CLINICAL PROFILE OF PERIPHERAL NEUROPATHY IN GERIATRIC POPULATION
DOI:
https://doi.org/10.22159/ajpcr.2024.v17i3.49759Keywords:
Clinical profile, Peripheral neuropathy, Geriatric populationAbstract
Objectives: The objective of this study was to describe the clinical profile of peripheral neuropathy (PN) in the geriatric population.
Methods: This prospective observational study was done among patients >65 years, found to have PN by Neuropathy Symptom Score, who were undergone history and clinical examination at the Department of Medicine and Gandhi Medical College and associated Hamidia Hospital Bhopal. Nerve conduction study was done in all subjects to observe the pattern and type of various peripheral neuropathies. Special investigations such as Serum Vitamin B-12, toxin screening of lead and arsenic, viral serology using the ELISA method, serum and urine electrophoresis, rheumatoid factor, antinuclear antibodies (ANA), and antinuclear cytoplasmic antibodies (c-ANCA and p-ANCA), and CSF examination were done as and when needed.
Results: Most of the patients were in the 60–65 years [93 (46.5%)] of age followed by 66–70 years [54 (27%)]. Most common clinical feature was Tingling [120 (60%)] followed by Tingling and Numbness [36 (18%)]. In most of the subjects, deep tendon reflexes were normal [132 (66%)] whereas in 42 (21%) subjects deep tendon reflexes were impaired and in 26 (13%) subjects deep tendon reflexes were absent. Most of the patients had sensory motor axonal demyelinating neuropathy [8 (4%)].
Conclusion: PN is a heterogeneous disease with diverse pathology. Recognition of the clinical homolog of these pathological processes is the first step in achieving the appropriate form of intervention. Treatment should be individualized such that the particular manifestation and underlying pathogenesis of each patient’s unique clinical presentation are considered.
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References
Anish L, Nagappa M, Mahadevan A, Taly AB. Neuropathy in elderly: Lessons learnt from nerve biopsy. Age Ageing 2015;44:312-7. doi: 10.1093/ageing/afu171, PMID 25362502
England JD, Gronseth GS, Franklin G, Carter GT, Kinsella LJ, Cohen JA, et al. Practice parameter: Evaluation of distal symmetric polyneuropathy: Role of laboratory and genetic testing (an evidence-based review); report of the American academy of neurology American association of neuromuscular and electrodiagnostic medicine, and American Academy of Physical Medicine and Rehabilitation. Neurology 2009;72:185-92. doi: 10.1212/01.wnl.0000336370.51010.a1, PMID 19056666
Richardson JK, Thies SB, DeMott TK, Ashton-Miller JA. A comparison of gait characteristics between older women with and without peripheral neuropathy in standard and challenging environments. J Am Geriatr Soc 2004;52:1532-7. doi: 10.1111/j.1532-5415.2004.52418.x, PMID 15341557
Kararizou E, Davaki P, Karandreas N, Davou R, Vassilopoulos D. Polyneuropathies in the elderly: A clinico pathological study of 74 cases. Int J Neurosci 2006;116:629-38. doi: 10.1080/00207450600592180, PMID 16644522
Trivedi S, Pandit A, Ganguly G, Das SK. Epidemiology of peripheral neuropathy: An Indian perspective. Ann Indian Acad Neurol 2017;20:173-84. doi: 10.4103/aian.AIAN_470_16, PMID 28904445
Ghosh B, Sengupta S, Bhattacharjee R, Pal S, Saha SP, Ganguly G, et al. Spectrum of peripheral neuropathy in Eastern India. J Indian Med Assoc 2006;104:170-3. PMID 16910321
Adgaonkar AA, Dawange AA, Adgaonkar SA, Kale VG, Shekokar PP. Clinical profile of peripheral neuropathy in diabetes mellitus by nerve conduction study. Sch J Appl Med Sci 2014;2:1973-7.
Ozkaraman A, Orlu N, Yesilbalkan OU, Karadakovan A. Peripheral neuropathy and falling risk in 65 years old and older patients receiving chemotherapy: A prospective study. Int J Caring Sci 2018;11:550-6.
Mold JW, Lawler F, Roberts M, Oklahoma Physicians Resource/ research Network Study. The health consequences of peripheral neurological deficits in an elderly cohort: An Oklahoma Physicians Resource/Research Network Study. J Am Geriatr Soc 2008;56:1259- 64. doi: 10.1111/j.1532-5415.2008.01736.x, PMID 18482305
Zarrelli MM, Amoruso L, Beghi E, Apollo F, Di Viesti P, Simone P, et al. Arterial hypertension as a risk factor for chronic symmetric polyneuropathy. J Epidemiol Biostat 2001;6:409-13. doi: 10.1080/135952201753337158, PMID 11822730
Novella SP, Inzucchi SE, Goldstein JM. The frequency of undiagnosed diabetes and impaired glucose tolerance in patients with idiopathic sensory neuropathy. Muscle Nerve 2001;24:1229-31. doi: 10.1002/ mus.1137, PMID 11494278
Impallomeni M, Kenny RA, Flynn MD, Kraenzlin M, Pallis CA. The elderly and their ankle jerks. Lancet 1984;1:670-2. doi: 10.1016/s0140- 6736(84)92181-0, PMID 6142359
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