IgM MGUS NEUROPATHY Although most patients who present with chronic distal sensory or sensorimotor symptoms and signs have an axonal polyneuropathy unrelated to a paraprotein, rarely, patients with distal clinical…
CLINICAL MANIFESTATIONS Diabetic polyneuropathy (DPN) is one of the most common neuropathies seen in clinical practices (see Plate 6-21). It is generally length dependent, with prominent sensory symptoms, and can…
The diagnosis of CIDP can be challenging. Patients generally have both proximal and distal weakness on examination. Deep tendon reflexes are markedly reduced or absent. Distal sensory loss is often…
The differential diagnosis for AIDP needs to be carefully considered because the classic electrophysiologic features are often not present early in the disease process. Acute spinal cord lesions may be…
Mild cases of AIDP may never come to medical attention, but the typical presentation in those that seek medical assistance is one of acute ascending paralysis, which reaches its peak…
A careful history and neurologic examination is crucial in these patients. Family history is very important, particularly a history of painful feet and/or amputations. Neurologic examination should include testing of…
Nerve conduction studies (NCS) distinguish predominantly demyelinating diseases, such as CMT1, from axonal neuropathies. In demyelinating neuropathies (e.g., CMT1a), conduction velocities are generally less than 60% of normal and may…
The cerebrospinal fluid (CSF) protein is often significantly increased. Nerve conduction studies may show absent sensory potentials and marked slowing of motor conduction velocity, with values in the range of…
The classifications of the different types of hereditary polyneuropathy were initially based on clinical and electrophysiologic features. More recently, however, advances in genetics have led to identification of many specific…
When muscle spindles respond to stretching or to a change in the length of a given muscle, there is increased activity in the Ia afferent fibers, which then directly stimulates…
