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Medication, Toxic, and Vitamin-Related Neuropathies

Morrison, Brett MD, PhD; Chaudhry, Vinay MD, MBA, FRCP, FAAN

CONTINUUM: Lifelong Learning in Neurology:
doi: 10.1212/01.CON.0000411565.49332.84
Review Articles
Abstract

Purpose of Review: Although medication, toxic, and vitamin-related neuropathies are rare causes of neuropathy, they are important to recognize because they are treatable and preventable. It is often difficult to conclusively demonstrate that a particular agent is the cause of neuropathy, but understanding the specific electrodiagnostic and clinical patterns produced by these agents is critical for making these assessments.

Recent Findings: The clinical and electrodiagnostic features for many of these neuropathies have been well established. The exact mechanism by which some of these agents produce neuropathy is only now beginning to be revealed. These mechanisms are critical for both understanding the normal function of nerves as well as eventually devising specific treatments.

Summary: A large number of medications and toxins can produce neuropathy. This article reviews the clinical characteristics, electrodiagnostic features, and mechanism of action (when known) of those agents that produce the most severe, or perhaps the most unique features of, neuropathy.

Author Information

Address correspondence to Dr Vinay Chaudhry, Johns Hopkins University School of Medicine, 601 N. Caroline St, 5072A, Baltimore, MD 21287, vchaudh@jhmi.edu.

Relationship Disclosure: Dr Morrison receives research support from Biogen-Idec for the study of novel compound in ALS. Dr Chaudhry serves as a consultant for Novartis Pharmaceuticals Corporation and is a member of The Neurologist Editorial Board. Dr Chaudhry receives license fee payments or royalty payments from Abbott Laboratories and Johnson & Johnson Services, Inc., and license fee payments through Johns Hopkins University for the Total Neuropathy Score. Dr Chaudhry receives research support from Nutricia for a study of ketogenic diet in ALS. Dr Chaudhry has served as a medical record reviewer and provided expert witness testimony for the Department of Justice Injury Compensation Program, and has also given a deposition in a legal case.

Unlabeled Use of Products/Investigational Use Disclosure: Drs Morrison and Chaudhry report no disclosure.

© 2012 American Academy of Neurology