[Polyneuritis, polyradiculoneuritis, polyneuropathies: development of a concept].

Area of Science:

• Neurology
• Genetics
• Pathology

Context:

• The classification and understanding of polyneuritis, polyradiculoneuritis, and polyneuropathy have undergone significant evolution.
• Historical concepts have been refined by advances in molecular biology, diagnostic imaging, and etiological research.

Purpose:

• To provide an updated overview of the current concepts in polyneuropathy, polyradiculoneuritis, and polyneuritis.
• To highlight the reclassification of previously defined neuropathies and the recognition of new etiological factors.

Summary:

• Charcot-Marie-Tooth disease is now divided into hypertrophic, neuronal, and spinal subtypes.
• Hereditary sensory neuropathies include Thévenard's acropathy, early-onset recessive forms, and congenital analgesia.
• Metabolic disorders (Refsum, Fabry, porphyria, amyloidosis, adrenoleukodystrophy) are key causes of adult hereditary polyneuropathies.
• Guillain-Barré syndrome is now understood to encompass chronic, recurrent, and multifocal demyelinating forms with specific antibody associations.
• Acute pandysautonomia shares similarities with polyradiculoneuritis.
• Numerous polyneuropathies result from infections (e.g., borreliosis, HTLV) and toxic exposures (drugs, industrial chemicals).
• Emerging concepts include small and large fiber neuropathies, distal/central degenerations, and myelin/neuronal diseases.

Impact:

• This revised understanding facilitates more precise diagnosis and targeted treatment strategies for various polyneuropathies.
• The identification of diverse etiologies underscores the importance of comprehensive etiological workup in polyneuropathy patients.
• Advances in diagnostic techniques are continually refining our conceptualization of peripheral nerve diseases.