Peripheral neuropathies
Hereditary neuropathies due to hypersensitivity to pressure.
Epidemiology The true prevalence of hereditary pressure hypersensitivity neuropathy (HNPP) is unknown, as the disease is underdiagnosed, but is estimated to be between 1/50,000 and 1/20,000. Clinical description The disease usually occurs between the second
Cervico-thoracic outlet syndrome
Anatomical reminder Cervico-thoracic parade syndrome corresponds to the compression of the brachial plexus (all of the upper limb nerves), the subclavian artery and/or the subclavian vein in the passage formed by the inter-scalènic parade and
Diabetic neuropathies. MEDECIN
Diabetic neuropathies. The frequency of diabetic neuropathy is more than 50% in patients with diabetes for more than 25 years. There are an estimated 100,000,000 patients with diabetic neuropathy worldwide. At the time of diagnosis
Diffuse Scarring Hyperesthesia Syndrome (DCHS) MEDECIN
This new clinical entity is found in some patients with chronic pain. Its current incidence is not known. It consists of a scarring neuropathy affecting all of the scars found in a patient. This entity
Meralgia paresthetica syndrome
Anatomical reminder Originates from the ventral branches of the 2nd and 3rd lumbar root It passes behind the psoas muscle (in red), exits the lateral part of the psoas towards its middle and crosses ventrally
Tarsal tunnel syndrome
Pathophysiology. Tarsal tunnel syndrome is a tunnel syndrome characterized by compression of the posterior tibial nerve and/or its distal terminal branches by the internal annular ligament. The posterior tibial nerve gives, in the retro-malleolar region,
Fibular nerve compression syndrome
Anatomical reminder The common peroneal nerve is formed by bifurcation of the sciatic nerve at the apex of the popliteal fossa. It runs along the medial edge of the biceps femoris muscle then its tendon.
Idiopathic radial palsy
Anatomical reminder From the posterior and lower part of the axillary fossa, it runs downwards and outwards into the posterior brachial region along the posterior surface of the humerus in the radial groove (in contact
Suprascapular nerve syndrome
Anatomical reminder The suprascapular nerve detaches from the upper primary trunk of the brachial plexus. It contains C5 C6 fibers. It passes through the coracoid notch (1) under the coracoid ligament (in green) then at
Ulnar canal syndrome at the elbow
Anatomical reminder 1- Radial nerve 2- vessels 3-Median nerve 4- Brachialis muscle 5- Humerus 6-Ulnar nerve 7- Olecranon The ulnar nerve travels in the epitrochleo-olecranon groove on the inner side of the elbow. It relates
Canal syndromes
Root canal syndromes: definition Nerve compression syndromes, called “ductal syndromes” (entrapment neuropathy in the English) are defined as the clinical translation of a conflict between a peripheral nerve trunk and a particular anatomical region of
Carpal tunnel syndrome MEDECIN
Anatomical reminder Carpal tunnel syndrome is linked to compression of the median nerve in the wrist. The carpal tunnel is a narrow tunnel formed posteriorly by the carpal bones and anteriorly by the anterior annular
Cicatricial neuropathy.
A new concept: Cicatricial neuropathy. The most misunderstood and yet the most frequent of the neuropathies responsible for neuropathic pain. Indeed, a recent study carried out by a Parisian pain center finds an incidence between
Pudendal nerve neuralgia MEDECIN LIBRE
Pathophysiology of neuralgia of the pudendal nerve Classic pudendal nerve neuralgia is a tunnel syndrome (like carpal tunnel syndrome). There are two areas of possible conflict in the pelvic area: at the level of the
Evolution of polyradiculoneuritis sensory impairment MEDECIN
Polyradiculoneuritis. Possible development The topographic evolution of this pathology is dependent on the length of the nerves. Its evolution can be schematized as follows (in red):
Hypoglycemic neuropathy MEDECIN
Etiology Two pathologies are likely to cause neuropathy (rare forms): Insulinoma (benign or malignant tumor secreting insulin), Insulin treatment responsible for repeated hypoglycaemia. Clinical Description It is a predominantly distal motor and sensory neuropathy (feet
Neuropathy and kidney failure MEDECIN
Peripheral neurological involvement is related to renal failure, not dialysis. Uremic polyneuropathy: Its occurrence is linked to the severity of the kidney damage and its duration. Diabetes is a significant cofactor (see diabetic neuropathy). Polyneuropathy
Alcoholic and nutritional neuropathies MEDECIN
Linked to a deficiency in essential nutrients. These neuropathies are frequent in developing countries, deficiencies being endemic. They mainly affect vitamin B deficiencies: B1 (beriberi), B6, B9 In developed countries, they are rather linked to
Alcoholic polyneuropathy MEDECIN
It is linked to direct toxicity of alcohol and its metabolites on the neurological tissue linked to vitamin malabsorption (competition between vit B1 and alcohol in the digestive tract, gastropancreatic disorders causing malabsorption of vitamins)
Neuropathies that are painful from the outset MEDECIN
Different origins are possible: – Idiopathic: Distal symmetrical small fiber polyneuropathy. – Inflammatory: Vasculitis and Perineuritis. – Hereditary: Fabry disease, Hereditary dysautonomic sensory neuropathy type V, Tangier disease, Hereditary amyloidosis. – Metabolic: damage linked to
Neuropathies and Acromegaly MEDECIN
Linked to excessive secretion of growth hormone. Symmetrical nerve damage, predominantly in the lower limbs with paresthesias of the feet or even legs. We can find an enlargement of the nerves in onion bulbs. If
Neuropathies and hyperlipidemia MEDECIN
Rare, it causes sensory impairment distally with a sensation of paresthesias at the tips of the feet. Treatment of hyperlipidemia results in recovery from neuropathy within a few months.
