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Causes of chronic neuropathies: a single-center experience

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Abstract

Objectives

Chronic neuropathies are a common cause of neurological disability worldwide. However, few reports have evaluated, in real life, the prevalence of the several conditions which can cause it.

Patients and methods

The authors reviewed informatic database for outpatient office to confirm identification of chronic neuropathy in a 3-year interval period.

Results

Among the 100 selected patients with chronic neuropathies, almost one fifth (19%) remained idiopathic. The most common etiologies were diabetes (17%), dysimmune neuropathies (38%), and vitamin B12 deficiency (9%). In the “dysimmune neuropathies” group, we distinguished various etiologies, including dysimmune neuropathies associated or not with systemic autoimmune diseases (7 and 3%, respectively), chronic inflammatory polyneuropathy (CIDP) (8%), multifocal motor neuropathy (MMN) (3%), paraproteinemic (8%), celiac disease-related (6%), and paraneoplastic (3%) neuropathies.

Conclusions

In this report from a single neurological center, treatable causes of chronic neuropathies, such as dysimmune neuropathies, including CIDP, and celiac disease-associated neuropathy, were common. These findings suggest the utility of routine screening with blood testing for dysimmune neuropathy and celiac disease for all patients presenting with idiopathic chronic polyneuropathy in whom primary diagnostic testings had failed to identify an etiology for the disease.

Significance

Our results indicate that patients with peripheral neuropathy could receive a benefit from being evaluated routinely in a specialized neurological center, as many of the conditions that were discovered represented potentially treatable causes of neuropathy.

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Abbreviations

CD :

celiac disease

CIDP :

chronic inflammatory demyelinating polyneuropathy

CMAP :

compound muscle action potential

CSF :

cerebrospinal fluid

DML :

distal motor latency

GBS :

Guillain-Barrè syndrome

HR CT :

high-resolution computed tomography

MCV :

motor conduction velocity

MGUS :

monoclonal gammopathy of undetermined significance

SCV :

sensory conduction velocity

SNAP :

Sensory nerve action potential

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Authors and Affiliations

  1. Unit of Neurology, Neurobiology, Department of Medicine, University Campus Bio-Medico of Rome, via Álvaro del Portillo, 21, 00128, Rome, Italy

    Lorenzo Ricci, Lucia Florio, Fioravante Capone & Vincenzo Di Lazzaro

  2. IRCCS, UOC Neurologia, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy

    Marco Luigetti

  3. Università Cattolica del Sacro Cuore, Sede di Roma, Rome, Italy

    Marco Luigetti

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  1. Lorenzo Ricci
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  2. Marco Luigetti
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  3. Lucia Florio
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  4. Fioravante Capone
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  5. Vincenzo Di Lazzaro
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Correspondence to Lorenzo Ricci.

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Ricci, L., Luigetti, M., Florio, L. et al. Causes of chronic neuropathies: a single-center experience. Neurol Sci 40, 1611–1617 (2019). https://doi.org/10.1007/s10072-019-03899-z

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