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What Is Axonal Neuropathy?

Idiopathic axonal neuropathy is more common in the elderly.
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  • Written By: Carey Reeve
  • Edited By: R. Halprin
  • Last Modified Date: 27 March 2014
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Axonal neuropathy is a condition in which the nerve cells begin to function abnormally because the axons are degenerating. The effects of the condition can be felt as tingling, burning, weakness, numbness, or as a loss of motor function. Several descriptions are used for various symptom profiles including axonal peripheral neuropathy or motor axonal neuropathy, and different versions of the condition may be chronic or acute in nature. It can be caused by a number of diseases and disorders such as diabetes or a genetic neurological disorder called giant axonal neuropathy. The options for treatment depend on the initial cause of the neuropathy.

Symptoms can occur in various combinations and depend partly on the extent of the damage. Tingling, pricking, and burning sensations are often the earliest symptoms, but they can continue as the condition advances. Numbness can be felt with or without an effect on motor function; likewise, loss of motor function or weakness may present with or without loss of feeling. A patient may also lose some sensitivity to temperature in the affected area.

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Axonal neuropathy is different from demyelinating neuropathies in that it involves degeneration of the entire axon rather than only degeneration of the myelin sheath around the axon. If demyelinating neuropathies are not caught and treated early enough, however, they may lead to degeneration of the axons as well. Axonal peripheral neuropathy begins in the nerves of the extremities like the hands and feet and may involve either sensory or motor signal interruption or both. Motor axonal neuropathy specifically affects the movement of the muscle tissue and may or may not include changes in sensory information.

Many genetic diseases like Charcot-Marie-Tooth and Spinocerebellar ataxia with axonal neuropathy cannot be cured and, of course, are considered chronic. Some conditions cause axon degeneration as a type of side effect to the primary illness; an example would be a deterioration of the bones in the spine that leads to bone compression that damages nerves. This type of neurpathy is also known to be a possible complication of chronic conditions such as diabetes, alcohol abuse, and leprosy. Guillain-Barr is the predominant example of acute axonal neuropathy; porphyria, alcohol abuse and diabetes can also cause acute cases.

When the symptoms are secondary to a condition like diabetes, managing that condition is the main focus of treatment. Various other causes may respond to intravenous immunoglobulin, plasma exchange, some immunosuppressant drugs, corticosteroids, or even infrared therapy. Many elderly patients experience idiopathic axonal neuropathy, i.e., that it has no known cause, for which there is no treatment at this time.

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anon344081
Post 2

Can you shed any light on how doctors tell the difference between Axonal and the demyelinating version, aside from the patient losing muscle control? From what you write in the content, it seems they have several symptoms in common. (My doctor is watching my neuropathy but has only said that we should watch to see if the pain/tingle/burning progresses to loss of motor function, which is a little worrisome. It's like watching a mass to see if it's benign or malignant.

anon311978
Post 1

This article was informative. I am trying to get a diagnosis. I have motor loss in both legs. My EMG nerve test was abnormal. The result said, "motor axon loss," but the doctor refuses to explain my test results. I got a copy of my test results from the medical record office. I am searching on my own for answers. I filed a complaint with the ombudsman, and still did not get any answers. I live in Cleveland, Ohio.

Maybe someone will reply on this site with some insight. FYI: 100,000 patients die each year from medical errors. (Research this; it is true!) Why aren't doctors held accountable?

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