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Paraesthesia (Symmetrical (Distal (DM
mx: gabapentin 300mg TDS/TCA
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Paraesthesia
Symmetrical
Distal
DM
- mx: gabapentin 300mg TDS/TCA
- refer NEM if very pain/cannot walk
Vit B12 deficiency
- sensory, vibration/proprioception loss
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Proximal
spinal cord
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syringomyelia
- cape-like distribution
- motor, pain, temperature
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Asymmetrical
patchy
one patch
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External compression (physical, tumour)
Carpal tunnel syndrome
- worse in morning, better with shaking
- can involve all 5 fingers
- refer HRM
multiple patches
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mononeuritis multiplex
DM, polyarthritis nodosa (autoimmune), sarcoidosis, amyloidosis
- asymmetrical random patches
- paraesthesia and weakness
sensory neuropathy
drugs - platinum, aminoglycoside (GNAT)
- motor spared
- areflexia & ataxia
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Higher cortical signs and symptoms
- aphasia, neglect, abnormalities of graphesthesia, stereognosis, two-point discrimination, extinction
Axonal (length-dependent) neuropathies:
- DM, leprosy
- hereditary conditions ((eg, Charcot-Marie-Tooth disease)
- Amyloidosis (light chain and familial)
- Vasculitis
- Uremia
- Chemo, EtOH
- paraneoplastic neuropathy
- nutritional deficiency (vit B2, B6, B12)
- infections (HBV, HCV, syphillis, HIV, lyme disease)