Differential Diagnosis for a Patient Presenting with Autoimmune Peripheral Neuropathy: A Case Report

Purpose: The purpose of this case report is to outline the differential diagnoses for a patient with a complex neurological presentation. It emphasizes the need for further research on diagnostic protocols and treatment standards for patients with autoimmune peripheral neuropathy. Background: Peripheral neuropathies are a common cause of sensory, motor, and autonomic symptoms in the body. With over one hundred known causes of associated symptoms in the peripheral nervous system, it is important for the medical team to distinguish one etiology from another in a timely manner.¹² Certain etiologies have symptoms that can be reversed when quickly diagnosed and treated according to current research. When left untreated or receiving delayed treatment, some etiologies have the potential to leave patients with irreversible symptoms of varying severities. Case Description: A 46-year-old female was treated at an inpatient rehabilitation facility (IRF) two weeks after falling in her home. During her stay she was treated for coordination deficits, distal sensory abnormalities, and proximal joint muscle weakness. Interventions focused on increasing coordination and improving functional status through transfer and gait training. Differential Diagnosis: The patient initially presented with an acquired acute axonal sensory and motor peripheral neuropathy. Throughout her stay, potential diagnoses included a variety of nutritional imbalances and autoimmune peripheral neuropathies, such as Guillain-Barré Syndrome, Sjögren's Disease, and vitamin B6 deficiency. Discussion: Medical management changed in accordance with each diagnosis while physical therapy interventions addressed the patient’s functional limitations. Special considerations for fatigue management were considered. The patient made functional improvements throughout her admission but required further interventions to increase independence and was discharged to a transitional care unit.