Peripheral neuropathy
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Synopsis

Common signs and symptoms depend to some extent on the class of peripheral nerves involved and include burning pain, numbness or tingling (often due to small fiber involvement), weakness, muscle atrophy, fasciculations, imbalance or difficulty walking, impaired joint position or vibratory sense (mostly due to large fiber involvement), or autonomic dysfunction including orthostatic hypotension, urinary incontinence, sexual dysfunction, or sweating abnormalities (due to autonomic fiber involvement). While many peripheral neuropathies can affect all fibers, some disorders cause pathology in one class more profoundly than the others. Thus some patients may have some or most of these symptoms. Progressive neuropathy in the lower extremities can lead to foot ulcerations (neurogenic ulcer), arthropathy with formation of Charcot joints, and increased risk of skin infections and osteomyelitis.
Codes
ICD10CM:G60.9 – Hereditary and idiopathic neuropathy, unspecified
SNOMEDCT:
302226006 – Peripheral nerve disease
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Radiculopathy
- Neuritis (eg, brachial neuritis)
- Fibromyalgia
- Compartment syndrome
- Peripheral arterial disease
- Vasculitis
- Spinal cord tumor (eg, meningioma, medulloblastoma, metastases, ependymoma)
- Guillain-Barré syndrome
- Sensory ganglionopathy
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:09/19/2018
Last Updated:03/17/2021
Last Updated:03/17/2021