Disorders of Peripheral Nerves, From Beginning to End

STEVEN L. LEWIS, MD, FAAN Peripheral Nerve and Motor Neuron Disorders p. 1128-1129 October 2020, Vol.26, No.5 doi: 10.1212/01.CON.0000718696.82635.68


This issue of Continuum is devoted to the diagnosis and management of the spectrum of neurologic diseases that involve the peripheral nerves, from the anterior horn cells and sensory ganglions to the most distal axons. To accomplish this monumental task, I am so thankful that Dr A. Gordon Smith, Chair of the American Academy of Neurology Education Committee and member of the Continuum Editorial Board, accepted my invitation to serve as the guest editor for this issue, and I am so appreciative of Dr Smith for his organization of such well-thought-out topics and for bringing such remarkable experts on board.

The issue starts with the article by Dr Zachary N. London, who provides his guide of how to approach the categorization and diagnosis of peripheral nervous system disorders, serving as a comprehensive introduction to the articles that follow in this issue. Next, Dr Christopher H. Gibbons discusses the pathophysiology, diagnosis, and management of the neuropathic disorders that occur because of diabetes and other metabolic disorders, the most common causes of neuropathy in our clinics.

Dr Kazim A. Sheikh then reviews the pathophysiology, diagnosis, and most up-to-date management considerations in Guillain-Barré syndrome and its variants. Similarly, in the following article, Dr Kelly Gwathmey reviews the pathophysiology, diagnosis, and current management options for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and its variants and includes a discussion of the relatively recent concept of the nodopathies and paranodopathies.

Next, Dr Christopher J. Klein discusses the evolving nomenclature, categorization, and clinical features of Charcot-Marie-Tooth disease and other hereditary neuropathies. Dr Chafic Karam then reviews the diagnosis and management of peripheral neuropathies that can occur in association with vasculitis (whether isolated to the peripheral nervous system or part of a systemic process) and autoimmune connective tissue diseases. Dr Nathan P. Staff then discusses peripheral neuropathies that occur as a consequence of vitamin and mineral deficiencies, toxins, and medications, important causes of peripheral neuropathy that are potentially reversible if recognized early. Next, Drs Amanda C. Peltier and Derek Wood discuss the management of neuropathic pain in polyneuropathy, a disabling symptom that can occur as a consequence of many of the variety of causes of polyneuropathy discussed in this issue.

The next articles discuss the disorders that involve dysfunction of the anterior horn cells. First, Drs Colin Quinn and Lauren Elman review the diagnosis and management of amyotrophic lateral sclerosis and other motor neuron diseases that predominantly present in adults. Next, Dr Jessica Rose Nance reviews spinal muscular atrophy, a previously untreatable disorder for which knowledge of the genetic underpinnings has led to recent and remarkable clinically beneficial therapeutic breakthroughs.

In the final review article of the issue, Drs Elie Naddaf and Michelle L. Mauermann carefully review the diagnostic investigations, implications, and management of the not uncommon clinical situation in which peripheral neuropathies are associated with monoclonal gammopathies.

This issue is distinguished by having two Practice Issues articles. In the first article, Dr Brian C. Callaghan analyzes the practical and important concept of test utilization and value in the investigation of peripheral neuropathies. In the second article, Drs Jason L. Crowell and Ted M. Burns provide their informed analysis and opinions regarding rising costs of drugs for neurologic diseases, including those of relevance to the topic of this issue.

After reading the issue and taking the Postreading Self-Assessment and CME Test written by Drs Douglas J. Gelb and D. Joanne Lynn, readers may earn up to 20 AMA PRA Category 1 CreditsTM toward self-assessment CME or, for Canadian participants, a maximum of 20 hours toward the Self-Assessment Program (Section 3) of the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada. Additional credit can be obtained by listening to Continuum Audio interviews associated with this and other Continuum issues, available to all subscribers, and completing tests on the Continuum Audio web platform or mobile app. Continuum Audio is also accredited by the Royal College of Physicians and Surgeons of Canada.

We continue to invite all readers to try the new Continuum mobile phone experience available at continpub.com/ConBeta. Using this intuitively built new mobile phone application, subscribers are able to search, access, and read full Continuum articles, including all text, tables, and figures, in an easy-to-view format wherever they are and whenever they want.

My sincere thank-you to Dr Smith for his hands-on devotion to this complex issue through every step of the editorial process. The result under Dr Smith’s guest editorship is an issue that will provide our readers with the knowledge and skills needed to diagnose and manage the many patients we see with disorders affecting the peripheral nervous system from the nerve cell bodies to the terminal axons and anywhere in between.

The result under Dr. Smith’s guest editorship is an issue that will provide our readers with the knowledge and skills needed to diagnose and manage … patients … with disorders affecting the peripheral nervous system from the nerve cell bodies to the terminal axons and anywhere in between.


© 2020 American Academy of Neurology.