Peripheral neuropathy differential diagnosis: Difference between revisions

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==Overview==
==Overview==
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 usually causes lower motor nerve damage, while lesions in brain and [[spinal cord]] usually cause [[lower motor neuron]] damage. 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. 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]].


==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 [differential dx1], [differential dx2], and [differential dx3].
* 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.


OR
* Peripheral neuropathy usually causes lower motor nerve damage, while lesions in brain and [[spinal cord]] usually cause [[lower motor neuron]] damage.


[Disease name] must be differentiated from [differential dx1], [differential dx2], and [differential dx3].
* 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.


OR
* 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]].
 
As [disease name] manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. [Subtype name 1] must be differentiated from other diseases that cause [clinical feature 1], such as [differential dx1] and [differential dx2]. In contrast, [subtype name 2] must be differentiated from other diseases that cause [clinical feature 2], such as [differential dx3] and [differential dx4].
 
===Differentiating [disease name] from other diseases on the basis of [symptom 1], [symptom 2], and [symptom 3]===
 
On the basis [symptom 1], [symptom 2], and [symptom 3], [disease name] must be differentiated from [disease 1], [disease 2], [disease 3], [disease 4], [disease 5], and [disease 6].
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|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
| colspan="6" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
| colspan="3" |'''Clinical manifestations'''
! colspan="7" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
| colspan="1" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
|-
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| colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
! colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
! colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
|-
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! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
 
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Symptom 1
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Symptom 2
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Symptom 3
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical exam 1
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical exam 2
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical exam 3
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab 1
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab 2
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab 3
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging 1
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging 2
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging 3
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 1
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 2
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 3
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|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
!Diseases
!Symptom 1
! colspan="1" rowspan="1" |Symptom 2
!Symptom 3
!Physical exam 1
! colspan="1" rowspan="1" |Physical exam 2
!Physical exam 3
!Lab 1
!Lab 2
!Lab 3
!Imaging 1
!Imaging 2
!Imaging 3
!Histopathology
|'''Gold standard'''
!Additional findings
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 4
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Deep tendon reflexes
| style="background: #F5F5F5; padding: 5px;" |
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type of paralysis
| style="background: #F5F5F5; padding: 5px;" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Muscular atrophy
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 5
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Peripheral neuropathy
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |[[Diminished stature|Diminished]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |[[Flaccid paralysis]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |Severe [[muscle atrophy]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |Negative [[babinski reflex]], [[fasciculation]]
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|-
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 6
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Brain|Brain lesion]] and most [[spinal cord]] lesions
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |[[Hyperactive reflexes|Hyperactive]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |[[Spastic paralysis]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |No [[muscle atrophy]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |Positive [[babinski reflex]], no [[fasciculation]]
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Revision as of 16:43, 6 September 2018

Peripheral neuropathy Microchapters

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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

Diseases Clinical manifestations Additional findings
Physical examination
Deep tendon reflexes Type of paralysis Muscular atrophy
Peripheral neuropathy Diminished Flaccid paralysis Severe muscle atrophy Negative babinski reflex, fasciculation
Brain lesion and most spinal cord lesions Hyperactive Spastic paralysis No muscle atrophy Positive babinski reflex, no fasciculation

References

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