Metabolic Neuropathy Questions & Answers

Updated: Dec 18, 2017
  • Author: Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Questions & Answers

Overview

What is metabolic neuropathy?

What is the pathophysiology of metabolic neuropathy?

What is the pathophysiology of diabetic polyneuropathy?

What is the pathophysiology of uremic polyneuropathy?

What is the pathophysiology of thyroid neuropathy?

What is the prevalence of metabolic neuropathy in the US?

What is the mortality and morbidity associated with metabolic neuropathy?

What are the racial predilections of metabolic neuropathy?

What are the sexual predilections of metabolic neuropathy?

Which age groups have the highest prevalence of metabolic neuropathy?

Presentation

How are metabolic neuropathies classified?

What are the sensory symptoms of metabolic neuropathy?

What are the motor symptoms of metabolic neuropathy?

What are the autonomic symptoms of metabolic neuropathy?

What is included in the physical exam to evaluate metabolic neuropathy?

Which sensory findings are characteristic of metabolic neuropathy?

Which motor findings are characteristic of metabolic neuropathy?

Which physical findings are characteristic of cranial neuropathies?

What are the signs and symptoms of peripheral neuropathies?

Which physical findings are characteristic of uremia in metabolic neuropathy?

Which physical findings are characteristic of thyroid neuropathy?

Which physical findings are characteristic of metabolic neuropathy in chronic liver disease?

Which physical findings are characteristic of metabolic neuropathy in COPD?

Which physical findings are characteristic of MGUS?

Which physical findings are characteristic of amyloid neuropathy (nonfamilial)?

Which physical findings are characteristic of porphyric neuropathy?

What are the common causes of metabolic neuropathy?

What are rare causes of metabolic neuropathy?

What are risk factors for metabolic neuropathy?

DDX

What are the differential diagnoses for Metabolic Neuropathy?

Workup

Which lab tests are performed in the workup of metabolic neuropathy?

What is the role of imaging studies in the workup of metabolic neuropathy?

What is the role of NCS in the workup of metabolic neuropathy?

What is the role of quantitative sensory testing (QST) in the workup of metabolic neuropathy?

What is the role of quantitative sudomotor axonal reflex testing (Q-SART) in the workup of metabolic neuropathy?

What is the role of nerve excitability measurement in the workup of metabolic neuropathy?

What is the role biopsy in the workup of metabolic neuropathy?

Which histologic findings are characteristic of metabolic neuropathy?

Treatment

How is metabolic neuropathy treated?

How is diabetic neuropathy treated?

How is gastroparesis treated in diabetic neuropathy?

How is enteropathy treated in diabetic neuropathy?

How is cystopathy treated in diabetic neuropathy?

How is diabetic peripheral neuropathic pain treated?

What is the role of surgery in the treatment of metabolic neuropathy?

Which specialist consultations are beneficial to patients with metabolic neuropathy?

Which dietary modifications are used in the treatment of metabolic neuropathy?

Which activity modifications are used in the treatment of metabolic neuropathy?

Follow-up

What is included in the long-term monitoring of metabolic neuropathy?

When is inpatient care of metabolic neuropathy indicated?

What instructions should be given to patients regarding medications for metabolic neuropathy?

When is patient transfer considered in the treatment of metabolic neuropathy?

What are the possible complications of metabolic neuropathy?

What is the prognosis of metabolic neuropathy?

What is included in patient education about metabolic neuropathy?

Medications

Which medications in the drug class Selective serotonin and norepinephrine reuptake inhibitors (SSNRI) are used in the treatment of Metabolic Neuropathy?

Which medications in the drug class Topical analgesics are used in the treatment of Metabolic Neuropathy?

Which medications in the drug class Dopamine agonists are used in the treatment of Metabolic Neuropathy?

Which medications in the drug class Analgesics are used in the treatment of Metabolic Neuropathy?

Which medications in the drug class Anticonvulsants are used in the treatment of Metabolic Neuropathy?

Which medications in the drug class Selective serotonin reuptake inhibitors are used in the treatment of Metabolic Neuropathy?

Which medications in the drug class Tricyclic antidepressants are used in the treatment of Metabolic Neuropathy?

Which medications in the drug class Cholinergic agents are used in the treatment of Metabolic Neuropathy?

Which medications in the drug class Broad-spectrum antibiotics are used in the treatment of Metabolic Neuropathy?

Which medications in the drug class Gastrointestinal agents are used in the treatment of Metabolic Neuropathy?