Radiculopathy refers to involvement of nerve roots, again singly or multiply. Mononeuropathy refers to involvement of major nerve trunks, singly or multiply. Peripheral neuropathy can be classified by the pattern of nerve involvement, time course, type of deficit or nature of the underlying pathology.8 (Box 1) The patterns of nerve involvement that occur include mononeuropathy, multiple mononeuropathy (mononeuritis multiplex), symmetrical polyneuropathy, radiculopathy and polyradiculoneuropathy. Pippa Medcalf, Consultant Physician, Gloucester Royal Hospital, Great Western Road, Gloucestershire, Email neuropathy is one pattern of damage to the peripheral nervous system.1 Physical signs of peripheral neuropathy are common in older people.2 Recognition of these deficits is particularly important because peripheral neuropathy may contribute to the vulnerability to falls that is common in this age group.3,4 More than 30% of patients aged over 65 years will fall at least once per year.5 Peripheral neuropathy commonly causes impairment of proprioception and balance, which can be identified from an inability to maintain unipedal stance for 10 seconds, impaired position sense at the great toe and decreased vibratory sense that improves proximally.6 Recognition of the cohort of patients with these deficits may identify treatable causes and provide a better management plan for patients prone to falling.6,7 Classification Management of peripheral neuropathy often needs a multidisciplinary team approach.Īuthors: Siyum Strait, Specialist Registrar Acute Medicine, Great Western Hospital, Swindon Peripheral neuropathy interferes with normal daily activities and leads to increased risk of falls, injury and poor quality of life. Although the ageing process itself may play a part, there are multiple other causes. Peripheral neuropathies are common in older people.

Neuropathy and falling