Toxic neuropathies: a practical approach.
CLINICAL NEUROLOGY
NEUROONCOLOGY
NEUROPATHY
NEUROPHYSIOLOGY
NEUROTOXICOLOGY
Journal
Practical neurology
ISSN: 1474-7766
Titre abrégé: Pract Neurol
Pays: England
ID NLM: 101130961
Informations de publication
Date de publication:
Apr 2023
Apr 2023
Historique:
accepted:
19
12
2022
pubmed:
26
1
2023
medline:
23
3
2023
entrez:
25
1
2023
Statut:
ppublish
Résumé
Toxic neuropathies result from exogenous substances damaging the peripheral nerves. There are numerous causes, including prescribed and recreational drugs, heavy metals, industrial agents and biological toxins. Timely recognition of these neuropathies gives better outcomes, as they usually improve or stabilise once the toxin is removed. Most toxic neuropathies are axonal, length-dependent and sensory predominant, although some have significant motor involvement or can present acutely or subacutely. Here, we outline our clinical approach and discuss the major causes of toxic neuropathy, while emphasising the clinical and neurophysiological features and the neuropathy phenotype. We also include an update on newer medications that can cause neuropathy, including immune checkpoint inhibitors and BRAF/MEK inhibitors.
Identifiants
pubmed: 36697225
pii: pn-2022-003444
doi: 10.1136/pn-2022-003444
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
120-130Informations de copyright
© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: DS is supported by the New Zealand Neurological Foundation. CK is supported by a UCL Queen Square Institute of Neurology and Cleveland Clinic London MPhil/PhD Neuroscience fellowship. ASC, AMR and MPL are supported by the National Institute for Health Research University College London Hospitals Biomedical Research Centre. DS, CK, ASC, AMR and MPL received no funding or sponsorship for this commissioned paper. ASC has received honoraria from CSL, Grifols, Akcea, BMS, BeiGene and Lupin for educational talks and advisory input. MPL has provided consultancy for UCB Pharma, CSL Behring and Polyneuron. He was the principal investigator on trials with Polyneuron and UCB Pharma for which his institution receives investigator fees. He has been on the data safety monitoring board for Octapharma, IoC trial, AstraZeneca Pharmaceuticals.