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What is peripheral neuropathy?


Peripheral neuropathy occurs when there is damage to the peripheral nervous system.  The peripheral nervous system is the pathway that gets information from your brain and spinal cord to your body. When this “information pathway” is damaged, some information from the body does not get to the brain (sensory system). Additionally, information from the brain does not get to the body (motor system). This disruption can affect muscle movement, prevent normal sensation in the arms and the legs, and cause pain.

Types of Peripheral Neuropathy


Mononeuropathy

Mononeuropathy is damage to a single peripheral nerve.  The most common cause is from trauma. This can occur if there is prolonged pressure (sitting or laying in a bed for long periods). Another way that this type of trauma can occur is from continuous or repetitive motions. In the latter, this is typically combined with poor movement “form” where abnormal forces are placed on the surrounding structure.

One example of mononeuropathy is peroneal nerve palsy (insert foot drop blog post).  This results when the nerve at the top of the calf on the outside of the knee is compressed. This leads to a condition called foot drop.

Polyneuropathy

Polyneuropathy is the most common form of peripheral neuropathy. Polyneuropathy occurs when multiple peripheral nerves throughout the body are affected at the same time.

One of the most common forms of chronic peripheral neuropathy is diabetic neuropathy. It is more severe in people with poorly controlled blood sugar levels.

The most common symptoms of polyneuropathy are:

  • Tingling
  • Numbness
  • Loss of sensation
  • A burning sensation in the feet and/or hands

One of the most serious polyneuropathies is Guillain-Barre syndrome, a rare disease that strikes suddenly when the body’s immune system attacks the nerves in the body. The onset of symptoms is quick and it progresses rapidly. THIS IS A MEDICAL EMERGENCY. Early symptoms include tingling in the hands and feet and spreads rapidly progressing to complete paralysis. The faster medical treatment is initiated to (reverse this attack) on the nervous system, the better chance of a complete recovery.

What are the symptoms of peripheral neuropathy?

  • Numbness, tingling, and pain
  • Unsteady gait (walking)
  • Muscle weakness (primarily ankle weakness)
  • Muscle cramps
  • Difficulty standing still – you constantly feel like you need to move your feet to maintain your balance.

What causes peripheral neuropathy?

There are many factors that determine the cause of peripheral neuropathy. This can be environmental factors such as toxins, trauma, illness, or infection.

Environmental Neuropathies

Environmental factors such as toxins, trauma, illness, or infection can cause acquired neuropathies. This may include one of the following:

    • Diabetes
    • Alcoholism
    • Vitamins deficiency
    • Certain types of cancer and chemotherapy treatment
    • Some prescription medications
    • Diseases such as Lyme disease, shingles, or AIDS
    • Kidney or thyroid disease

Hereditary Neuropathies

Hereditary neuropathies are diseases of the peripheral nerves that pass from parent to child. The most common of these is Charcot-Marie-Tooth (CMT) disease type 1.  This is a disease is caused by degeneration of the insulation that normally surrounds the nerves (myelin sheath). The myelin sheath is the “conductor” of the electrical current that triggers muscle movement.

Idiopathic Neuropathies

Sometimes peripheral neuropathy seems does not have a root cause. Doctors call this disorder “idiopathic”, which means “of unknown cause.” Typically, idiopathic peripheral neuropathy occurs in people over 60 years old and progresses slowly.

What is the treatment for peripheral neuropathy?


The treatment will focus on managing the cause of your neuropathy and to relieve the symptoms.

Medications

  • Pain relievers
  • Anti-seizure medications – You doctor may prescribe medications used to treat epilepsy such as gabapentin (neurontin) and pregabalin (Lyrica).  These medications can help relieve nerve pain. Side effects can include drowsiness and dizzyness. 
  • Topical treatments – Lidocaine patches can sometimes help relieve pain. 
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Medical Treatment

Plasma exchange and intravenous immune globulin

These procedures, which help suppress immune system activity, might benefit people with certain inflammatory conditions.  Plasma exchange involves removing your blood, then removing antibodies and other proteins from the blood and returning the blood to your body. In immune globulin therapy, you receive high levels of proteins that work as antibodies (immunoglobulins).

Surgery

If you have neuropathies caused by pressure on nerves, such as pressure from tumors, you might need surgery to reduce the pressure.