II. Causes: Symmetric Proximal Motor Neuropathy (Type 1)

  1. Characteristics
    1. Symmetric proximal Muscle atrophy and weakness
  2. Acute Inflammatory Demyelinating Polyneuropathy (Guillain-Barre Syndrome)
    1. Guillain-Barre Syndrome typically starts in the distal extremities (esp. legs) and ascends
  3. Chronic Inflammatory Demyelinating Polyneuropathy
  4. Primary Myelinopathy
  5. Hypothyroidism(
  6. Diabetes Mellitus
  7. Lyme Disease
  8. Diphtheria
  9. Malignancy
  10. HIV or AIDS
  11. Hepatitis B
  12. Buckthorn
  13. Vincristine
  14. Acute Arsenic Poisoning

III. Causes: Symmetric Distal sensorimotor Polyneuropathy or DSPN (Type 2)

  1. Characteristics
    1. Symmetric distal sensory (pain, Paresthesias, proprioception, autonomic) and motor (weakness, atrophy) Neuropathy
  2. Diabetic Neuropathy (Diabetic DSPN)
  3. Alcoholism induced Neuropathy (Alcoholic DSPN)
  4. HIV Infection or AIDS
  5. Malignancy (paraneoplastic syndrome)
  6. Charcot-Marie-Tooth
  7. Toxins
    1. Acrylamide
    2. Allyl chloride
    3. Carbon disulfide
    4. Carbon Monoxide
    5. Ethylene oxide
    6. Hexacarbons
    7. Trichloroethylene
    8. OPIDP, PCBs, PNU
    9. Organophosphates
    10. Nitrous Oxide Abuse (due to secondary Vitamin B12 Deficiency)
  8. Heavy Metal Poisoning
    1. Arsenic
    2. Lead Poisoning
    3. Gold
    4. Mercury
    5. Thallium
  9. Medications
    1. See Drug-Induced Polyneuropathy
  10. Vitamin Deficiency
    1. Thiamine deficiency (Beriberi)
    2. Niacin Deficiency (Pellagra)
    3. Vitamin B12 Deficiency (Pernicious Anemia)
    4. Nitrous Induced Subacute Combined Degeneration of the Spinal Cord
    5. Vitamin B6 deficiency
    6. Trace Element Deficiency (e.g. Copper deficiency)
    7. Folate Deficiency
  11. Paraproteinemia
    1. Amyloidosis
    2. Multiple Myeloma
    3. Waldenstrom's Macroglobulinemia
  12. Miscellaneous causes
    1. Acromegaly
    2. Chronic lung disease
    3. Hypothyroidism
    4. Chronic Kidney Disease
    5. Porphyria
    6. Cryoglobulinemia
    7. Chronic Liver Disease
    8. Tic Paralysis
    9. Lyme Disease
    10. Celiac Disease
    11. Connective Tissue Disorder of Vasculitis
    12. Gouty Neuropathy
    13. Whipple Disease

IV. References

  1. Gallagher in Marx (2002) Rosen's Emergency Med, p. 1506
  2. Pryse-Phillips in Noble (2001) Primary Care, p. 1579
  3. Castelli (2020) Am Fam Physician 102(12): 732-9 [PubMed]

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Ontology: Polyneuropathy (C0152025)

Definition (CHV) a nerve disease where many peripheral nerves are affected
Definition (CHV) a nerve disease where many peripheral nerves are affected
Definition (MSH) Diseases of multiple peripheral nerves simultaneously. Polyneuropathies usually are characterized by symmetrical, bilateral distal motor and sensory impairment with a graded increase in severity distally. The pathological processes affecting peripheral nerves include degeneration of the axon, myelin or both. The various forms of polyneuropathy are categorized by the type of nerve affected (e.g., sensory, motor, or autonomic), by the distribution of nerve injury (e.g., distal vs. proximal), by nerve component primarily affected (e.g., demyelinating vs. axonal), by etiology, or by pattern of inheritance.
Concepts Disease or Syndrome (T047)
MSH D011115
ICD10 G62.9 , A69.22
SnomedCT 42345000, 193204000, 193166009, 194530007, 307326004, 267706009, 155080009
English Polyneuropathy, Polyneuropathy, unspecified, [X]Polyneuropathy, unspecified, Polyneuropathy unspecified, polyneuropathy (diagnosis), polyneuropathy, Polyneuropathy NOS, Polyneuropathies, Polyneuropathies [Disease/Finding], polyneuropathies, Polyneuropathy (multiple nerve disorder), [X]Polyneuropathy, unspecified (disorder), Polyneuropathy unspecified (disorder), Polyneuropathy (disorder), neuropathy; multiple, Polyneuropathy, NOS
Italian Polineuropatia, Polineuropatia NAS, Polineuropatie
Dutch polyneuropathie NAO, neuropathie; multipel, Polyneuropathie, niet gespecificeerd, polyneuropathie, Neuropathie, poly-, Polyneuropathie
French Polyneuropathie SAI, Polyneuropathie, Neuropathies multiples, Polyneuropathies
German Polyneuropathie NNB, Polyneuropathie, nicht naeher bezeichnet, Polyneuropathie, Polyneuropathien
Portuguese Polineuropatia NE, Polineuropatia, Polineuropatias
Spanish Polineuropatía NEOM, polineuropatía no especificada (trastorno), polineuropatía (trastorno de múltiples nervios), [X]polineuropatía, no especificada, polineuropatía no especificada, [X]polineuropatía, no especificada (trastorno), polineuropatía (trastorno), polineuropatía, Polineuropatía, Polineuropatías
Swedish Polyneuropatier
Czech polyneuropatie, polyneuritida, Polyneuropatie, Polyneuropatie NOS
Finnish Polyneuropatiat
Russian POLINEVRIT, POLINEVROPATII, ПОЛИНЕВРИТ, ПОЛИНЕВРОПАТИИ
Japanese タハツニューロパチー, 多発ニューロパチーNOS, タハツニューロパチーNOS, 神経障害-多発性, 多発神経炎, 多発神経障害, 多発性ニューロパシー, ポリニューロパチー, 多発ニューロパチー, 多発性ニューロパチー, 多発性神経炎, 多発ニューロパシー, ポリニューロパシー, 多発性神経障害, ニューロパチー-多発, 神経炎-多発性
Korean 상세불명의 다발 신경병증
Croatian POLINEUROPATIJE
Polish Zapalenie wielonerwowe, Choroby wielonerwowe, Polineuropatie
Hungarian Polyneuropathia, Polyneuropathia k.m.n.
Norwegian Polynevropatier