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Harrison's Principles of Internal Medicine, 18e
| Part 17. Neurologic Disorders > Section 3. Nerve and Muscle Disorders > |
Chapter 384. Peripheral Neuropathy
Sections: Peripheral Neuropathy: Introduction, General Approach, Specific Disorders, Other Hereditary Neuropathies, Acquired Neuropathies, Neuropathies Associated with Malignancy, Other Toxic Neuropathies, Nutritional Neuropathies, Cryptogenic (Idiopathic) Sensory and Sensorimotor Polyneuropathy, Mononeuropathies/Plexopathies/Radiculopathies, Radiculopathies, Plexopathies, Further Readings.
Topics Discussed: peripheral neuropathy.
Excerpt:"Peripheral nerves are composed of sensory, motor, and autonomic elements. Diseases can affect the cell body of a neuron or its peripheral processes, namely the axons or the encasing myelin sheaths. Most peripheral nerves are mixed and contain sensory and motor as well as autonomic fibers. Nerves can be subdivided into three major classes: large myelinated, small myelinated, and small unmyelinated. Motor axons are usually large myelinated fibers that conduct rapidly (approximately 50 m/s). Sensory fibers may be any of the three types. Large-diameter sensory fibers conduct proprioception and vibratory sensat ion to the brain, while the smaller-diameter myelinated and unmyelinated fibers transmit pain and temperature sensation. Autonomic nerves are also small in diameter. Thus, peripheral neuropathies can impair sensory, motor, or autonomic function, either singly or in combination. Peripheral neuropathies are further classified into those that primarily affect the cell body (e.g., neuronopathy or ganglionopathy), myelin (myelinopathy), and the axon (axonopathy). These different classes of peripheral neuropathies have distinct clinical and electrophysiologic features. This chapter discusses the clinical approach to a patient suspected of having a peripheral neuropathy, as well as specific..."
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