Peripheral Nervous System Disorders

Peripheral Nervous System Disorders

Neuropathies, Guillain-Barre Syndrome & Amyotrophic Lateral Sclerosis (ALS)



  • Disorder of the nerves
  • Symptoms can vary because of the type of nerves affected & the location of the nerves
  • Clinical Manifestations: can be weakness, numbness, pins & needles, burning pain (sensory nerve damage), muscle weakness, cramps & spasms (motor nerve damage)
  • May be acute or chronic.
  • Causes of acute neuropathies are: drugs, infections, autoimmune reactions & toxins
  • Chronic neuropathies can be caused by Diabetes Mellitus, ETOH abuse & connective tissue diseases


Generalized symmetric polyneuropathies

Neuropathy that is in the same areas on both sides of the body


Guillain-Barre Syndrome

  • Also known as Acute idiopathic polyneuropathy
  • An inflammatory demyelinating disease of the peripheral nervous system
  • Acute onset with ascending motor paralysis (starts in lower extremities and goes up- it is a lower motor neuron disorder)
  • Some causes are: viral infections & influenza vaccine
  • Causes demyelination of the peripheral nerves
  • Damages the myelin sheath


Clinical Manifestations

  • progressive ascending weakness or paralysis in legs (usually begins in legs then goes up to arms & face), can not stand or walk.
  • Some patients become bedridden, Respiratory failure (some patients may have to be intubated)



Diagnosis is made by: patient history, nerve conduction tests & physical examination



  • Treatment supportive care. Most patients will recover from this in the first year


Amyotrophic Lateral Sclerosis (ALS) “Lou Gehrig Disease”

  • Affects the upper & lower motor neurons of the cerebral cortex, brain stem & spinal cord (corticospinal tracts & anterior roots- these neurons start to die)
  • Progressive disease that leads to respiratory failure & death
  • Higher incidence in men between the ages 40-60
  • Patients have normal intellectual and sensory function


Clinical Manifestations

  • Early symptoms may be muscle twitching, cramping & stiffness in the hands or upper extremities
  • The patient will develop severe weakness with loss of voluntary movement
  • This progresses into respiratory failure than death.



  • Electromyography (EMG), nerve conduction studies
  • MRI & laboratory testing
  • At this time, Riluzole (Rilutek), a glutamate inhibitor, is the only FDA approved treatment and may only prolong life several months & delay the need for ventilator assistance
  • Patient’s signs & symptoms



McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2010). Pathophysiology: The biologic basis for disease in adults and children (6th ed.).

Dunphy, L.M., Winland-Brown, J. E. (2011).  Primary Care:  The Art and Science of Advanced Practice Nursing.  Philadelphia, PA.  F.A. Davis. 

Uphold, C.R., & Graham, M.V. (2013). Clinical guidelines in family practice. (5th ed.)    Gainesville, Fl.: Barmarrae Books, Inc.