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Old 03-27-2011, 03:11 AM #1
drswami drswami is offline
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Default differential diagnosis

does anyone know of a good source of differential diagnosis for peripheral neuropathy. i discovered this recently, and am wondering if there is anything better.

http://books.google.com/books?id=9_x...20diet&f=false
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Old 03-27-2011, 03:37 AM #2
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Lightbulb

There are many terms used like differential in medicine.
A "differential" test for blood work, involves listing all the white blood cells present and in what quantity.

Basically there are primary neuropathies... which exist on their own. Hereditary ones are primary. Poisoning types are primary.. like thallium or arsenic.

Then there are secondary ones, that occur when other conditions are present and causative. Diabetes, thyroid disease.

The word differential is used to distinguish the secondary causes from the primary ones most often. But differential also could just mean a listing of all the known types. Then the doctors go thru the list to rule out each one by testing etc.

There are many causes of "abnormal sensations" which are not permanent also...sometimes called paresthesias. Drug side effects, temporary low blood sugar, exposures to solvents, anxiety. These reactions typically are short lived and go away when the offending agent is removed or the situation is corrected. When those sensory feelings become cemented in occurance and permanent, they then usually are called one of the neuropathies. The progressive types of neuropathies often include motor functions or the autonomic system, and those typically get more attention from doctors.

The purely sensory types often get dismissed as "psychological", IMO. But that situation is totally unfair and causes MORE stress for the patient, who then has to prove it is "real" while enduring pain and discomfort as well as the dismissive doctor.

Thanks for the link... this forum always welcomes useful links!
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Old 03-27-2011, 03:52 AM #3
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In medicine, differential diagnosis is the process whereby a given condition or circumstance, called the presenting problem or chief complaint, is examined in terms of underlying causal factors and concurrent phenomena as discerned by appropriate disciplinary perspectives and according to several theoretical paradigms or frames of reference, and compared to known categories of pathology or exceptionality. Differential diagnosis allows the physician to:
more clearly understand the condition or circumstance
assess reasonable prognosis
eliminate any imminently life-threatening conditions
plan treatment or intervention for the condition or circumstance
enable the patient and the family to integrate the condition or circumstance into their lives, until the condition or circumstance may be ameliorated, if possible.
If the patient's condition does not improve as anticipated when the treatment or therapy for the disease or disorder has been applied, the diagnosis must be reassessed.


i have read a number of articles and papers listing various neuropathies, the way they present and progress, and the best form of treatment etc, and i have read countless times that there are over 100 known forms of neuropathy. i have also read that when a more thorough investigation is done a cause is found for the 75% of what are initially classes as idiopathic small fiber neuropathies.

what i am looking for is a comprehensive list of neuropathies something like the one below which lists known nutritional neuropathies.

http://emedicine.medscape.com/article/1171558-overview
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Old 03-27-2011, 04:05 AM #4
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Lightbulb

We have more links in the Subforum above and some in the stickies at the top of the page.

I think is may be more productive to do a life style investigation with the patient, to narrow the scope of the testing.
Most people just cannot afford to go thru a huge list of 100 or more conditions that may be a cause. Dietary habits, and exposure to drugs/vaccines/toxins remain large culprits IMO. Much of PN is an environmental issue.

And it sadly remains that some of the neuropathies are not treatable at this time. Hereditary ones, for example.

Glenn has put up in the stickies, Dr. Latov's list of testing that he prefers. It is pretty complete at this time. Its there somewhere. If you search Latov you may find it quickly.
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Old 03-27-2011, 07:07 AM #5
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Default And--

--besides the Latov/Quest clinical application paper:

http://www.questdiagnostics.com/hcp/...eralNeurop.htm

--there are also the Poncelet protocols:

http://www.aafp.org/afp/980215ap/poncelet.html

The Neuropathy Association website also has a breakdown by type and presenting symptoms:

http://www.neuropathy.org/site/PageServer
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