Thickened peripheral nerves are seen in all the following conditions except
Diabetic neuropathy is due to conversion of sugar to sorbitol which causes nerve demyelination; neuropathy is distal, diffuse with a stocking distribution; it takes around 10 years to develop diabetic neuropathy. Glucose forms sorbitol by aldose reductase enzyme and galactose forms galactitol. If sorbitol level raises it gets trapped in peripheral nerves, retina and lens causing neuropathy, cataract and retinopathy. There may be formation of abnormal aeriovenous communications under the skin leads into nerve ischaemia and neuropathy. Sensory neuropathy causes loss of vibration sense, sense of position, touch, pain and temperature. Sensation may be absent in the entire sole due to medial and plantar nerve involvement. Foot feels like dead with like walking in the sand and prone for minor repeated traumas which are not noticed by the patient. Motor neuropathy causes paralysis of intrinsic muscles of foot leading into claw toes and hammer toe. Longitudinal arch of the foot becomes flat causing loss of foot curvature; loss of joint position and Loss of foot muscle strength leads into altered gait and positions of foot leading into the deep seated trophic ulcers over the heads of the metatarsals. Autonomic neuropathy causes absence of sweating and loss of skin elasticity making more prone for breakdown and infection. Autosympathectomy is common in diabetics involving foot area. Ref: SRB's Manual of Surgery 5th edition Pgno : 26
Hansen's neuropathy
Amyloid polyneuropathy
Diabetic neuropathy
Refsum's disease
Trauma