A Clinical Approach to the Neuropathies

Abstract

Neuropathies are disorders of peripheral nerves. The peripheral nervous system consists of the peripheral and cranial nerves together with their nerve cells, i.e. the anterior horn cells and cranial motor nuclei, the dorsal root ganglia and cranial sensory nuclei, and the autonomic ganglia of the sympathetic and parasympathetic nervous systems. Disease may affect these structures proximally or peripherally, or even at their central cell body. The latter is sometimes termed neuronopathy, but the clinical expression of this pathological process consists of dysfunction in the peripheral nervous system and thus resembles that of primary disorders of the peripheral parts of the cell, i.e. the axon. Either motor cells and their axons, or sensory cells and their axons, or both, may be affected. Although autonomic disturbances rarely form a major aspect of the clinical features of peripheral neuropathy, autonomic neuropathy, e.g. in diabetes mellitus, can be a major source of disability.