Polyneuropathy, axonal and demyelinating neuropathies (mechanism of disease)
This is a flowchart on polyneuropathy, covering axonal neuropathy and demyelinating neuropathy, including the etiology, pathophysiology, and manifestations of these conditions.
ADDITIONAL TAGS:
Hypothyroidism
Variable progression, with
periods of recovery, stabilization, exacerbations, slow decline, etc.
Progression: slow decline over years, affecting longer axons (lower extremities) first.
Distal muscle wasting: feet, lower legs, hands (if severe)
Damage to multiple peripheral nerve fibers, mainly involving:
Axon loss → ↓ signal
amplitude (axonal neuropathy)
Risk factors / SDOH
Cell / tissue damage
Nutrition / diet
Polyneuropathy
Medicine / iatrogenic
Infectious / microbial
Biochem / metabolic
Immunology / inflammation
Signs / symptoms
Tests / imaging / labs
Environmental / toxin
Genetic / hereditary
Flow physiology
Pathophysiology
Etiology
Manifestations
Alcohol use disorder
Impaired interaction between Schwann cells and axons →
↓ conduction velocity, ↑ latency (demyelinating neuropathy)
Generalized muscle weakness: distal proximal
Distal sensory loss (abnormal vibration and proprioception pain or temperature)
Diffusely ↓ or absent reflexes
Distal sensory loss (all senses: pain, temperature, proprioception, vibration)
↓ or absent distal reflexes (usually begins in the ankles)
Atrophy of muscles
+/- neuropathic pain, paresthesias, and motor weakness
Burning-foot syndrome: burning pain, tingling, pins-and-needles sensation, or formication (feels like insects crawling on/under skin)
Sensory ataxia
Malnutrition (↓ thiamine)
Cytotoxic effects
Alcoholic polyneuropathy
Diabetes mellitus
Chronic hyperglycemia
Glycation of axon proteins
HIV
Leprosy
Borreliosis
Chemotherapy-induced peripheral neuropathy (cisplatin, doxorubicin)
Drug-induced (suramin, amiodarone)
Diphtheria → diphtheria toxin
Charcot-Marie-Tooth disease (aka Hereditary motor sensory neuropathy)
Scoliosis
Foot deformities (high arches, hammer toes)
Krabbe disease, adrenoleukodystrophy, metachromatic leukodystrophy
Other inflammatory: vasculitis; connective tissue disorders
Other viruses: CMV, VZV, herpes zoster, measles, mumps, rubella, flu
Uremic polyneuropathy
Heavy metals (lead, arsenic, thallium)
Guillain-Barré: cross reactive Ab (molecular mimicry against Schwann cells)
GI or resp infxn
Motor sensory in early dz
Пікірлер: 10
just wow this channel is a true gem, I was so lost with what polyneuropathy actually entailed but with the mechanism of disease flowchart you made it understandable. I have a neurology oral exam in a week so this is just what i need thanks a lot.
Thanks, a nice quick comprehensive breakdown of polyneuropathy. I "might" have Axonal neuropathy, as CIDP has apparantly been ruled out, so now testing for Axonal. Runner's dystonia was also a possible diagnosis but none of the treatments helped, just horrible side-effects.
Great summary, thanks. But from what I've read leprosy causes both axonal and demyelinating neuropathy since it also infects Schwann cells,.
Thanks for the informative flow chart.
Thank you for this! It really helped.
I didn't realize that hypothyroidism and borrelia ( both of which I've had ) caused axonal disease. And I have a pretty good idea that none of my doctors over the years knew that either.
Interesting video. I have axonal really bad, but it's unknown as to the cause. I don't drink, never did drugs & to my knowledge, don't have the diseases listed in this video. I am in bad shape, though. Severe pain along with numbness at the same time in my legs down to my feet & muscle wasting throughout my body. I'm even getting trouble breathing now at times & it's difficult even taking a shower. I am taking gabpentin & I take 325 to 650mg Tylenol each day.
@florabraswell-nm1re
10 ай бұрын
So sorry for your neuropathy problems, l have just been diagnosed with Polyneuropathy ‘ l have been suffering with this for years and l still have no glue as to what it is , l have had Nerve Conduction test and EMG also an MRI of Spine still nothing but a Polyneuropathy diagnosis and l don’t know what kind , now l am being sent to a Neurologist, l have to take a Gabapentin and 3 extra strength BCs to get going and l am still in pain and flu like symptoms 🙏💜
And I wonder if chickenpox could cause it too ( got that at age 35 )
You missed CIDP/AIDP. It’s a demyelinating neuropathy.