Polyneuropathy 797862 212572978 2008-05-15T10:16:27Z 128.176.66.204 /* Evaluation */ {{Infobox_Disease | Name = {{PAGENAME}} | Image = | Caption = | DiseasesDB = | ICD10 = {{ICD10|G|60||g|60}}-{{ICD10|G|64||g|60}}| ICD9 = {{ICD9|356.4}}, {{ICD9|357.1}}-{{ICD9|357.7}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = | eMedicineTopic = | MeshID = D011115 | }} '''Polyneuropathy''' is a [[neurological disorder]] that occurs when many [[peripheral nerve]]s throughout the body malfunction simultaneously. It may be acute and appear without warning, or chronic and develop gradually over a longer period of time. Many polyneuropathies have both motor and sensory involvement and some have autonomic dysfunction. These disorders are often symmetric and frequently involve distal extremities. There is a very large [[Differential diagnosis|differential]] for polyneuropathy. ==Evaluation== Evaluation and classification of polyneuropathies begins with a history and physical exam in order to document what the pattern of the disease process is (arms, legs, distal, proximal, symmetric), when they started, how long they've lasted, if they fluctuate, and what deficits and pain are involved. If pain is a factor, and it often is, determining where and how long the pain has been present is important. The patient must be interviewed, and physical testing is often necessary to further delineate and document the pain. One also needs to know what disorders are already present within the family and what diseases the patient may currently have. This is vital in forming a differential diagnosis. ==Diagnosis/testing== Although often diseases are suggested by the physical exam and history alone, testing is still a large part of the diagnosis. Tests which may be employed include: electrodiagnostic testing using [[electromyography]], [[muscle biopsy]], serum [[creatine kinase]] (CK), [[antibody]] testing, . Nerve biopsy is not used much, but is helpful in determing [[Small fiber peripheral neuropathy|small fiber neuropathy]]. Other tests may be used, especially tests for specific disorders associated with polyneuropathies. ==Differential== There is a large [[Differential diagnosis|differential]] for polyneuropathies: [[vitamin deficiency]], [[cancer]], toxins, infections (ex. [[Guillain-Barré Syndrome]]), [[liver]] disease, [[endocrine]] disease (inc. [[diabetes]] with [[diabetic and pre-diabetic neuropathy]]), [[amyloidosis]], [[genetics|genetic]] disorders, motor neuron disorders, motor neuropathies, [[kidney failure]][http://www.nlm.nih.gov/medlineplus/ency/article/000471.htm],[[paraneoplastic]], [[polio]], [[porphyria]] (some types), [[spinal muscular atrophy]], [[catecholamine]] disorders, and many others. This is not a complete list. ==See also== * [[Neuropathy]] * [[Mononeuropathy]] * [[Polyneuropathy in dogs and cats]] * [[Neuritis]] ==External links== *[http://www.merck.com/mrkshared/mmanual_home2/sec06/ch095/ch095h.jsp Merck Manual overview] *[http://www.neuroland.com/nm/pn_evaluate.htm Diagram Diagnosis page] *[http://www.neuro.wustl.edu/neuromuscular/naltbrain.html Wash U. Neuro website, very complete] *[http://www.familydoctor.org Discussion of diabetic polyneuropathy with Spanish translation] [[Category:Neurological disorders]] {{medicine-stub}} {{PNS diseases of the nervous system}} [[de:Polyneuropathie]] [[fr:Polyneuropathie]] [[nl:Polyneuropathie]] [[no:Polynevropati]] [[pl:Polineuropatia]] [[pt:Polineuropatia]]