Neuropatioiden

Neuropatioiden, or neuropathies, are disorders caused by damage to peripheral nerves that mediate sensation, movement, and autonomic functions. They can present as polyneuropathy, mononeuropathy multiplex, or autonomic neuropathy. The most common form is distal symmetric polyneuropathy, typically beginning in the feet and hands.

Causes are diverse and include metabolic and vascular diseases (notably diabetes), nutritional deficiencies (e.g., vitamin B12), toxins and medications (such as chemotherapy), inflammatory or autoimmune processes (CIDP, Guillain-Barré syndrome), infections, hereditary disorders (Charcot‑Marie‑Tooth), and nerve injury. Pathology may be axonal degeneration, demyelination, or both.

Symptoms depend on the fibers affected. Sensory-pominant neuropathies cause numbness, tingling, burning pain, and reduced proprioception; motor involvement leads to weakness and gait impairment; autonomic neuropathy can cause orthostatic hypotension, gastrointestinal symptoms, urinary dysfunction, and abnormal sweating. On examination, reflex loss and sensory deficits in a distal distribution are common.

Diagnosis relies on history and examination, supported by nerve conduction studies and electromyography to distinguish axonal from demyelinating processes. Laboratory testing screens for diabetes and metabolic factors, B12, thyroid function, renal and liver disease, autoimmune markers, infections, and, when indicated, genetic testing for hereditary forms.

Treatment targets the underlying cause when possible and alleviates symptoms. Glycemic control is central in diabetic neuropathy; neuropathic pain is managed with anticonvulsants, antidepressants, topical agents, and physical therapy. Immunotherapies may help immune‑mediated neuropathies. Prognosis varies by cause; many neuropathies are chronic and may progress or stabilize with treatment.