neuropathic

neu·ro·path·ic

(nū'rō-path'ik), Relating in any way to neuropathy.

neu·ro·path·ic

(nūr'ō-path'ik) Relating in any way to neuropathy.

neuropathy

(noo-rop'a-the) [ neuro- + -pathy] Any disease of the nerves. neuropathic (noor?o-path'ik), adjective See: table; polyneuropathy.

AIDS peripheral neuropathy

Direct infection of peripheral nerves by HIV, resulting in sensory and motor changes due to destruction of axons or their myelin covering. Acute or chronic inflammatory myelin damage may be the first sign of peripheral nerve involvement. Patients display gradual or abrupt onset of motor weakness and diminished or absent reflexes. Diagnostic biopsies of peripheral nerves show inflammatory changes and loss of myelin. Distal sensory neuropathy occurs in up to 30% of patients with AIDS, usually late in the disease. There is increased risk in older patients and those with diabetes mellitus, nutritional deficiencies, low CD4 cell counts, and vitamin B₁₂ deficiencies. Patients report sharp pain, numbness, or burning in the feet. Destruction of dorsal root ganglions and degeneration of central peripheral axons are seen on autopsy. Some older antiretroviral drugs (ddI, ddC, and d4T) also cause a reversible peripheral neuropathy in about 20% of patients. See: AIDS; Guillain-Barré syndrome; chronic inflammatory demyelinating polyneuropathy

Treatment

Nonsteroidal anti-inflammatory drugs, opioids, gabapentin, anticonvulsants, and topical agents have all been used with variable success to treat the pain of AIDS-related sensory neuropathy. Acupuncture is not effective. Human nerve growth factor, which stimulates regeneration of damaged nerve fibers, is being studied, esp. to minimize the neuropathy that antiretroviral drugs cause.

ascending neuropathy

Neuropathy that ascends from the lower part of the body to the upper.

auditory neuropathy

Abbreviation: AN
Impaired hearing in children due to an absence of auditory evoked potentials, despite the presence of normal cochlear hair cell structure and function. Synonym: auditory dyssynchrony

descending neuropathy

Neuropathy that descends from the upper part of the body to the lower.

NEUROPATHIC FOOT DUE TO DIABETES

diabetic neuropathy

Damage to autonomic, motor, and/or sensory nerves due to metabolic or vascular derangements in patients with long-standing diabetes mellitus. In Western nations, diabetes is the most common cause of neuropathy. Symptoms usually include loss of sensation or unpleasant sensations in the feet, erectile dysfunction, focal motor deficits, gastroparesis, loss of the ability to maintain postural blood pressure, and diseases of cardiac innervation. Sensory loss in the feet may result in undetected injuries that become infected or gangrenous. Synonym: diabetic polyneuropathy See: illustration

Treatment

Tight control of blood sugar levels may prevent some neuropathic symptoms in patients with diabetes mellitus.

dysthyroid optic neuropathy

Crowding of and damage to the optic nerve in patients with Grave's disease. It is characterized by loss of visual acuity and color vision, swelling of the optic disk, and compression of the optic nerve at the apex of the orbit. Synonym: apical crowding

entrapment neuropathy

Nerve entrapment syndrome.

facial sensory neuropathy

Trigeminal neuralgia.

focal neuropathy

Any nerve disease or injury, e.g., carpal tunnel syndrome or peroneal nerve palsy, that affects a single nerve.

generalized neuropathy

A rarely used synonym for polyneuropathy.

glue-sniffer's neuropathy

Malfunction of sensory and motor nerves due to inhaling toxic hydrocarbons. The lower extremities and trigeminal nerve are most often damaged.

interdigital neuropathy

See: Morton, Thomas George

multifocal motor neuropathy

An asymmetrical motor weakness occasionally found in middle-aged men.

optic neuropathy

Pathological injury to the optic nerves or the blood supply to them. Usually, only one eye is affected. Several forms have been described, including ischemic optic neuropathy, which, if prolonged, leads to blindness in the affected eye; optic neuritis due to acute demyelination of optic nerve fibers; infiltrative optic neuropathy, in which the optic nerve is compressed by a tumor or aneurysm; and optic neuropathy due to toxic nutritional factors, e.g., methanol or a combined nutritional and vitamin deficiency.

peripheral neuropathy

Any syndrome in which muscle weakness, paresthesias, impaired reflexes, and autonomic symptoms in the hands and feet are common. This syndrome occurs in patients with diabetes mellitus, renal or hepatic failure, alcoholism, or in those who take certain medications such as phenytoin and isoniazid.

