Nutritional and Toxic Neuropathies

OBJECTIVE: This article reviews the etiologies, clinical presentations, and management of nutritional and toxic neuropathies. LATEST DEVELOPMENTS: Nutritional deficiencies and certain toxins and medications are common causes of nerve injury. The increase in rates of bariatric surgery and immunotherapy to treat malignancies has led to a need for increased awareness of associated neuropathies. Vitamin deficiency-related neuropathy due to inadequate supplementation after bariatric surgery is important to recognize early. Checkpoint inhibitor neuropathy can occur as a side effect of this medication class and can require urgent evaluation and treatment. ESSENTIAL POINTS: Peripheral nerve damage related to toxins or nutritional deficiencies can occur and can be stabilized or, in some cases, improved once diagnosed. Early detection and appropriate interventions, along with symptomatic treatment, are important for achieving an optimal response and improving quality of life.