How to diagnose and manage polyneuropathy

Clinicians may find diagnosing polyneuropathy challenging due to the vague and insidious onset of symptoms. Identifying signs consistent with polyneuropathy and determining which investigations to conduct and when to be concerned can be daunting.

Polyneuropathy involves simultaneous dysfunction of multiple peripheral nerves, with the most common form being distal symmetric polyneuropathy. Symptoms primarily occur distally, mainly at the bottom of the feet, and progress proximally. Sensory symptoms are more frequent than motor symptoms and signs. Patients with distal symmetric polyneuropathy may experience neuropathic pain, impairments in walking, and distal motor function, significantly impacting their quality of life.

Dr. Ario Mirian, a fifth-year neurology resident at the University of Western Ontario's Schulich School of Medicine and Dentistry, is the lead author of a review article in CMAJ entitled "Diagnosis and management of patients with polyneuropathy". In this episode, Dr. Mirian presents a practical approach to diagnosing and managing polyneuropathy while highlighting 'red flags' that should prompt clinicians to investigate potentially serious underlying causes, such as malignancy or vasculitis.

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