Causes of Loss of Vibratory Sense Types of sensory fibers Small-fibers (unmyelinated): Large-fibers (myelinated): pain, temperature (PT) vibration,

position sense, light tou h (PTV)

Position sense and vibratory sense are both ondu ted through the dorsal olumn of the spinal ord, so they are generally lost together! "o#ever, a $%%$ &'( arti le (ref )) indi ated that *Some neurologi al disorders affe t one of these sensory fun tions #hile partially or ompletely sparing the other!+ , #as not able to find the names of these disorders, but they li-ely affe t either the )) termination points in the thalamus or orte., or $) the origin points (the re eptors)! So, #hat are the auses of loss of vibration (and position) sense #ith preservation of pain and temperature/ 0emyelinating type of neuropathy 0iseases of the dorsal olumns of the spinal ord Some dorsal olumn diseases are tabes dorsalis, vitamin &)$ defi ien y, multiple s lerosis! Listed belo# are some ommon auses of peripheral neuropathy, #hi h an be a.onal, demyelinating, or neuronal, or mi.ed! 0emyelinating neuropathies are highlighted in blue! Metabolic & Systemic: 0iabetes mellitus, 1l oholism, 2remia, Thiamine defi ien y, Vitamin &)$ defi ien y, 'ultiple myeloma, 3aldenstrom4s ma roglobulinemia, '52S, 1myloidosis, Cryoglobulinemia, "ypothyroidism or hyperthyroidism, Sar oidosis, Paraneoplasti syndrome (eg, lung an er), 6europathy asso iated #ith riti al illness, 6ephroti syndrome, ,nflammatory bo#el disease Infectious & Inflammatory: "ansen7s disease (leprosy), ",V81,0S, Lyme disease, 0iphtheriti neuropathy, Polyarteritis nodosa, 9heumatoid arthritis, Temporal (giant ell) arteritis, "epatitis & or C Toxic: 'etals (lead), 0rugs ( hloro:uine, pro ainamide, ta rolimus), ,ndustrial agents or pesti ides (organophosphates) Hereditary: Char ot-'arie-Tooth disease (hereditary motor and sensory neuropathy, "'S6 type , ; ,,), 0e<erine-Sottas disease ("'S6 type ,,,), 9efsum disease ("'S6 type ,V) Mostly motor: 5uillain-&arr= syndrome, Chroni inflammatory demyelinating polyneuropathy (C,0P), Porphyria, To.i neuropathy, Poliomyelitis, Periodi paralysis syndrome

9eferen es: )! http:88<nnp!bm<! om8 ontent8>?8@8A>?!full $! 0iagnosaurus sear h for 00. of 4Peripheral neuropathy (polyneuropathy)4 http:88###!a essmedi ine! om8diag!asp./ odeB))AC?A ?! http:88###!uptodate! om8 ontents8approa h-to-the-patient-#ith-sensory-loss/ sour eBsear hDresult;sear hBlossEofEvibrationEsense;sele tedTitleB)F)@% A! http:88###!uptodate! om8 ontents8 hroni -inflammatory-demyelinating-polyneuropathy-etiologylini al-features-and-diagnosis/ sour eBsear hDresult;sear hBdemyelinatingEpolyneuropathy;sele tedTitleB)F)@% @! http:88neuromus ular!#ustl!edu8nother8myelin!html