Metabolic and endocrine neuropathies

Metabolic and endocrine neuropathies, although generally well characterized clinically and electrophysiologically, represent an area in which improved mechanistic understanding is still needed. Although in most cases early detection and reversal of underlying abnormalities is the most effective therapeutic intervention, there are clinical states where metabolic abnormalities may persist for decades without complete resolution, e.g., chronic renal or hepatic failure in the absence of transplantation. In these instances, there remains a compelling clinical impetus for scientific advances in this area. In this chapter, we discuss the clinical manifestations, electrophysiological findings, presumed pathogenesis, treatment options, and prognosis of peripheral neuropathy associated with renal failure, hepatic disease, thyroid dysfunction, and pituitary (acromegaly) dysfunction.