Idiopathic Progressive Neuropathy

6. This results in the loss of current stability across the nerve, which in turn provides a far less reliable message. Severing of the nerve (axon) can result in numbness or complete paralysis.

Importantly, in any patients with neuropathy and specifically patients with a severe form,it is essential to rule out any other causes apart from diabetes such as ,drug induced neuropathy (e.g. isoniazid) , alcohol abuse, nutritional deficiency like vitamin B12 deficiency(Wile DJ,et al 2010),vasculitis , inherited neuropathies, and renal disease (Freeman R.2009)

The patient is an 80-year-old right-handed white female, who presents with her male partner for evaluation of left lower extremity symptoms. She did present for an EMG nerve conduction study in May. At that time, she gave a history of intermittent numbness into the anterior lateral thigh. The numbness rarely extended below the knee at that time, and it rarely occurred on the right. There was no clear radicular component. Her exam was normal. Her EMG of the left lower extremity was limited because she is on Pradaxa, but it was normal and CBs were consistent with a mild motor neuropathy. The diagnosis was possible meralgia paresthetica. The patient now states that the numbness is intermittent. It is on the anterior thigh, but now it goes down into the calf anteriorly and

present an overview of the Peripheral nerve injury, its pathology, types, and the various methods

Most of the patients that I have encountered are diagnosed with Diabetic Neuropathy (DN). Diabetic Neuropathy is a brought about by a complication of Type 1 and Type 2 Diabetes. In 2012, there are about 29.1 million Americans, or 9.3% of the population, had diabetes (American Diabetes Association [ADA], 2016). Due to its increase

Peripheral nerves are bundles of nerve fibers that exit the spinal cord individually or via two main plexuses known as the brachial plexus and the lumbosacral plexus. Peripheral nerve fibers transmit sensory and motor information between the body and the central nervous system (brain and spinal cord) through ventral and dorsal roots. Axons of motor neurons innervate muscles to produce both voluntary and involuntary movements. On the other hand, sensory axons make connections with sensory receptors in the skin to detect pain and sensation.

Patient is 71-year-old white right-handed white female who presents with her sister for evaluation of peripheral neuropathy. She states that it started about a year and a half ago in her toes and has slowly increased to involve her soles of her feet and the dorsum and now the lower one third of her calves bilaterally. There is occasional problems with edema in her lower extremities, but this has come later. The severity of the numbness changes if she walks for a long period of time, at which point it gets more numb. She currently is not having any burning or jabbing pain. She does not have the symptoms in her hands or in her torso. She does have hypothyroidism, but she is on medication. She is obese with problems with fasting glucose and hyperglycemia. Her hemoglobin A1C went from 4 to slightly over 5 over the course of the last year, but she has not been given the diagnosis of diabetes. She has no other medical risk factors for developing the peripheral neuropathy. She is unable to give any further history, except on detailed questioning, she does not have any problems with ambulation in the dark or on uneven surfaces and has not had any falls.

The cause of the disorder is when the spinal cord with the rest of the body. There is a peripheral nerve fiber that extend from your nerve cells into your body's periphery back toward the spinal cord. The muscle-controlling nerve cells in the spinal cord out toward the muscles. Axons transmit electrical signals for sensation and movement to and from the spinal cord.

Select individuals may suffer from neurological symptoms resulting in the inability to work and participate in leisure activities

Peripheral neuropathy is an issue in which the peripheral nerves are damaged. This often leads to symptoms that are associated with either the hands or the feet but it may also affect more than one area

The patient’s chief complaint was weakness and reduced sensations in the left leg and left arm since June 2005 when he suffered from stroke. Also, the patient complained of difficulty in performing activities of daily living like buttoning his shirt, eating, etc. since then. The patient also mentioned that he has difficulty in identifying the weight of an object e.g. light or heavy when he uses his right hand. The patient described his weakness as heaviness which starts from left elbow, which goes down till left fingers and from left knee till left toes. The weakness started when patient suffered from stroke back in 25th June 2005. His left side was totally paralyzed even though the patient could use his left side before stroke for activities like writing, throwing, balling, etc. The patient had several episodes of fall after that till date. Currently, he said he falls

Based on the progress report dated 03/01/16, the patient feels that his neuropathic pain in his left leg is worse since he injured his right leg. The right leg has healed since his fall. The pain starts as a tingling sensation and then it narrows down to a specific point. The pain is initially mild and

The muscular system, in conjunction with the skeletal system, is responsible for movement of the body among other things (VanPutte, 270). The ability of the human body to move has been critical in the survival of the species over the years—for example; escaping from predators is only possible with skeletal muscle contraction. Hansen’s disease generally only affects the peripheral nerves of the extremities, not the locations of the larger muscle groups; however the smaller muscles of the hands and feet are vital for the well-being of individuals. For example, it would be quite difficult to feed oneself without the use of hands. Unfortunately, extreme cases of Hansen’s disease cause paralysis of the individual’s hands and feet. Paralysis occurs due to deadening of the peripheral nerves, both sensory and motor. As the afferent neurons lose the ability to receive and send stimuli, the nerve impulses (action potentials) are sent to the central nervous system less and less often. Even so, the action potentials that are transmitted to the CNS still are unlikely to stimulate the skeletal muscles for contraction. This is because the efferent peripheral neurons of the hands and feet are damaged as well. In effect, the sensory nerves of the extremities cannot receive much stimuli, and the motor neurons are also less able to start the action potentials in the skeletal muscle

Of note, EMG/nerve conduction study of the left leg revealed an absent sural sensory response while the motor studies were grossly within normal limits, except slightly reduced conduction velocity of the tibial nerve. There was no definitive lumbar radiculopathy. Peripheral neuropathy cannot be determined as only one extremity was studied.

Most of the time, the pain is distributed in a neurological distribution. There maybe impairment in mood, quality of life, and activities of daily living.20 Sensory deficit may present in a glove and stocking (peripheral neuropathy), dermatomal (mononeuropathy), or hemispheric (stroke) distribution. Palpation of the skin may show coolness and mottling in a neurological distribution (autonomic neuropathy).17 Depending on the history and clinical findings, work up may include chemistry profile, CBC, CRP, ESR, TSH, free T4, vitamin B1, B6, B12, RPR, HIV, Lyme titer, and ANA. One may also consider MRI, CT, EMG, nerve conduction velocity, nerve biopsy, and skin biopsy.