Evaluation of the patient with Peripheral NeuropathyNani Kurniani

Three basic challenges

Complaints and the physical finding are the result of the peripheral neuropathy Type and cause of neuropathyThe Apropiate theraphy.

Table. 1. Anatomic Distribution of Neuropathies and differential Diagnosis

Table. 1. Anatomic Distribution of Neuropathies and differential Diagnosis

Table. 1. Anatomic Distribution of Neuropathies and differential Diagnosis

History and Examination of the Patient Historical information :Chief complaint and History of present illnessPast medical historyFamily historySosial historyReview systems

Table. 2. Drugs Causing Peripheral Neuropathy

Table. 3. Occupation and Habits Predisposing to Peripheral Neuropathy

Table. 3. Occupation and Habits Predisposing to Peripheral Neuropathy

Table. 4. Neuropathies Associated with Organ System Impairment

Examining the patientGeneral physical ExaminationNeurological Examination

General physical Examination

General physical examinationSkeletal abnormalitiesChanges in skin hair and nailsLesions of the tongue and the oral and genital mucosaOcular manifestationOrganomegaly

Table. 5. Neuropathies Commonly Associated with Painless Injuries

Table. 6. Skin, Hair, and Nail Changes Associated with Peripheral Neuropathies* POEMS = polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes (chapter 14) Chronic inflammatory demylinating polyradiculoneuropathy

Table. 7. Oral and Genital Mucosal, Tongue, and Salicary Gland Changes

Table. 8. Ocular findings Associated with Peripheral Neuropathies

Neurogical Examination

Neurological ExaminationCranial nerve findingsMuscle weaknessMuscle stretch reflex changesSensory abnormalityAutonomic Nervous System Abnormalities

Table. 9. Causes of Tonic Pupil

Table. 10. Causes of Facial Weakness and Peripheral Neuropathy

Table. 11. Large-Fiber Neuropathies Causing Loss of Kinesthetic Function

Table. 12. Causes of Painful Neuropathies

Table. 12. Causes of Painful Neuropathies Guillain-Barre syndrome differ from most others because of its predominant motoro component and rapid evolution; however, some cases are thought to be mainly sensory.* Perhexilene, paclitaxel (taxol), suramin, zalcitabine, didanosine, stavudine, nitrofurantoin, thalidomide, gold, almitrine, disulfiram, misonidazole, metronidazole

Table. 13. Neuropathies with Prominent Autonomic Dysfunction

Evaluation of the peripheral neuropathyElectrodiagnostic testingQuantitative sensory testingAutonomic reflexs testAutoantibody testing .Skin biopsi

Somatoform disorderDorsal radiculopathyMyelopathyA few axonal neuropathies with sensory predominance Recovered Guillain-Barre syndromeIgM monoclonal gammopathyRare cases of active Guillain-Barre syndrome, chronic inflammatory demylinating polyradicaloneuropathy, and the Fisher syndromeFriedreichs ataxiaIdiopathic sensory neuropathyCarcinomatous sensory neuropathySjgrens syndrome with ataxic neuropathySome neurotoxic disordersNormal electrodiagnostic studiesAxonal sensorimotor neuropathyDemyelinating neuropathyPure sensory fiber lossFig. 1. Electrodiagnostic differentiation of ataxic neuropathies