neuropathy

What is Peripheral Neuropathy?

Peripheral neuropathy refers to a diverse group of diseases affecting the motor-sensory and autonomic nerves lying outside the central nervous system. This can cause a wide variety of symptoms, such as weakness, numbness, or sensitivity to touch.

The peripheral nerves make up a vast network that transmits information from/to the brain and spinal cord (the central nervous system) to/from every other part of the body. Information for movement is conveyed from the central nervous system via the nerves (motor pathways) and information regarding sensation from the peripheries to the central nervous system (sensory pathways).

Causes

Diabetes is the most common cause of peripheral neuropathy. At least half of all diabetics develop some form of neuropathy during the course of the disease.

Other factors that can cause peripheral neuropathy are:

Excessive alcohol intake, which leads to poor dietary choices
Autoimmune diseases like lupus and rheumatoid arthritis
Exposure to toxic substances like heavy metals and certain medications, like chemotherapy

Viral or bacterial infections
Trauma or compression of the nerves
The tumor on or surrounding the nerves
Vitamin deficiencies

Signs and Symptoms

As you might expect, the symptoms of peripheral nerve damage vary greatly. However, they can be generally divided into:

Feeling numb in a specific area of the body
Burning or sharp electric pain
Sensitivity to touch or heat
Impaired coordination

Muscle weakness or paralysis
Bowel or bladder incontinence
Foot infection and ulcers

Diagnosis

Peripheral neuropathy involves the exact detection of nerve damage and its cause, which is difficult to diagnose. Your doctor will review your medical history and family history for neurological diseases and will conduct physical and neurological examinations for muscle strength, sensation, posture, and coordination.

Your doctor may order other tests including:

Blood tests for vitamin, sugar, and thyroid levels and liver and kidney function
Computed tomography (CT) scan or MRI to detect herniated disks or spinal tumors
Nerve function tests using electromyography to measure the electrical activity of the nerves
Nerve biopsy, in which a part of the damaged nerve is removed to test for abnormalities
Lumbar puncture to test cerebrospinal fluid in the lower back for signs of disease

How is it treated?

Any underlying condition is treated first, followed by symptomatic treatment. Symptoms often can be controlled, and eliminating the causes of specific forms of neuropathy often can prevent new damage.

In general, adopting healthy habits, such as maintaining optimal weight, avoiding exposure to toxins, following a physiotherapist supervised exercise program, eating a balanced diet, correcting vitamin deficiencies, and limiting or avoiding alcohol consumption can reduce the physical and emotional effects of peripheral neuropathy.

Quitting smoking is particularly important because smoking constricts the blood vessels that supply nutrients to the peripheral nerves and can worsen neuropathic symptoms.

Systemic diseases frequently require more complex treatments. The strict control of blood glucose levels has been shown to reduce neuropathic symptoms and help people with diabetic neuropathy avoid further nerve damage. Inflammatory and autoimmune conditions leading to neuropathy can be controlled with steroids or immunosupressive medications.