Sensory Predominant Neuropathy

Sensory Predominant Neuropathy

1. Sensory predominant Neuropathy Ade Wijaya – July 2019

2. Botez SA, Herrmann DN. Sensory neuropathies, from symptoms to treatment. Current opinion in neurology. 2010 Oct 1;23(5):502-8.

3. Inherited neuropathies with sensory involvement Hereditary sensory and autonomic neuropathies Familial amyloid polyneuropathies (FAPs ) Neuropathies associated with mitochondrial disorders Charcot–Marie–Tooth (CMT ) disease Burns TM, Phillips LH 2nd, Dimberg EL, et al. Novel myelin protein zero mutation (Arg36Trp) in a patient with acute onset painful neuropathy . Neuromuscul Disord 2006 ; 16:308–310. Sowden JE, Logigian EL, Malik K, Herrmann DN . Genotype-phenotype correlation in a family with late onset CMT and an MPZ lys236del mutation . J Neurol Neurosurg Psychiatry 2005; 76:442–444.

4. Management Immune-mediated sensory neuropathies and sensory neuronopathies IVIG for ataxic SNN or progressive refractory painful sensory neuropathies or SFSN in Sjogren’s syndrome TNF-a inhibitor ( etanercept) considered in patients with progressive, disabling SNN in the setting of connective tissue disorders, who are refractory to IVIG and in whom there is no evidence of central or peripheral nervous system demyelination ( a potential complication of TNF-a blockade) Figueroa JJ, Tabechian D, Herrmann DN. Severe long-standing dysimmune sensory neuronopathy responsive to etanercept. J Clin Neuromuscul Dis 2008 ; 9:415–420 Caroyer JM, Manto MU, Steinfeld SD. Severe sensory neuronopathy responsive to infliximab in primary Sjo¨ gren’s syndrome. Neurology 2002 ; 59:1113–1114 . Morozumi S, Kawagashira Y, Iijima M, et al. Intravenous immunoglobulin treatment for painful sensory neuropathy associated with Sjo¨ gren’s syndrome. J Neurol Sci 2009; 279:57–61.

5. HIV - Neuropathy DSP is the most common neurological complication of HIV infection Symptoms are usually symmetric , mainly distal and sensory with only minimal motor involvement Pathogenesis: indirect neurotoxicity of the HIV virus via immune activation and direct neurotoxicity of HIV proteins A cute toxic neuropathy (ATN) due to dideoxynucleoside reverse transcriptase inhibitor drugs Management: gabapentin, high concentrated capsaicin patch Botez SA, Herrmann DN. Sensory neuropathies, from symptoms to treatment. Current opinion in neurology. 2010 Oct 1;23(5):502-8.

6. Diabetic Neuropathy - Management FDA approved: pregabalin dan duloxetine TENS as adjunctive therapy Botox injections Botez SA, Herrmann DN. Sensory neuropathies, from symptoms to treatment. Current opinion in neurology. 2010 Oct 1;23(5):502-8.

7. Summary Sensory neuropathies are challenging because of their diversity Diagnostic criteria for DSP, SFSN and sensory ganglionopathies have improved with the ever widening array of neuropathy assessment tools such as skin biopsy, which permit more precise characterization of sensory neuropathies Genetic testing allows the diagnosis of sensory predominant hereditary neuropathies , providing insight into disease mechanisms and potential treatments IVIG are demonstrating promise for a widening range of immune-mediated sensory neuropathies