Recent study gave a breakdown of what they found re cause. Frank diabetes was eliminated from selection as the cause would be obvious? Top 4 were Idiopathic 47%, Chronic Demyelinating Inflammatory Polyneuropathy(CIDP) 38%, Pre-diabetes 16%, and Charcot Marie Tooth syndrome (CMT) 9%.
Toronto Clinical Neuropathy Score is valid for a wide spectrum of polyneuropathies
A. Abraham et al
European Journal of Neurology 2018, 25: 484–490
Table 2 Etiologies for polyneuropathy in 151 patients; () are per cent
Etiology
Idiopathic 47 (31)
Chronic inflammatory demyelinating polyneuropathy (CIDP) 38 (25)
Pre-diabetes 16 (11)
Charcot–Marie–Tooth (CMT) 9 (6)
Chemotherapy 8 (5)
MMN multifocal motor neuropathy 6 (4)
Monoclonal gammopathy of undetermined significance (MGUS) 4 (3)
Myelin-associated glycoprotein (Anti-MAG) 4 (3)
B12 deficiency 4 (3)
Renal 2 (1)
Alcohol 2 (1)
hereditary neuropathy with liability to pressure palsies (HNPP) 1 (1)
Miscellaneous 10 (7)
Miscellaneous includes connective
tissue disorders, vasculitis, amyloidosis, dorsal root ganglionopathy,
human immunodeficiency virus and lymphoproliferative disorders.
Data are given as n (%).
Diabetes o
CIDP usually has both motor and sensory changes with typical EMG. Loss of ankle jerks, and elevated CSF proteins are typical
MGUS show a elevated band on protein electrophoresis
Anti-MAG has sensory ataxia and motor weakness. Elevated IgM monoclonal levels, elevated cerebral spinal fluid proteins, and Anti-MAG antibodies
MMN multifocal motor neuropathy – presents with muscle weakness and cramps and muscle atrophy. Might have muscle twitching like seen in ALS. EMG and serology for GM1 antibodies for diagnosis