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Epothilones cause microtubule disruption (like taxane-based drugs), which impairs axonal transport and leads to hyperexcitability of peripheral neurons. They can cause neuropathy characterized by paresthesias, numbness, and pain in the hands and feet.
Idiopathic peripheral neuropathy refers to neuropathy with no known cause. [ 41 ] Toxic causes: drugs ( vincristine , metronidazole, phenytoin , nitrofurantoin , isoniazid , ethyl alcohol , statins ), [ medical citation needed ] organic herbicides TCDD dioxin , organic metals, heavy metals , excess intake of vitamin B 6 (pyridoxine).
The causes of polyneuropathy can be divided into hereditary and acquired and are therefore as follows: [2] Inherited – hereditary motor neuropathies, Charcot–Marie–Tooth disease, and hereditary neuropathy with liability to pressure palsy; Acquired – diabetes mellitus, vascular neuropathy, alcohol use disorder, and vitamin B12 deficiency
The inciting cause of neuropathy has important consequences for its mechanistic basis as different tissues and cells are involved. The mechanistic basis of neuropathic pain remains controversial as do the relative contributions of each pathway.
Sural nerve biopsy; biopsy is considered for those patients in whom the diagnosis is not completely clear, when other causes of neuropathy (e.g., hereditary, vasculitic) cannot be excluded, or when profound axonal involvement is observed on EMG. Ultrasound of the peripheral nerves may show swelling of the affected nerves. [32] [33] [34]
The exact cause of the syndrome is unknown, although it has been associated with inhibition of patatin-like phospholipase domain-containing protein 6 (PNPLA6, aka neuropathy target esterase). There is no specific treatment, and recovery is usually incomplete, affecting only sensory nervous system , while motor neuropathy persists.
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