Taber's Medical Dictionary
neuropathy
(noo-rop′ă-thē)
[neuro- + -pathy]
Any disease of the nerves.
neuropathic (noor″ŏ-path′ik), adj. SEE TABLE: Common Neuropathies;SEE: polyneuropathy.
Common Neuropathies
| Name | Affected Nerve(s) | Affected Part(s) | Affects Sensation? | Affects Movement? | Clinical Features | Type of Neuropathy |
| Bell palsy | Facial | Eye, nasolabial fold, lip (corner of the mouth) | Occasionally | Yes | Paralysis of the facial muscles, usually on just one side of the face | Inflammatory |
| Carpal tunnel syndrome | Median | Wrist and hand | Yes | Yes | Pain and numbness of the hand and wrist, often caused by repetitive movements or overuse such as typing, sawing, hammering, or polishing | Entrapment |
| Diabetic sensory neuropathy | Multiple | Feet, lower extremities; sometimes hands late in the course | Yes | No | Burning, stinging pain beginning in both feet, typically occurring after several years of poorly controlled diabetes. Can predispose to foot injury and infections. | Metabolic |
| Idiopathic brachial plexopathy (neuralgic amyotrophy; Parsonage-Turner syndrome; shoulder girdle syndrome) | Brachial | Shoulder | Yes | Yes | Pain in the shoulder, esp. after vigorous physical activity. Occasionally followed by shoulder girdle muscle atrophy | Entrapment |
| Meralgia paresthetica | Lateral femoral cutaneous | Thigh | Yes | No | Stinging pain in the anterolateral thigh. Usually found in obesity or in diabetes mellitus | Entrapment |
| Morton neuroma (interdigital neuropathy) | Interdigital nerves of the feet | Ball of foot | Yes | No | Pain often occurring between the web spaces of the 3rd and 4th toes during walking or standing | Entrapment |
| Piriformis syndrome | Sciatic | Buttock, with radiation into the leg | Yes | No | Buttock pain without back pain that is worsened by sitting and is relieved by walking | Entrapment/compression |
| Radial nerve palsy (musculospiral paralysis; Saturday night palsy) | Radial nerve (spiral groove entrapment) | Wrist, hand, and forearm | Yes | Yes | Temporary paralysis and numbness of the hand and arm, which may mimic a stroke. Caused by nerve compression, e.g., falling asleep on one’s side on a hard surface | Entrapment/ compression |
| Suprascapular neuropathy | Suprascapular | Back of the shoulder | Yes | Yes | Shoulder pain and muscular atrophy. Decreased ability to rotate or abduct the shoulder | Entrapment |
| Tarsal tunnel syndrome | Posterior tibial | Sole of the foot | Yes | No | Pain under the foot that is worsened by walking | Entrapment |
| Trigeminal neuralgia | Trigeminal | Cheek, nose, upper lip | Yes | No | Intense, repetitive facial pains that are often worsened by chewing, shaving, or toothbrushing, usually accompanied by spasm on the affected side of the face | Entrapment |
AIDS peripheral neuropathy
Direct infection of peripheral nerves by HIV, resulting in sensory and motor changes due to destruction of axons or their myelin covering. Acute or chronic inflammatory myelin damage may be the first sign of peripheral nerve involvement. Patients display gradual or abrupt onset of motor weakness and diminished or absent reflexes. Diagnostic biopsies of peripheral nerves show inflammatory changes and loss of myelin. Distal sensory neuropathy occurs in up to 30% of patients with AIDS, usually late in the disease. There is increased risk in older patients and those with diabetes mellitus, nutritional deficiencies, low CD4 cell counts, and vitamin B12 deficiencies. Patients report sharp pain, numbness, or burning in the feet. Destruction of dorsal root ganglions and degeneration of central peripheral axons are seen on autopsy. Some older antiretroviral drugs (ddI, ddC, and d4T) also cause a reversible peripheral neuropathy in about 20% of patients.
SEE: AIDS; SEE: Guillain-Barré syndrome; SEE: chronic inflammatory demyelinating polyneuropathy
TREATMENT
Nonsteroidal anti-inflammatory drugs, opioids, gabapentin, anticonvulsants, and topical agents have all been used with variable success to treat the pain of AIDS-related sensory neuropathy. Acupuncture is not effective. Human nerve growth factor, which stimulates regeneration of damaged nerve fibers, is being studied, esp. to minimize the neuropathy that antiretroviral drugs cause.
ascending neuropathy
Neuropathy that ascends from the lower part of the body to the upper.
auditory neuropathy
ABBR: AN Hearing loss that results from nerve damage or impaired nervous system processing of normal signals received from sensory hair cells in the Organ of Corti.
