Tiny Tips: “TREADMILLS” Peripheral Neuropathy mnemonic

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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

This post has been uploaded by Gaibrie Stephen (@SGaibrie).

References 

1.
Hughes R. Peripheral neuropathy. BMJ. 2002;324(7335):466-469. [PubMed]
2.
Azhary H, Farooq M, Bhanushali M, Majid A, Kassab M. Peripheral neuropathy: differential diagnosis and management. Am Fam Physician. 2010;81(7):887-892. [PubMed]

Dr. Fareen Zaver
Clinical Assistant Professor, University of Calgary. Calgary Zone Emergency Physician
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Sean Patrick

Sean Patrick

Sean Patrick is a senior medical student at the University of Ottawa with an interest in Emergency Medicine, Leadership, and Simulation.