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Uncomplicated Peripheral neuropathy – Severe

Mild
Moderate
Severe

Management escalation pathway

  • Withhold ICPI and admit patient Initiate (methyl) prednisolone 2mg/kg i.v.
  • Involve neurologist in care
  • Respiratory function should be checked 6 x pd
  • Daily or more frequent neurological review according to severity
Multidisciplinary team involvement:
  • Physiotherapy, occupational therapy and speech therapy as appropriate, opthalmology review for ocular/cranial nerve issues
  • Orthopedic devices (e.g. for foot drop) should be considered

Assessment and Investigations

  • MRI brain/spine advised
  • EMG
  • Lumbar puncture
  • Consider pulmonary function or diafragmatic function tests
  • Neurological consult
Abbreviations

Abbrevations

CMV: Cytomegalovirus
CIDP: Chronic Inflammatory Demyelinating Polyneuropathy
GBS: Guillain Barré Syndrome
PJP: Pneumocystis Jirovei Pneumopathy