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Immunology of the peripheral nervous system: the inflammatory neuropathies

Published on April 30, 2025   23 min

Other Talks in the Series: The Immune System - Key Concepts and Questions

Other Talks in the Series: Periodic Reports: Advances in Clinical Interventions and Research Platforms

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0:00
Hello. I'm Simon Rinaldi. I'm an Associate Professor of Neurology, and the lecture today is going to be about immunology of the peripheral nervous system with a particular focus on the inflammatory neuropathies.
0:13
In this lecture, I'm going to cover the clinical spectrum of the inflammatory neuropathies, targets and mechanisms of these disorders in an immunological sense and also talk about established and upcoming therapies.
0:25
The inflammatory neuropathies can broadly be defined as a range of disorders characterised by immune-mediated damage to peripheral nerves. Within this broad definition, there are a wide range of different possibilities, different disorders and different immune-mediated mechanisms.
0:47
We think about the clinical presentation of neuropathies in general, and inflammatory neuropathies, in particular, can be associated with a range of symptoms. We can think of positive sensory features, such as tingling, burning and pain; and negative sensory features such as numbness, loss of sensation, loss of dexterity and imbalance. There can also be motor involvement with loss of strength, and the cranial nerves and autonomic nervous system can also be involved. This also translates into the range of signs that can be seen on clinical examination. This includes weakness, which can be distal or proximal, wasting, cranial nerve dysfunction, fasciculations, reduced muscle tone, suppression of the deep tendon reflexes, evidence of sensory loss, sensory ataxia, and autonomic dysfunction.
1:31
The inflammatory neuropathies can be considered and placed on a range of different spectra. For example, some are acute, reaching nadir within four weeks; whereas, others have ongoing progression and nerve injury beyond eight weeks and will be considered chronic. Similarly, they can be monophasic with a single nadir and improvement, or they can be relapsing, remitting, or chronically progressive. They may be focal, multifocal, or generalised. They may be pure motor, pure sensory, or sensory-motor, and they may affect proximal or distal muscles, or both. Furthermore, the pathology can affect the myelin sheath and cause demyelinating neuropathies or be primarily targeted at the axon and cause axonal neuropathies.

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