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Radial and Acute severe neuropathy

Radial neuropathy is condition where an individual nerve is damaged by entrapment or pressure. Because of long course of radial nerve and its relation to the humerus, the nerve is vulnerable to compression.

Radial neuropathy is of common occurrence when a person sleeps with pressure on the arm (Saturday Night Palsy). Patient generally complains of dropping of the wrist and fingers. Sensory involvement may or may not be present.

Power of Brachio radialis is reduced and there is marked weakness of dorsiflexors of wrists and fingers.

Most patients improve with symptomatic treatment (Analgesics, Massage and Physiotherapy) in a weeks time but some may take longer to recover.

Acute severe neuropathy

This group includes acute infective polyneuritis (Guillain-Barre syndrome), poliomyelitis, porphyria, post diphthritic and post anti rabies vaccine neuropathy and neuropathy as part of acute disseminated encephomyeloneuropathy (ADEM).

Infective polyneuritis (Guillain-Barre syndrome)

It is an acute anterior radiculopathy which occurs as an immunologic injury and is characterized by symmetrical involvement of proximal and distal muscles, motor weakness more than sensory and loss of reflexes.

Ascending paralysis is most common and weakness spreads from lower extremities to upwards. Cranial nerve involvement occurs in small percentage of cases.

Subjective or objective sensory symptoms are common and there may be glove and stocking distribution. Autonomic system involvement is present.

Circulating and antimyelin antibodies are present in high titers in early part of illness.

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