Idiopathic sensory and sensorimotor neuropathies

Rebecca E Traub MD (Dr. Traub of Columbia University has no relevant financial relationships to disclose.)
Thomas H Brannagan III MD (Dr. Brannagan of the Peripheral Neuropathy Center at Columbia University College of Physicians and Surgeons and also of the Electromyography Laboratory at New York-Presbyterian Hospital has no relevant financial relationships to disclose.)
Louis H Weimer MD, editor. (Dr. Weimer of Columbia University has received consulting fees from Roche.)
Originally released March 15, 2001; last updated April 16, 2010; expires April 16, 2013
Notice: This article has expired and is therefore not available for CME credit.

This article includes discussion of idiopathic sensory and sensorimotor neuropathies, and idiopathic sensory neuronopathies. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Overview

Idiopathic sensory and sensorimotor neuropathies typically present in middle to late adulthood as length-dependent polyneuropathies with predominantly axonal features on electrodiagnostic and histologic examination. A large number of disorders cause distal polyneuropathy, and a full diagnostic evaluation must be completed before categorizing a neuropathy as idiopathic. An expanding number of conditions and risk factors are associated with neuropathy, including impaired glucose tolerance, celiac antibodies, and monoclonal gammopathies. Skin biopsy for assessment of intraepidermal nerve fiber density is a valid and reliable method of confirming the diagnosis of small fiber sensory neuropathy, but this category of polyneuropathy continues to have a high percentage of patients without known etiology. Neuropathic pain is a common presenting symptom and is often the focus of medical management; a number of antidepressants and antiepileptics have demonstrated efficacy.

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