1. What is a peripheral neuropathy?

Peripheral neuropathy is disorder of nerve(s) apart from the brain and spinal cord. Patients with peripheral neuropathy may have tingling, numbness, unusual sensations, weakness, or burning pain. What causes a peripheral neuropathy? There are many possible causes of peripheral neuropathy, including: 1. Diabetes Mellitus 2. Shingles (post herpetic neuralgia) 3. Vitamin deficiency, particularly B12 and folate 4. Alcohol 5. Autoimmune diseases, including lupus, rheumatoid arthritis or GuillainBarre syndrome 6. AIDS, whether from the disease or its treatment, syphilis, and kidney failure 7. Inherited disorders, such as amyloid polyneuropathy or Charcot-MarieTooth disease 8. Exposure to toxins, such as heavy metals, gold compounds, lead, arsenic, mercury, and organophosphate pesticides 9. Cancer therapy drugs such as vincristine (Oncovin, Vincasar), and other medications [for example antibiotics such as metronidazole (Flagyl), and isoniazid (Nydrazid, Laniazid)] While diabetes and post herpetic neuralgia are the most common causes of peripheral neuropathy, often times no cause is found. In these situations, it is referred to as idiopathic peripheral neuropathy. Sometimes, peripheral nerve entrapments, such as carpal tunnel syndrome, are considered peripheral neuropathies. In these cases, pressure on the nerve rather than a disease state leads to nerve malfunction.

2. J Neurol Neurosurg Psychiatry 2002;73:769-771 doi:10.1136/jnnp.73.6.769

Short

report

Peripheral nerve granuloma in a patient with tuberculosis 1. 2. 3. R W Orrell1,2, R H M King1, J V Bowler1,2,3,

4.

L Ginsberg1,2

+ Author Affiliations 1.
1

University Department of Clinical Neurosciences, Royal Free

and University College Medical School, University College London, London, UK 2. 3. 1.

2 3

Department of Neurology, Royal Free Hospital, London, UK North Middlesex Hospital, London, UK

C Correspondence to: Dr R W Orrell, Department of Clinical

Neurosciences, Royal Free and University College Medical School, University C College London, Rowland Hill Street, London NW3 2PF, UK; r.orrell@rfc.ucl.ac.uk
Received Accepted Revised

31 May 2002 30 August 2002

21 August 2002

Abstract The cause of peripheral neuropathy associated with tuberculosis is controversial. Possibilities include an immune mediated neuropathy, direct invasion of nerves, vasculitic neuropathy, compressive neuropathy, a meningitic reaction, and the toxic effects of antituberculous chemotherapy. This report describes the unusual finding of granulomas in the peripheral nerve of a patient with tuberculosis. The pathological findings were of a delayed hypersensitivity reaction, but with no more specific indications of the mechanism of the neuropathy.

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