Severe(Uncomplicated Peripheral neuropathy)


Limits self-care and aid warranted, life threatening (e.g. respiratory problems)

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
Advice on steroid wean

More information

Assessment and Investigations

  • Neurologic consult within 24-48h
  • Patient history : diabetes, alcohol, medication
  • EMG
  • Blood analysis : diabetic screen, Vitamine B12/folate, immunoelectrophoresis/ immunofixation, renal function, hematology, autoimmune serology, serology for lyme and HIV
  • Lumbar puncture
  • MR spine/brain to exclude other causes


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