Peripheral Neuropathy Due to Vitamin Deficiency, Toxins, and Medications

Nathan P. Staff, MD, PhD; Anthony J. Windebank, MD, FAAN Peripheral Nervous System Disorders p. 1293-1306 October 2014, Vol.20, No.5 doi: 10.1212/01.CON.0000455880.06675.5a
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Purpose of Review: Peripheral neuropathies secondary to vitamin deficiencies, medications, or toxins are frequently considered but can be difficult to definitively diagnose. Accurate diagnosis is important since these conditions are often treatable and preventable. This article reviews the key features of different types of neuropathies caused by these etiologies and provides a comprehensive list of specific agents that must be kept in mind.

Recent Findings: While most agents that cause peripheral neuropathy have been known for years, newly developed medications that cause peripheral neuropathy are discussed.

Summary: Peripheral nerves are susceptible to damage by a wide array of toxins, medications, and vitamin deficiencies. It is important to consider these etiologies when approaching patients with a variety of neuropathic presentations; additionally, etiologic clues may be provided by other systemic symptoms. While length-dependent sensorimotor axonal peripheral neuropathy is the most common presentation, several examples present in a subacute severe fashion, mimicking Guillain-Barré syndrome.

Address correspondence to Dr Nathan P. Staff, Department of Neurology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, [email protected].

Relationship Disclosure: Dr Staff receives grants from the National Cancer Institute and National Center for Advancing Translational Sciences and research funding from BrainStorm Cell Therapeutics. Dr Windebank receives grants from the National Institute of Aging, National Center for Advancing Translational Sciences, Armed Forces Institute of Regenerative Medicine, Morton Cure Paralysis Fund, Craig H. Neilsen Foundation, and research funding from BrainStorm Cell Therapeutics.

Unlabeled Use of Products/Investigational Use Disclosure: Drs Staff and Windebank report no disclosures.

© 2014 American Academy of Neurology