Epidemiology of peripheral neuropathy

Abstract

Peripheral neuropathy occurs as a component of several common and many rare diseases. It is heterogenous in aetiology, diverse in pathology, and varied in severity. The term peripheral neuropathy includes symmetric polyneuropathy, single and multiple mononeuropathy, and radiculopathy. Further classification depends on a mixture of phenomenological, pathological, and genetic or other aetiological features. All of these things cause problems for epidemiologists who, without agreed definitions of what constitutes a case, find it difficult to describe patterns of occurrence of disease. Perhaps it is not very surprising that information about the descriptive epidemiology of peripheral neuropathy derived from population based studies is scarce.What data do exist suggest that peripheral neuropathy may be rather commoner than is usually thought. A recent study, carried out in two regions of Italy, estimated the frequency of chronic symmetric symptomatic polyneuropathy in people over the age of 55 years attending general practitioners' surgeries. Probable polyneuropathy was diagnosed if they answered positively to a screening questionnaire for neuropathic symptoms and showed signs compatible with peripheral neuropathy when examined by a neurologist.' Around 8% of people met these diagnostic criteria for polyneuropathy. The commonest condition associated with polyneuropathy was diabetes. This study was not population based; only people already attending their general practitioner were included-a group in whom chronic disease is likely to be overrepresented and who will therefore be at increased risk of neuropathy. Despite this caveat, the rate of polyneuropathy detected was surprisingly high. Two studies of prevalence, one in Bombay2 and the other in Sicily,3 also suggest that peripheral neuropathy is common in the community. Cases were identified by a door to door survey. Those who answered positively to questions about sensory or motor symptoms were examined by a neurologist. In Bombay the prevalence of peripheral neuropathy was 2-4% and the commonest diagnoses were carpal tunnel syndrome and diabetic peripheral neuropathy. In Sicily, 7% of the population responded positively to the initial screening questions. After further investigation, diabetic neuropathy was diagnosed in 0 3% but no details about the frequency of other types of neuropathy were published.Peripheral neuropathies are a disparate group of diseases. Attempts to consider them as a whole emphasise their contribution to the burden of disease and disability in the community, but may obscure interesting epidemiological features that could lead to a better understanding of aetiology. In this review we consider the commoner forms of peripheral neuropathy separately. Diabetic neuropathiesThe neuropathic complications of diabetes mellitus include distal, symmetric, predominantly sensory neuropathy, autonomic neuropathy, asymmetric proximal neuropathy, and cranial and other mononeuropathies. Several of these neuropathic manifestations may coexist in same patient....

Sonography of the median nerve in CMT1A, CMT2A, CMTX, and HNPP

“…Most notably, the numbers of patients were not large for the CMT2A, CMTX, and HNPP types, which limits the ability to distinguish between these disease groups and controls using median nerve sonography. A small cohort is fairly typical in studies of this type, and this is difficult to overcome in a single‐center study because types 2, X, and HNPP are less common than type 1A, which accounts for nearly the half of the cases . As noted elsewhere, the results do not exclude the possibility that clinical and electrodiagnostic correlations may emerge with larger group sizes.…”

Passive transfer of demyelination by serum or IgG from chronic inflammatory demyelinating polyneuropathy patients

“…In EAN, both humoral and cellmediated arms of the immune system play a role. Anti-GM1 antibodies binding to nodal axolemma seem to play an important role in AMAN and AMSAN, 7,8,10 and antibodies to GQ1b are characteristically found in MFS and AIDP with ophthalmoplegia. Antibody-mediated demyelination, however, has been amply demonstrated in several experimental models of inflammatory demyelinating disease in both the peripheral and central nervous systems.…”

Impairments and comorbidities of polyneuropathy revealed by population-based analyses

“…From those studies, certain polyneuropathies have been suggested to have substantial disease burden from physical impairments 16,17 or even mortality. 18,19 However, mortality and disease burden quantification of polyneuropathies irrespective of etiology through a large population-based study has not been performed.…”