SYN: SEE: auditory dyssynchrony
chemotherapy-induced neuropathy
Damage to peripheral nerves causing pain, muscle weakness, or autonomic failure after treatment with medications like cisplatin, vincristine, or taxol. VAR: chemotherapy-induced peripheral neuropathy.
descending neuropathy
Neuropathy that descends from the upper part of the body to the lower.
diabetic neuropathy
Damage to autonomic, motor, and/or sensory nerves due to metabolic or vascular derangements in patients with long-standing diabetes mellitus. In Western nations, diabetes is the most common cause of neuropathy. Symptoms usually include loss of sensation or unpleasant sensations in the feet, erectile dysfunction, focal motor deficits, gastroparesis, loss of the ability to maintain postural blood pressure, and diseases of cardiac innervation. Sensory loss in the feet may result in undetected injuries that become infected or gangrenous.
SYN: SEE: diabetic polyneuropathy
NEUROPATHIC FOOT DUE TO DIABETES
TREATMENT
Tight control of blood sugar levels may prevent some neuropathic symptoms in patients with diabetes mellitus.
dysthyroid optic neuropathy
Crowding of and damage to the optic nerve in patients with Grave disease. It is characterized by loss of visual acuity and color vision, swelling of the optic disk, and compression of the optic nerve at the apex of the orbit.
SYN: SEE: apical crowding
entrapment neuropathy
facial sensory neuropathy
familial amyloidotic neuropathy
A rare, progressive autosomal dominant disease, ultimately fatal, caused by the deposition of abnormally folded transthyretin (TTR) in multiple body tissues. The first symptoms include altered sensations of pain and temperature in the feet. TTR eventually damages the eyes, heart, liver, and other internal organ.
focal neuropathy
Any nerve disease or injury, e.g., carpal tunnel syndrome or peroneal nerve palsy, that affects a single nerve.
generalized neuropathy
A rarely used synonym for polyneuropathy.
glue-sniffer's neuropathy
Malfunction of sensory and motor nerves due to inhaling toxic hydrocarbons. The lower extremities and trigeminal nerve are most often damaged.
idiopathic facial neuropathy
SEE: Bell palsy.
interdigital neuropathy
ischemic optic neuropathy
ABBR: ION Damage to the optic nerve due to insufficient blood flow to the nerve head. It typically occurs in people over 50 and is often associated with chronic diabetes mellitus, hypertension, or temporal arteritis.
Leber hereditary optic neuropathy
multifocal motor neuropathy
An asymmetrical motor weakness occasionally found in middle-aged men.
optic neuropathy
Pathological injury to the optic nerves or the blood supply to them. Usually, only one eye is affected. Several forms have been described, including ischemic optic neuropathy, which, if prolonged, leads to blindness in the affected eye; optic neuritis due to acute demyelination of optic nerve fibers; infiltrative optic neuropathy, in which the optic nerve is compressed by a tumor or aneurysm; and optic neuropathy due to toxic nutritional factors, e.g., methanol or a combined nutritional and vitamin deficiency.
peripheral neuropathy
Any syndrome in which muscle weakness, paresthesias, impaired reflexes, and autonomic symptoms in the hands and feet are common. The most common cause of peripheral neuropathy is diabetes mellitus. Other, less common, causes of peripheral neuropathy include nerve entrapment syndromes, alcoholism, medication toxicities, malnutrition, hepatic failure, or chronic kidney disease.
plantar neuropathy
Any of several conditions in which nerves that supply sensation to the sole of the foot are injured or chronically compressed, resulting in burning and tingling sensations and difficulty standing, walking, or running.
subacute myelo-optic neuropathy
subacute myelo-optico neuropathy ABBR: SMON Neuropathy that usually begins with abdominal pain or diarrhea, followed by sensory and motor disturbances in the lower limbs, ataxia, impaired vision, and convulsions or coma. It is reported mostly in Japan and Australia. Most patients survive, but neurological disability remains. Many of those who have the disease have a history of taking drugs of the halogenated oxyquinoline group such as clioquinol (formerly called iodochlorhydroxyquin).
sural neuropathy
A relatively rare form of sensory neuropathy affecting the lateral ankle, typically associated with the wearing of poorly fitting work boots or shoes that compress the sural nerve.
tomaculous neuropathy
The presence of sausage-shaped areas of thickened myelin with secondary axon constriction in some cases of familial recurrent brachial neuropathy.
toxic-nutritional optic neuropathy
Bilateral visual impairment with central scotomas. This is usually associated with a toxic or nutritional disorder, e.g., the ingestion of methyl alcohol.
