Peripheral neuropathy differential diagnosis: Difference between revisions

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__NOTOC__
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{{Peripheral neuropathy}}
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Peripheral_neuropathy]]
{{CMG}}; {{AE}} {{MMJ}}
{{CMG}}; {{AE}} {{MMJ}}


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==Differentiating peripheral neuropathy from other diseases==
==Differentiating peripheral neuropathy from other diseases==
* Peripheral neuropathy must be differentiated from other diseases that cause , [[sensorineural]], [[Motor skill|motor]], [[autonomic]] and [[Balance disorder|balance]] problems, such as [[spinal cord]] lesions and [[Brain|brain lesion]]<nowiki/>s.
* Peripheral neuropathy must be differentiated from other diseases that cause , [[sensorineural]], [[Motor skill|motor]], [[autonomic]] and [[Balance disorder|balance]] problems, such as [[spinal cord]] lesions and [[Brain|brain lesion]].<ref name="pmid23642725">{{cite journal| author=Saporta MA, Shy ME| title=Inherited peripheral neuropathies. | journal=Neurol Clin | year= 2013 | volume= 31 | issue= 2 | pages= 597-619 | pmid=23642725 | doi=10.1016/j.ncl.2013.01.009 | pmc=3646296 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23642725  }} </ref><ref name="pmid18615140">{{cite journal| author=Marchettini P, Lacerenza M, Mauri E, Marangoni C| title=Painful peripheral neuropathies. | journal=Curr Neuropharmacol | year= 2006 | volume= 4 | issue= 3 | pages= 175-81 | pmid=18615140 | doi= | pmc=2430688 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18615140  }} </ref><ref name="pmid22548615">{{cite journal| author=Brannagan TH| title=Current issues in peripheral neuropathy. | journal=J Peripher Nerv Syst | year= 2012 | volume= 17 Suppl 2 | issue=  | pages= 1-3 | pmid=22548615 | doi=10.1111/j.1529-8027.2012.00387.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22548615  }} </ref>


* Peripheral neuropathy usually causes lower motor nerve damage, while lesions in brain and [[spinal cord]] usually cause [[lower motor neuron]] damage.
* Peripheral neuropathy usually causes lower motor nerve damage, while lesions in brain and [[spinal cord]] usually cause [[lower motor neuron]] damage.<ref name="pmid28003344">{{cite journal| author=Garg N, Park SB, Vucic S, Yiannikas C, Spies J, Howells J et al.| title=Differentiating lower motor neuron syndromes. | journal=J Neurol Neurosurg Psychiatry | year= 2017 | volume= 88 | issue= 6 | pages= 474-483 | pmid=28003344 | doi=10.1136/jnnp-2016-313526 | pmc=5529975 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28003344  }} </ref>


* The difference between [[Upper motor neuron|upper]] and [[lower motor neuron]] symptoms and signs may be very helpful to differentiate peripheral neuropathy from brain and [[spinal cord]] lesions.
* The difference between [[Upper motor neuron|upper]] and [[lower motor neuron]] symptoms and signs may be very helpful to differentiate peripheral neuropathy from brain and [[spinal cord]] lesions.<ref name="pmid28003344">{{cite journal| author=Garg N, Park SB, Vucic S, Yiannikas C, Spies J, Howells J et al.| title=Differentiating lower motor neuron syndromes. | journal=J Neurol Neurosurg Psychiatry | year= 2017 | volume= 88 | issue= 6 | pages= 474-483 | pmid=28003344 | doi=10.1136/jnnp-2016-313526 | pmc=5529975 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28003344  }} </ref>


