We’ll take a look at types
of hereditary neuropathy.
Under here, we’ll take a look at
a very important differential,
and this is called
We’ll take a look at
We have what’s known as HNPP,
hereditary neuropathy with
liability to pressure palsies.
And we have hereditary sensory
and autonomic neuropathy,
and that actually will make perfect sense
because the name will imply exactly
what’s going on with your patient.
And then you have neuropathy with
what’s known as leukodystrophy.
These are hereditary neuropathies.
Most prevalent inherited neurologic
disease we’ll take a look at
would be Charcot-Marie,
There are multiple types.
We have CMT Type 1, 2, and such.
High variability in symptoms even within
the family, even though it’s hereditary.
All are demyelinating
except the CMT-2,
it’s an axonal CMT.
No specific treatment
Under toxic neuropathy.
Heavy metals: arsenic,
your patient might
be exposed to water,
Drugs such as vincristine,
Substance abuse such alcohol,
and of course, nitric oxide type
of inhalation, or nitrous oxide.
Industrial poisons: These are risk
factors for toxic neuropathy.
Infectious neuropathy: HIV, Lyme, leprosy,
most common neuropathy
in the world, actually,
and even --
well, think about your immunocompromised
patients here, and CMV and herpes.
There are many type of neuropathies
in which we are going to walk through
in terms of classifications.
We'll begin by looking at
We have HIV.
Distal sensory polyneuropathy,
one-third of your AIDS patients actually
have distal sensory polyneuropathy.
You have something called mononeuropathies,
and this is typically later in the disease.
So, if I were you, I would know the
timeline here for HIV neuropathy, please.
And may actually have and
develop what’s known as
acute, acute, acute.
The reason that I bring that to your
attention is because you know in HIV,
your CD4 count is on a
downhill swing, right?
But if it’s acute
inflammatory, maybe, maybe,
there might be a lymphocytic
pleocytosis in CSF,
but that obviously
has a variable.
In this case, the only reason I
bring that to your attention
is because it may result
in acute inflammatory.
Or lumbosacral, in other words, down by
your lower region, polyradiculopathy
associated with CMV.
Usually, we’d think about
CMV type of infection.
should come to mind.
Neuropathy of leprosy.
We have to talk about this
because it’s one of the
most common infectious
It’s a sensory versus a motor
type of neuropathy, more so.
Now at this point, can we
now have a discussion,
a healthy discussion where you’re
not just memorizing stuff?
So what does that mean to you?
You have one nerve that is
undergoing damage or injury
but in multiple
Presentation of immunologic origin.
Predilection for ulnar
and peroneal nerve.
Now, think about your ulnar that
we’ve talked about in great detail.
You’re worried about your medial
aspect in fourth and fifth digits.
And if it’s peroneal, then
by the leg, obviously.
An there, I’ve given you much
detail about how to localize
where the damage to the nerves are,
and you know every single board and every
single ward love that type of information.
So, spend some time to make
sure that you know how to
conduct a proper physical exam to
localize your nerve injury, please.
And if you don’t, we’ve done it.
We've done it.
Make sure you go
back and review it.