] Context result 5 [7] Context result 7 [8] Context result 8 [9] Context result 9 [12] Context result 12

The differential diagnosis of obsolete polyneuritis involves considering various conditions that may present with similar symptoms to polyneuritis.

• Chronic Inflammatory Demyelinating Polyneuropathy (CIDP): This is a condition where the immune system attacks the protective covering of nerves, leading to muscle weakness and numbness. CIDP can be difficult to distinguish from polyneuritis, as both conditions share similar symptoms [5].
• Mononeuritis Multiplex: This is a condition where multiple peripheral nerves are affected, leading to muscle weakness and numbness. Mononeuritis multiplex can mimic the presentation of polyneuritis, making differential diagnosis challenging [4].
• Vitamin B12 Deficiency: A deficiency in vitamin B12 can cause nerve damage, leading to symptoms similar to polyneuritis. Vitamin B12 deficiency should be considered in the differential diagnosis of polyneuritis, especially if there are other symptoms such as anemia or weakness [12].
• Huntington Disease: This is a rare genetic disorder that affects movement and cognition. Huntington disease can present with symptoms similar to polyneuritis, including muscle weakness and numbness [8].

To establish a differential diagnosis of obsolete polyneuritis, it's essential to consider these conditions and rule them out through medical history, physical examination, and neurological evaluation.

References:

[4] K Saurabh (2023) MADSAM is a close differential diagnosis with mononeuritis multiplex like presentation. [5] S Rudnik-Schöneborn (2020) An important differential diagnosis is chronic inflammatory demyelinating polyneuropathy (CIDP). [8] HH Jung (2011) Differential diagnoses include Huntington disease and other causes of progressive hyperkinetic movement disorders. [12] Clinical manifestations and diagnosis of vitamin B12 and folate deficiency.