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Overview of acquired peripheral neuropathies in children

Author
Peter B Kang, MD, FAAP, FAAN
Section Editors
Douglas R Nordli, Jr, MD
Jeremy M Shefner, MD, PhD
Deputy Editor
John F Dashe, MD, PhD

INTRODUCTION

Peripheral neuropathy is defined as a disorder of the peripheral nerves. It typically is characterized by weakness, sensory loss (numbness), and/or positive sensory symptoms such as paresthesia, pain, or burning sensations. Most peripheral nerve disorders in children are hereditary (figure 1). However, many systemic illnesses, drugs, and toxins can injure the peripheral nervous system (table 1).

An overview of acquired peripheral neuropathies is presented here. Hereditary peripheral neuropathies and specific disorders that affect the peripheral nerves are discussed separately. (See "Overview of hereditary neuropathies" and "Hereditary primary motor sensory neuropathies, including Charcot-Marie-Tooth disease" and "Hereditary sensory and autonomic neuropathies" and "Neuropathies associated with hereditary disorders".)

CLINICAL FEATURES

Most peripheral nerve disorders have a gradual and slowly progressive course. Acute presentation may occur with trauma, toxic exposure, or inflammatory conditions.

Most peripheral neuropathies show bilateral, symmetric, predominantly distal involvement, though focal neuropathies do occur in children from various causes such as trauma. The severity of diffuse nerve injuries is related directly to axon length; thus, longer axons are affected first, resulting in symptoms that typically have an earlier presentation and are more prominent in the distal lower extremities. Most neuropathies have combined sensory and motor involvement. However, some disorders have only motor or sensory abnormalities.

The most common motor symptom is weakness. It may present as clumsiness, difficulty with running or climbing stairs, or impaired fine motor skills such as writing, buttoning clothes, opening jars, or tying shoes. Ataxia, or balance difficulty, is another motor symptom associated with neuropathy. Sensory symptoms may include numbness or positive sensory symptoms such as paresthesia, pain, or burning sensations.

                                                      

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Literature review current through: Nov 2016. | This topic last updated: Mon May 30 00:00:00 GMT+00:00 2016.
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