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CLASSIFICATION OF PERIPHERAL NEUROPATHIES

There are more than 100 types of peripheral neuropathy, based on their symptoms and prognosis[3]

Peripheral neuropathy is one of the most common neurological conditions. Currently, more than 100 types of peripheral neuropathy have been defined, based on their symptoms and prognosis[3].

Peripheral neuropathies are generally classified according to the type of nerve damage[3].

Mononeuropathy

Some forms of neuropathy involve damage to a single nerve.

Mononeuropathy

More often, several nerves are affected.

How does the nerve react to injury?

The possible reactions of nerves to these injuries are[4]:

  • Axonal degeneration: some peripheral neuropathies are due to damage to nerve cell axons. In this case, the myelin sheaths surrounding the axons degenerate secondarily.

Recovery will depend on the regeneration of the axons, which is why it is slow and often incomplete.

  • Demyelination: the myelin layer degenerates in a primary way, usually with preservation of the axons. In this case, there is a slowdown of nerve conduction, or even a blockage.

When re-myelination (myelin regeneration) occurs, nerve function usually recovers quickly and completely.

Did you know that peripheral neuropathy is one of the most common neurological conditions encountered by doctors of all specialties?[5]

In the current context, with an increasingly ageing population and a progressively higher incidence of diabetes and obesity, the prevalence of peripheral neuropathy is increasing, which is a major public health problem[6].
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Find out the main causes of peripheral neuropathy[4,9]

In some instances of peripheral neuropathy, a specific underlying cause cannot be identified, accounting for approximately 25-46% of cases. This condition is termed idiopathic neuropathy [10],

In all other situations, this disorder can be inherited or acquired through disease or trauma processes:

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Traumatic and entrapment neuropathies manifest as discomfort and functional impairments in specific peripheral nerves, often due to compression, which can stem from various causes:[11]

Some forms of polyneuropathies are linked to endocrine and renal diseases.

Inflammatory neuropathies are a diverse group of diseases caused by the patient’s own immune system attacking the peripheral nerves (autoimmune disease).

These neuropathies can be acute or chronic and have varying levels of severity, including:

Infectious neuropathies are those caused by a virus (Cytomegalovirus, Herpes simplex, Herpes zoster, Hepatitis C, Hepatitis B, HIV type 1) or by bacteria or parasites (Borrelia burgdorferi, Corynebacterium diphtheriae, Mycobacterium leprae, Trypanosoma cruzi)[32]

Toxic neuropathies arise due to a combination of factors linked to environmental exposure, heavy metals, medications, coexisting health conditions, and adverse reactions resulting from patients' medical treatments. These toxic neuropathies account for 2-4% of all neuropathies[45]

Hereditary neuropathies include various congenital degenerative peripheral neuropathies that can affect sensory (sensory processing), motor (voluntary movements) and autonomic (involuntary body functions) abilities.[4,5]

Bibliographic references

3. Neuropatía periférica | NINDS Español. https://espanol.ninds.nih.gov/es/trastornos/forma-larga/neuropatia-peri… (último acceso junio 23, 2021).

4. Casademont Pou J. Neuropatías: concepto, manifestaciones clínicas, clasificación, diagnóstico, pruebas complementarias y estrategias terapéuticas. Med – Programa Form Médica Contin Acreditado 2003;8:5373–8. doi:10.1016/s0304-5412(03)70997-4.

5. Watson JC, Dyck PJB. Peripheral Neuropathy: A Practical Approach to Diagnosis and Symptom Management. Mayo Clin Proc 2015;90:940–51. doi:10.1016/j.mayocp.2015.05.004.

6. Barrell K, Smith AG. Peripheral Neuropathy. Med Clin North Am 2019;103:383–97. doi:10.1016/j.mcna.2018.10.006.

7. Negrão L, Almeida P, Alcino S, Duro H, Libório T, Melo Silva U, et al. Effect of the combination of uridine nucleotides, folic acid and vitamin B12 on the clinical expression of peripheral neuropathies. Pain Manag 2014;4:191–6. doi:10.2217/pmt.14.10.

8. Hicks CW, Selvin E. Epidemiology of Peripheral Neuropathy and Lower Extremity Disease in Diabetes. Curr Diab Rep 2019;19:86. doi:10.1007/s11892-019-1212-8.

9. Neuropatía periférica – Síntomas y causas – Mayo Clinic. https://www.mayoclinic.org/es-es/diseases-conditions/peripheral-neuropa… (último acceso junio 23, 2021).

10. Castelli G, Desai K, Cantone R. Peripheral Neuropathy: Evaluation and Differential Diagnosis – PubMed. Am Fam Physician 2020;102:732–9.

11. Galán MGM, Alonso JJR, García HV. Neuropatías por atrapamiento. FMC Form Médica Contin en Atención Primaria. 2008;15(1):10-20. doi:10.1016/S1134-2072(08)70726-6

32. Pradilla G. Diagnóstico y tratamiento de las neuropatías periféricas Diagnóstico y tratamiento de las neuropatías periféricas. https://www.acnweb.org/guia/g5cap14.pdf (último acceso abril 25, 2022).

45. Manji H. Toxic neuropathy. Curr Opin Neurol. 2011;24(5):484-490. doi:10.1097/WCO.0B013E32834A94B6

 

Revised content: July 11, 2022.