Neuropathies and hyperthyroidism MEDECIN
Description This complication is rare and presents in the form of sensory-motor impairment with predominance of sensitivity disorders. This damage is reversible with treatment of hyperthyroidism (minimum 6 months). Not to be confused with the
Neuropathies and hypothyroidism MEDECIN
Two types of neurological damage: mononeuropathies and polyneuropathies. Be careful, these forms can be associated with hypothyroidism myositis responsible for muscle pain and cramps. Mononeuropathy: The most common is damage to the median nerve at
Acute forms of neuropathies MEDECIN
Installation in a few hours: Mainly vasculitis (polyarteritis nodosa) The picture is more of a multineuritis with multiple radicular or truncal involvement. Installation in a few days: – Guillain-Barrè syndrome and its variants. – Neuropathy
Subacute neuropathies MEDECIN
Etiology Installation in several months. In general : – Metabolic neuropathies, – neuropathies of deficiency origin, – toxic neuropathies, – alcoholic neuropathies, – dysproteinemia neuropathies (myeloma, plasmacytoma, cryoglobulemia, monoclonal gammopathy), – lymphoma neuropathies, – acquired
Toxic neuropathies MEDECIN
Below is a list of toxic agents used in industry and potentially toxic to peripheral nerves. This list is not exhaustive. – Acrylamide (flocculating agent) causes sensory damage to large nerves with sensory ataxia. –
Mucocutaneous signs associated with certain neuropathies MEDECIN
Ulcers and poor perforation: Found in diabetic neuropathy, hereditary sensory and dysautonomic neuropathies, and in neuropathy linked to leprosy. Purpura: Found in cryoglobulinemia and vasculitis. Mees lines: (definition) Seen in arsenic and thallium poisoning. Bullous
Dysautonomic neuropathy MEDECIN
It corresponds to damage to the autonomic nervous system (sympathetic and parasympathetic). This attack is responsible for different manifestations: Sudomotor manifestations: Anhidrosis (absence of sweat secretion). Abnormal vasomotor response to temperature changes. Lacrimal dryness (dry
Ocular signs associated with peripheral neuropathy MEDECIN
Corneal opacities: Found in Fabry disease, amyloid neuropathy and Tangier disease. Cataract: In Fabry disease and Refsum disease. Optic atrophy: Found in Refsum disease and Charcot-Marie-Tooth disease. Retinitis pigmentosa: Found in Refsum disease and Charcot-Marie-Tooth
Trigeminal neuralgia MEDECIN LIBRE
The trigeminal nerve (V: anatomical reminder), the V divided into 3 territories V1, V2 and V3. Description : It is most often a woman over 50, frequent around 70 years. The pain is systematized in
Peripheral neuropathies MEDECIN LIBRE
Definition. The peripheral nervous system is composed of: – Spinal nerve roots, – the posterior spinal ganglia, – the peripheral nerves up to their terminal ramifications, – the autonomic nervous system, – the cranial nerves
Peripheral nerves
Nerves are formed by the axons of nerve cells (the axon is an extension of the nerve cell). These axons are or are not surrounded by myelin sheath from other cells: Schawnn cells. Anatomy: A