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Colegio de Medicina Interna de México.

2025, Número 07

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Med Int Mex 2025; 41 (07)


Neuropatía periférica en el adulto mayor: diagnóstico y tratamiento

Prado F

Idioma: Español
Referencias bibliográficas: 51
Paginas: 424-438
Archivo PDF: 681.50 Kb.


RESUMEN

Antecedentes: La neuropatía periférica repercute en la funcionalidad y el envejecimiento saludable de los adultos mayores. Un alto porcentaje queda sin diagnóstico causal, lo que reduce las opciones terapéuticas.
Objetivo: Resumir los aspectos decisivos del diagnóstico y tratamiento de la neuropatía periférica en adultos mayores de 64 años.
Metodología: Búsqueda de bibliografía indexada y de alta calidad científica.
Resultados: Los cambios fisiológicos que ocurren al envejecer aumentan el riesgo de neuropatía periférica en los adultos mayores. La neuropatía periférica puede clasificarse en cinco patrones clínicos. El inicio, avance, tipo de fibras afectadas y características clínicas apoyan al clínico para el diagnóstico diferencial. Las causas más comunes de neuropatía periférica en adultos mayores son la diabetes, deficiencias nutricionales (por reducción de la absorción o por pérdidas urinarias de micronutrientes), medicamentos y toxinas neurotóxicas; también hay casos de neuropatía periférica mediada por inmunidad. La prevención del daño neurológico, la atención médica a las causas tratables y la prevención de complicaciones son acciones indispensables del tratamiento integral.
Conclusiones: Además del dolor, la neuropatía periférica ocasiona miedo a caerse, dificultad para la marcha y pérdida de sensibilidad y equilibrio. Estos problemas afectan la funcionalidad y promueven un envejecimiento patológico. El tratamiento depende, en gran medida, del diagnóstico causal. La prevención del daño neurológico y el tratamiento temprano son decisivos para el éxito terapéutico.


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