ABSTRACT
Therapeutic measures available for the specific underlying cause of most neuropathies that affect children are few or not very effective. Notable exceptions are the inflammatory and some metabolic neuropathies, where treatment can be remarkably effective. For most of the hereditary neuropathies, the basic mechanisms are poorly understood and progression is irreversible. Even in the absence of a treatment for the primary pathology, however, there are many ways in which function can be enhanced and symptoms minimized. As reviewed by Hallett et al. (1): ‘‘Three kinds of therapy are possible. If the etiology of the neuropathy is identified, then therapy directed to the underlying illness may be beneficial to the neuropathy. Regardless of whether the etiology of the neuropathy is known or unknown, it may be possible to improve nerve function with therapy directed to improving nerve metabolism itself. If it is impossible to reverse the neuropathy, it still maybe possible to be helpful with symptomatic therapy.’’ Especially in children, where the additional dimension of growth adds layers of both complexity and opportunity, judicious use of orthotics and surgery may often prevent the contractures and deformities that may occur in those whose primary condition resists treatment.
