Definition
Peripheral neuropathy is a problem with the nerves that carry information to and from the brain and spinal cord. This produces pain, loss of sensation, and inability to control muscles.
- "Peripheral" means nerves beyond the brain and spinal cord.
- "Neuro" means nerves.
- "Pathy" means abnormal.
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Definition
Peripheral neuropathy is a problem with the nerves that carry information to and from the brain and spinal cord. This produces pain, loss of sensation, and inability to control muscles.
- "Peripheral" means nerves beyond the brain and spinal cord.
- "Neuro" means nerves.
- "Pathy" means abnormal.
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Symptoms
The symptoms depend on which type of nerve is affected. The three main types of nerves are sensory, motor, and autonomic. Neuropathy can affect any one or a combination of all three types of nerves. Symptoms also depend on whether the condition affects the whole body or just one nerve (as from an injury).
SENSATION CHANGES
Damage to sensory fibers results in changes in sensation, burning sensations, nerve pain , tingling or numbness , or an inability to determine joint position, which causes incoordination.
For many neuropathies, sensation changes often begin in the feet and progress toward the center of the body with involvement of other areas as the condition worsens.
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Causes
The peripheral nerves relay information from your central nervous system (brain and spinal cord) to muscles and other organs and from your skin, joints, and other organs back to your brain. Peripheral neuropathy occurs when these nerves fail to function properly, resulting in pain, loss of sensation, or inability to control muscles.
In some cases, the failure of nerves that control blood vessels, intestines, and other organs results in abnormal blood pressure, digestion problems, and loss of other basic body processes. Peripheral neuropathy may involve damage to a single nerve or nerve group ( mononeuropathy ) or may affect multiple nerves (polyneuropathy).
There are numerous reasons for nerves to malfunction. In some cases, no cause can be identified. Damage to nerves can result from one of the specific conditions associated with neuropathy, including:
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Treatment
The first steps of treatment are to identify and treat the underlying medical problem (such as diabetes) or remove the cause (such as alcohol). Other goals include controlling symptoms, curing the disorder if possible, and helping the patient gain maximum independence and self-care ability.
Physical therapy, occupational therapy, and orthopedic interventions may be recommended. For example, exercises and retraining may be used to increase muscle strength and control. Wheelchairs, braces, and splints may improve mobility or the ability to use an affected arm or leg.
Safety is an important consideration for people with neuropathy. Lack of muscle control and reduced sensation increase the risk of falls and other injuries. The person may not notice a potential source of injury because he or she can't feel it. For this reason, ...
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Other Names
Peripheral neuritis; Neuropathy - peripheral; Neuritis - peripheral
Possible Complications
The inability to feel or notice injuries can lead to infection or structural damage. Changes include poor healing, loss of tissue mass , tissue erosions, scarring, and deformity. Other complications include:
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Outlook (Prognosis)
The outcome greatly depends on the cause of the neuropathy. In cases where a medical condition can be identified and treated, the outlook may be excellent. However, in severe neuropathy, nerve damage can be permanent, even if the cause is treated appropriately.
For most hereditary neuropathies, there is no cure. Some of these conditions are harmless, while others progress more rapidly and may lead to permanent, severe complications.
Prevention
If a prolonged procedure or immobility is expected, appropriate measures (such as padding vulnerable areas) can be taken beforehand to reduce the risk of nerve problems.
Some people have a hereditary predisposition for neuropathy. Such people need to be especially careful to limit alcohol and manage other medical problems closely.
All people can reduce the risk of neuropathy through a balanced diet, drinking alcohol in moderation, and maintaining good control of diabetes and other medical problems, if present.
Exams and Tests
A detailed history will be needed to determine the cause of the neuropathy. Neurologic examination may reveal abnormalities of movement, sensation, or organ function. (See also entries on the specific nerve dysfunction.) Changes in reflexes and muscle bulk may also be present.
Tests that reveal neuropathy may include:
- EMG (a recording of electrical activity in muscles)
- Nerve conduction tests
- Nerve biopsy
- Blood tests to screen for medical conditions, such as diabetes and vitamin deficiency, among others.
Tests for neuropathy are guided by the suspected cause of the disorder, as suggested by the history, symptoms, and pattern of symptom development. They may include various blood tests, x-rays, scans, or other tests and procedures.
References
Delalande S, de Seze J, Fauchais AL, et al. Neurologic manifestations in primary Sjogren syndrome: a study of 82 patients. Medicine (Baltimore). 2004 Sep;83(5):280-91.
Mori K, Iijima M, Sugiura M. Sjogren's syndrome associated painful sensory neuropathy without sensory ataxia. J Neurol Neurosurg Psychiatry . 2003 Sep;74(9):1320-2.