plantar neuropathy

Any of several conditions in which nerves that supply sensation to the sole of the foot are injured or chronically compressed, resulting in burning and tingling sensations and difficulty standing, walking, or running.

subacute myelo-optic neuropathy

, subacute myelo-optico neuropathy Abbreviation: SMON
Neuropathy that usually begins with abdominal pain or diarrhea, followed by sensory and motor disturbances in the lower limbs, ataxia, impaired vision, and convulsions or coma. It is reported mostly in Japan and Australia. Most patients survive, but neurological disability remains. Many of those who have the disease have a history of taking drugs of the halogenated oxyquinoline group such as clioquinol (formerly called iodochlorhydroxyquin).

sural neuropathy

A relatively rare form of sensory neuropathy affecting the lateral ankle, typically associated with the wearing of poorly fitting work boots or shoes that compress the sural nerve.

tomaculous neuropathy

The presence of sausage-shaped areas of thickened myelin with secondary axon constriction in some cases of familial recurrent brachial neuropathy.

toxic-nutritional optic neuropathy

Bilateral visual impairment with central scotomas. This is usually associated with a toxic or nutritional disorder (e.g., the ingestion of methyl alcohol).

vibration-induced neuropathy

Hand-arm vibration syndrome.

Name	Affected nerve(s)	Affected part(s)	Affects sensation?	Affects movement?	Clinical features	Type of neuropathy
Bell’s palsy	Facial	Eye, nasolabial fold, lip (corner of the mouth)	Occasionally	Yes	Paralysis of the facial muscles, usually on just one side of the face	Inflammatory
Carpal tunnel syndrome	Median	Wrist and hand	Yes	Yes	Pain and numbness of the hand and wrist, often caused by repetitive movements or overuse such as typing, sawing, hammering, or polishing	Entrapment
Diabetic sensory neuropathy	Multiple	Feet, lower extremities; sometimes hands late in the course	Yes	No	Burning, stinging pain beginning in both feet, typically occurring after several years of poorly controlled diabetes. Can predispose to foot injury and infections.	Metabolic
Idiopathic brachial plexopathy (neuralgic amyotrophy; Parsonage-Turner syndrome; shoulder girdle syndrome)	Brachial	Shoulder	Yes	Yes	Pain in the shoulder, esp. after vigorous physical activity. Occasionally followed by shoulder girdle muscle atrophy	Entrapment
Meralgia paresthetica	Lateral femoral cutaneous	Thigh	Yes	No	Stinging pain in the anterolateral thigh. Usually found in obesity or in diabetes mellitus	Entrapment
Morton’s neuroma (interdigital neuropathy)	Interdigital nerves of the feet	Ball of foot	Yes	No	Pain often occurring between the web spaces of the 3rd and 4th toes during walking or standing	Entrapment
Piriformis syndrome	Sciatic	Buttock, with radiation into the leg	Yes	No	Buttock pain without back pain that is worsened by sitting and is relieved by walking	Entrapment/compression
Radial nerve palsy (musculospiral paralysis; Saturday night palsy)	Radial nerve (spiral groove entrapment)	Wrist, hand, and forearm	Yes	Yes	Temporary paralysis and numbness of the hand and arm, which may mimic a stroke. Caused by nerve compression, e.g., falling asleep on one’s side on a hard surface	Entrapment compression
Suprascapular neuropathy	Suprascapular	Back of the shoulder	Yes	Yes	Shoulder pain and muscular atrophy. Decreased ability to rotate or abduct the shoulder	Entrapment
Tarsal tunnel syndrome	Posterior tibial	Sole of the foot	Yes	No	Pain under the foot that is worsened by walking	Entrapment
Trigeminal neuralgia	Trigeminal	Cheek, nose, upper lip	Yes	No	Intense, repetitive facial pains that are often worsened by chewing, shaving, or toothbrushing, usually accompanied by spasm on the affected side of the face	Entrapment

neuropathic

neu·rop·a·thy

neuropathic

neu·ro·path·ic

neu·ro·path·ic

neuropathy

AIDS peripheral neuropathy

Treatment

ascending neuropathy

auditory neuropathy

descending neuropathy

diabetic neuropathy

Treatment

dysthyroid optic neuropathy

entrapment neuropathy

facial sensory neuropathy

focal neuropathy

generalized neuropathy

glue-sniffer's neuropathy

interdigital neuropathy

multifocal motor neuropathy

optic neuropathy

peripheral neuropathy

plantar neuropathy

subacute myelo-optic neuropathy

sural neuropathy

tomaculous neuropathy

toxic-nutritional optic neuropathy

vibration-induced neuropathy