* Lower motor neuron signs and symptoms in peripheral neuropathy typically present with [[Diminished stature|diminished]] [[Deep tendon reflex|deep tendon reflexes]], [[flaccid paralysis]], severe [[muscle atrophy]], negative [[babinski reflex]] and[[fasciculation]] whereas upper motor neuron signs and symptoms in brain and [[spinal cord]] lesions typically present with [[Hyperactive reflexes|hyperactive]] [[Deep tendon reflex|deep tendon reflexes]], [[spastic paralysis]], no [[muscle atrophy]], positive [[babinski reflex]] and no [[fasciculation]].
* Lower motor neuron signs and symptoms in peripheral neuropathy typically present with [[Diminished stature|diminished]] [[Deep tendon reflex|deep tendon reflexes]], [[flaccid paralysis]], severe [[muscle atrophy]], negative [[babinski reflex]] and[[fasciculation]] whereas upper motor neuron signs and symptoms in brain and [[spinal cord]] lesions typically present with [[Hyperactive reflexes|hyperactive]] [[Deep tendon reflex|deep tendon reflexes]], [[spastic paralysis]], no [[muscle atrophy]], positive [[babinski reflex]] and no [[fasciculation]].<ref name="pmid28003344">{{cite journal| author=Garg N, Park SB, Vucic S, Yiannikas C, Spies J, Howells J et al.| title=Differentiating lower motor neuron syndromes. | journal=J Neurol Neurosurg Psychiatry | year= 2017 | volume= 88 | issue= 6 | pages= 474-483 | pmid=28003344 | doi=10.1136/jnnp-2016-313526 | pmc=5529975 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28003344  }} </ref>
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
| colspan="3" |'''Clinical manifestations'''
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
|-
! colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
|-
 
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Deep tendon reflexes
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type of paralysis
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Muscular atrophy
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Peripheral neuropathy
| style="background: #F5F5F5; padding: 5px;" |[[Diminished stature|Diminished]]
| style="background: #F5F5F5; padding: 5px;" |[[Flaccid paralysis]]
| style="background: #F5F5F5; padding: 5px;" |Severe [[muscle atrophy]]
| style="background: #F5F5F5; padding: 5px;" |Negative [[babinski reflex]], [[fasciculation]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Brain|Brain lesion]] and most [[spinal cord]] lesions
| style="background: #F5F5F5; padding: 5px;" |[[Hyperactive reflexes|Hyperactive]]
| style="background: #F5F5F5; padding: 5px;" |[[Spastic paralysis]]
| style="background: #F5F5F5; padding: 5px;" |No [[muscle atrophy]]
| style="background: #F5F5F5; padding: 5px;" |Positive [[babinski reflex]], no [[fasciculation]]
|}
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Latest revision as of 22:21, 8 March 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

Overview

Peripheral neuropathy must be differentiated from other diseases that cause , sensorineural, motor, autonomic and balance problems, such as spinal cord lesions and brain lesions. Peripheral neuropathy usually causes lower motor nerve damage, while lesions in brain and spinal cord usually cause lower motor neuron damage. The difference between upper and lower motor neuron symptoms and signs may be very helpful to differentiate peripheral neuropathy from brain and spinal cord lesions. Lower motor neuron signs and symptoms in peripheral neuropathy typically present with diminished deep tendon reflexes, flaccid paralysis, severe muscle atrophy, negative babinski reflex andfasciculation whereas upper motor neuron signs and symptoms in brain and spinal cord lesions typically present with hyperactive deep tendon reflexes, spastic paralysis, no muscle atrophy, positive babinski reflex and no fasciculation.

Differentiating peripheral neuropathy from other diseases

References

  1. Saporta MA, Shy ME (2013). "Inherited peripheral neuropathies". Neurol Clin. 31 (2): 597–619. doi:10.1016/j.ncl.2013.01.009. PMC 3646296. PMID 23642725.
  2. Marchettini P, Lacerenza M, Mauri E, Marangoni C (2006). "Painful peripheral neuropathies". Curr Neuropharmacol. 4 (3): 175–81. PMC 2430688. PMID 18615140.
  3. Brannagan TH (2012). "Current issues in peripheral neuropathy". J Peripher Nerv Syst. 17 Suppl 2: 1–3. doi:10.1111/j.1529-8027.2012.00387.x. PMID 22548615.
  4. 4.0 4.1 4.2 Garg N, Park SB, Vucic S, Yiannikas C, Spies J, Howells J; et al. (2017). "Differentiating lower motor neuron syndromes". J Neurol Neurosurg Psychiatry. 88 (6): 474–483. doi:10.1136/jnnp-2016-313526. PMC 5529975. PMID 28003344.

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