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Neuropathy, Peripheral

Aruna S. Khan, MD and Sally-Ann L. Pantin, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Peripheral neuropathy (PN) is a functional or structural disorder of the peripheral nervous system (PNS).

  • PN affects any combination of motor, sensory, or autonomic nerves.

  • The motor P...

DIAGNOSIS

HISTORY

  • A detailed inquiry for symptoms of sensory, motor, or autonomic dysfunction:

    • Numbness, tingling, prickling, burning pain, a “tightly wrapped” sensation, and an “unsteady gait”

    • Distal ...

TREATMENT

GENERAL MEASURES

  • Counsel on foot care and properly fitted footwear.

  • Monitor feet for early signs of ulcer and injury.

  • Targeted treatment for underlying systemic conditions:

    • Glycemic control, t...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • Physical therapy and gait assistive devices as needed

  • Flu vaccination should be avoided in the 1st year following GBS.

PROGNOSIS

  • Late-onset idiopathic distal symmetr...

REFERENCES

1
Lauria G, Hsieh ST, Johansson O, et al. European Federation of Neurological Societies/Peripheral Nerve Society Guideline on the use of skin biopsy in the diagnosis of small fiber neuropath...

ADDITIONAL READING

Watson JC, Dyck PJ. Peripheral neuropathy: a practical approach to diagnosis and symptom management. Mayo Clin Proc.  2015;90(7):940–951. [View Abstract on OvidMedline] 

CODES

ICD10

  • G62.9 Polyneuropathy, unspecified

  • G60.9 Hereditary and idiopathic neuropathy, unspecified

  • G60.8 Other hereditary and idiopathic neuropathies

  • G60.0 Hereditary motor and sensory neuropathy

  • G62.89...

CLINICAL PEARLS

  • There are many causes of PN. Diagnosis is made by history and physical exam, targeted laboratory testing, NCS/EMG, skin biopsy, or ANS testing.

  • Consider hereditary neuropathy if patient...

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