Florian P Thomas MD MA PhD MS

Hereditary neuropathy with predisposition to pressure palsy

In typical HNPP, motor symptoms predominate over sensory symptoms. Slight compression of peripheral nerves and repeated local exercise leads to episodes of weakness with decreased perception to touch and pain. Attacks present with a single nerve involvement, with onset on awakening, and are usually triggered by mild compression that resolves in days to months.

Charcot-Marie-Tooth disease: CMT2, CMT4, and others

Charcot-Marie-Tooth disease typically involves autosomal dominant forms with chronic and progressive weakness, muscle wasting, and sensory loss predominantly in the distal legs, with onset in the first 2 decades of life.

Charcot-Marie-Tooth disease type 1B

Charcot-Marie-Tooth disease type 1B is characterized by slowly progressive peripheral nerve manifestations with distal dominant weakness, sensory loss, and limb deformities. It has an autosomal dominant inheritance pattern and is caused by mutations in the myelin protein zero gene.

Charcot-Marie-Tooth disease type 1A

Charcot-Marie-Tooth disease type 1A is characterized by childhood onset and progressive peripheral nerve manifestations with distal dominant weakness, sensory loss, and limb deformities. Demyelinating changes are also characteristic. Mutations in the peripheral myelin protein 22 gene are the cause.

Peripheral neuropathies: supportive measures and rehabilitation

Neuropathic pain: treatment

Antidepressants, anticonvulsants, antiarrhythmics, topical agents, and analgesics are common treatments for neuropathic pain. Treatment must be individualized to the patient. Effective pain management without the use of narcotics is the primary goal.

Uremic neuropathy

Uremic neuropathy is a distal sensorimotor polyneuropathy caused by uremic toxins. Symptoms are insidious at onset. Paresthesias are usually the earliest symptoms; weakness and atrophy will follow the sensory symptoms. Chronic dialysis may prevent neuropathy in some patients, especially if begun early. Renal transplantation is generally the most successful method to prevent neuropathy.