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Multifocal Motor Neuropathies and Diabetic Neuropathy

by Carlo Raj, MD
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    Cause of metabolic neuropathy. Diabetes is always on top of that list, as is thyroid disease, hepatic failure, your kidney is failing, uremic neuropathy, that’s an important one. At the end of this entire section, I want to walk you through a very, very important, what I call a polyneuropathy Nirvana diagram, as we shall see. Porphyric neuropathy, what does that mean? You know much biochemistry, you should know about your porphyria pathway on your way to produce your heme. And in that porphyria pathway, there are a couple of diseases or biochemical pathologies that you should be familiar with. One of them being acute intermittent porphyria. Vitamin deficiencies, either B1, B6, or B12. Once again, remember, B1, that's a problem. Thiamine. B6 required, for once again, proper myelination. And of course, B12. Critical care neuropathy, these are metabolic neuropathies, important etiologies Let’s quickly walk through diabetic neuropathy. Chronic progressive distal symmetric diabetic polyneuropathy. Every single word there is incredibly important. Diabetes, in the U.S., type 2 diabetes, of course, extremely common. Chronicity, decades have gone by, and now at this point, you’re going to have symmetric distal neuropathy taking place. We call this stocking-glove, don't we? Most common presentation, small and large fiber involvement. There is no discrimination with diabetic neuropathy. It affects you everywhere. Neuropathic pain is usually prominent. For example, what about the nerves in the stomach, would they be lost? Oh, absolutely. So, you have paralysis of the stomach. We call this gastroparesis, or maybe your patient has suffered myocardial infarction, and there was no chest pain. A sound myocardial infarction, nerves have been lost. Or down in the feet, and here once again, the nerves, you’re worried about decubitus ulcers, aren’t you? Diabetic neuropathy, small and large fibers. Neuropathic pain, usually prominent, if you’re actually...

    About the Lecture

    The lecture Multifocal Motor Neuropathies and Diabetic Neuropathy by Carlo Raj, MD is from the course Polyneuropathy. It contains the following chapters:

    • Multifocal Motor Neuropathies
    • Diabetic Neuropathy

    Included Quiz Questions

    1. Burning sensation in all the fingers up to the wrist
    2. Burning sensation in the right hand from the wrist to fingers only
    3. Burning sensation in the left hand from the wrist to fingers only
    4. Burning sensation in the left hand from wrist to fingers and in right hand up to the biceps
    5. Burning sensation of right-hand 4th and 5th fingers only
    1. Acute intermittent porphyric polyneuropathy
    2. Uremic polyneuropathy
    3. B12 polyneuropathy
    4. Critical care neuropathy
    5. Diabetic neuropathy
    1. Constant control of glucose levels
    2. Use of Gabapentin
    3. Use of Carbamazepine
    4. Use of NSAID's
    5. Use of opioids
    1. Neuromyelitis optica
    2. Compression neuropathy
    3. Decubitus ulcers
    4. Mononeuropathy
    5. Polyradiculopathy

    Author of lecture Multifocal Motor Neuropathies and Diabetic Neuropathy

     Carlo Raj, MD

    Carlo Raj, MD


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