Classification

Classification

Anatomical classification (after Schaumburg et al , 1983):
Two overall types 1) Symmetrical generalised
2) Local and multifocal
1) Symmetrical generalised neuropathies (polyneuropathies)
a) Distal axonopathies I) Toxic (eg drugs, chemicals)
ii) Metabolic (eg uraemia, diabetes mellitus, porphyria)
ii) Deficiency (eg thiamine, pyridoxine)
iv) Genetic (eg HMSN II)
v) Malignancy associated (eg multiple myeloma)
b) Myelinopathies I) Toxic (eg diptheria)
ii) Immunologic (eg Guillain-Barre)
iii) Genetic (eg Refsum disease)
c) Neuronopathies
i) Somatic motor 1) Undetermined (eg amyotropic lateral sclerosis)
2) Genetic (eg hereditary motor neuropathies)
ii) Somatic sensory 1) Infectious (eg herpes zoster neuronitis)
2) Malignancy associated (eg sensory neuronopathy syndrome)
3) Toxic (eg pyridoxine sensory neuropathy)
4) Undetermined (eg subacute sensory neuronopathy syndrome)
iii) Autonomic 1) Genetic (eg hereditary dysautonomia)
2) Focal (mononeuropathy) and multifocal (multiple mononeuropathy) neuropathies
a) Ischaemia (eg polyarteritis, diabetes mellitus, rheumatoid arthritis)
b) Infiltration (eg leukaemia, lymphoma, granuloma, schwannoma, amyloid)
c) Physical injuries (eg severance, focal crush, compression, entrapment)
d) Immunologic (eg brachial and lumbar plexopathy)

Mnemonic for the most common disease affecting the peripheral nerves :
DANG THE RAPIST – Diabetes; Alcohol; Nutritional; Gullain-Barre; Trauma; Hereditary; Environmental toxins and drugs; Rheumatic; Amyloid; Paraneoplastic; Infections; Systemic disease; Tumours

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