Peripheral neuropathy is prevalent in up to 2.4% of the general population1. It is often characterized by an asymmetric distribution with sensory symptoms following a dermatomal pattern. Initial investigations include a complete blood count (CBC), metabolic panel (electrolytes, glucose, urea, creatinine), and thyroid stimulating hormone (TSH)2. There are many causes for peripheral neuropathy, so when considering the etiology, think “TREADMILLS.”
Toxins
- Ethanol, Heavy metals, Tetanus, Organophosphates, Diphtheria
Renal Failure
Endocrine
- Diabetes, Hypothyroidism
Acquired Immunodeficiency Syndrome (AIDS)
Drugs/Deficiency
- Amiodarone, Procainamide, Digoxin, Hydralazine, Statins, Isoniazid, Chloroquine, Misoprostol, Metronidazole, Nitrofurantoin
- Vitamin B6 deficiency, Vitamin B12 deficiency
Malignancy
- Carcinoma (paraneoplastic), Multiple myeloma, Lymphoma
Inherited
- Charcot-Marie-Tooth (CMT), Leukodystrophy
Liver Disease
Lyme Disease
Syphilis
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References
Dr. Fareen Zaver
Clinical Assistant Professor, University of Calgary. Calgary Zone Emergency Physician
Sean Patrick
Sean Patrick is a senior medical student at the University of Ottawa with an interest in Emergency Medicine, Leadership, and Simulation.
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