Management -1. General -(I) Elimination of possible Toxic or Infectious cause. (ii) Control of any existing metabolic or nutritional deficiencies -cor

. Local measures - (I) Feliel of pain - Hot packs or soaks, or infrared light or 'heat crade" analgesics (ii) Prevention of loot drop and wrist drop and contractures by splints or sand bags (III) Dally massage and passive movements as soon as calf muscles are less tender. Care should be taken nol to overstrain weak muscles 3 Specific • e.g, vitamin B1 for thiamine deficiency, adequate control of dlabeles. etc Corticosteraids may be helpful In chronic relapsing demyelinating neuropathies and some patients may respond to immunosuppressive and cytotoxic drugs and to plasrnapheresis. I Inherited neuropathies Peroneal Muscular Atrophy (Charcot-Marie-Tooth disease. CMT) Clinical features: (a) Age - Most common hereditary disorder of peripheral nerves appearing in second or third decade, (b) Muscle wasting - Earliest signs are dstal wasting of lower limbs with pescavus and subsequen foot drop. Later the calf muscles and distal third of the thigh atrophy producing a'stork leg'or'Inverted champagne bottle' appearance ol the leg. Wasting of intrinsic hand muscles occurs and mild dstal sensory loss is usual. The condition progresses very slowly over many years TYPES - Two major forms are - CMT type I - Is a demyelinating neuropathy, usually autosomal dominant. Patients present with foot deformity .In early childhood, which leacds to foot drop and weakness in the legs. Sensory loss Is relatively mild Nerve conduction studies reveal severely reduced peripheral n conduction CMT type II -is an axonal disease either dominant or recessive. Presentation is similar to type I, though there may be more extensive wasting. II Inflammatory demyelinating polyneuropathies; Acute Inflammatory Demyelinating Polyra-diculoneuropathy (Gulllain-Barra Syndrome) Definition Guillain-Barre syndrome is an acute, predominantly motor neuropathy, which progresses to Its peak in less than 4 weeks Etiology - Age =