Peripheral Neuropathies Due to Vitamin and Mineral Deficiencies, Toxins, and Medications

Nathan P. Staff, MD, PhD, FAAN Peripheral Nerve and Motor Neuron Disorders p. 1280-1298 October 2020, Vol.26, No.5 doi: 10.1212/CON.0000000000000908
REVIEW ARTICLES
BROWSE ARTICLES
Article as PDF
-- Select an option --

PURPOSE OF REVIEW Vitamin and mineral deficiencies, neurotoxins, and, particularly, prescription medications, are some of the most common causes of peripheral neuropathy. Recognition and prompt treatment of these neuropathies require a high index of suspicion and an accompanied detailed history. This article provides a comprehensive approach and list of items that must be considered in the setting of new-onset neuropathy.

RECENT FINDINGS Although many of the neuropathies described in this article have decreased in prevalence in developed countries because of public health interventions and occupational/environmental regulations, new causes for this class of neuropathy continue to be uncovered.

SUMMARY The peripheral nervous system is susceptible to a broad array of metabolic and toxic abnormalities, which most often lead to a length-dependent sensory-predominant axonal peripheral neuropathy. A careful history accompanied by recognition of multisystem clues can increase recognition of these neuropathies, which is important as many have specific treatments that may either improve the neuropathy or halt its progression.

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

RELATIONSHIP DISCLOSURE: Dr Staff serves as an associate editor of Stem Cell Research & Therapy and receives research/grant support from BrainStorm Cell Limited, Disarm Therapeutics, the National Institutes of Health (R01 CA211887); Orion Therapeutics, LLC; and Regenerative Medicine Minnesota (RMM 11215 CT002).

UNLABELED USE OF PRODUCTS/INVESTIGATIONAL USE DISCLOSURE: Dr Staff reports no disclosure.

© 2020 American Academy of Neurology.