[Therapeutic approach in peripheral neuropathies]

On the whole, the treatment of peripheral neuropathies is disappointing, even when a cause has been identified, because nerve lesions, and particularly axonal diseases, are frequently severe, and the mechanisms or peripheral nerve fibre repair is very slow. However, during the last few years important advances have been made in the treatment of acute and chronic acute inflammatory demyelinating polyneuropathies, most probably of dysimmune origin, with plasma exchanges and, more recently, intravenous human plasma immunoglobulins. Therapeutic trials are in progress in neuropathies associated with monoclonal gammopathies, notably IgM. In diabetic neuropathy numerous studies are going on, in particular with aldolase reductase inhibitors and with gangliosides.