Systemic lupus erythematosus may be associated with a variety of neuropsychiatric syndromes, including peripheral neuropathy, mostly sensorimotor types. However, all parts of the peripheral and central nervous system may be affected, and careful and repeated neurological evaluation is important.
MRI of the brachial plexus and/or lumbar plexus may be helpful in making a diagnosis of chronic inflammatory demyelinating polyradiculopathy in patients who do not meet the standard criteria. Imaging findings include increased signal intensity, nerve hypertrophy, and nerve contrast enhancement.
SYNOPSIS: Vasculitic neuropathy is characterized by stepwise progression of sensorimotor neuropathy, usually with axonal features on electrodiagnostic studies, and often the presence of antimyeloperoxidase and rheumatoid factor antibodies and cryoglobulins. However, peripheral nerve biopsy is necessary for a definitive diagnosis.
Long-term symptoms and disability from chemotherapy-induced peripheral neuropathy occur in more than half of childhood survivors of cancer, with vinca alkaloids and platinum agents implicated most often.
Microstructural nerve damage in distal symmetric diabetic neuropathy differs between subjects with type 1 diabetes (T1D) and type 2 diabetes (T2D). The predominant nerve lesions in T1D correlated with hyperglycemia and nerve conduction impairment, while the predominant lesions in T2D correlated with dyslipidemia.
SYNOPSIS: This careful analysis of MRI imaging of the brachial plexus in patients with well-defined Parsonage-Turner Syndrome showed that the lesions are in peripheral branches of the brachial plexus and not in the roots or cords.
The cause of most cases of small-fiber neuropathy is uncertain, but many patients have accompanying autoimmune biomarkers. In a carefully selected group of such patients, intravenous immunoglobulin treatment appears to provide benefit.
Most patients with anti-MAG neuropathy complain of painful paresthesias or dysesthesias, but unlike diabetic neuropathy, these symptoms are not severe and do not affect quality of life as much as motor weakness.
The hallmark of neuropathy associated with type 2 diabetes is reduction of sensory nerve action potential amplitude and not a reduction in conduction velocity, supporting the hypothesis that hyperglycemia causes axonal dysfunction and injury.