General Aspects of Neuropathies
摘要
Introduction: Neuropathies consist of a heterogeneous group of diseases whose etiologies are extremely numerous, such as compressive syndromes, inflammatory diseases, genetic and paraneoplastic syndromes, infectious processes, and deficiency diseases. Neuropathies are classified into mononeuropathy, radiculopathies, plexopathies, ganglionopathies, and multiple mononeuropathies. Objective: This chapters aims to conduct a review on the main clinical aspects of neuropathies, emphasizing the anamnesis, clinical findings, physical examination of the patient, and complementary tests. Discussion: Symptoms are usually symmetrical, but significant asymmetry may indicate radiculopathy, plexopathy, spinal cord, or brain involvement. Common symptoms include neuropathic pain, paresthesia, and sensory deficits. Motor fiber impairment may lead to hyporeflexia or areflexia. Muscle strength should be evaluated using the MRC scale, and muscle inspection aids in identifying affected groups. Palpation of nerves helps determine neuropathy etiology. Nerve biopsy can confirm inflammatory or vasculitic neuropathies. Electroneuromyography (ENM) distinguishes between neuropathy, radiculopathy, myopathy, and ganglionopathy, assesses severity, and classifies neuropathy as axonal or demyelinating. Laboratory tests should include B vitamins, inflammatory and infectious markers, thyroid hormones, kidney function, fasting blood glucose test, and genetic testing when necessary. Conclusion: As neuropathies consist of a heterogeneous group of diseases with dozens of etiologies, the anamnesis and physical examination are fundamental for the correct identification of the cause.