Peripheral Neuropathy/
Definition and Overview
Peripheral neuropathy refers to a range of conditions that involve damage to the peripheral nervous system, the vast communication network that transmits information between the central nervous system (the brain and spinal cord) and every other part of the body. Symptoms can range from numbness or tingling, to pricking sensations (paresthesia), or muscle weakness. Areas of the body may become abnormally sensitive leading to an exaggeratedly intense or distorted experience of touch (allodynia). In some instances, individuals with peripheral neuropathy may experience persistent pain or discomfort for no apparent reason. Pain is a complex perception that differs enormously among individual patients, even those with similar physical findings or disease states.
Classification
Peripheral neuropathy may be either inherited or acquired. Causes of acquired peripheral neuropathy include physical injury (trauma) to a nerve, tumors, toxins, autoimmune responses, nutritional deficiencies, alcoholism, and vascular and metabolic disorders. Acquired peripheral neuropathies are grouped into three broad categories: those caused by systemic disease, those caused by physical injury, and those caused by infection or immune disease.
Symptoms
The symptoms of peripheral neuropathy depend on which type of peripheral nerves are damaged. Neuropathic pain is often described as burning, stabbing, shooting, aching, or like an electric shock. Other symptoms may include:
- Sensory nerve damage often results in tingling, numbness, pain, and extreme sensitivity to touch. - Damage to motor nerves can cause muscle weakness, cramps, and spasms. - Damage to the autonomic nerves can affect blood pressure, heart rate, digestion, and other body functions.
Diagnosis
Diagnosis of peripheral neuropathy begins with a complete medical history that includes a description of the symptoms, the time of onset, the pattern of pain and other sensory abnormalities, and any environmental factors that may be contributing. The diagnosis is further formed by a physical examination and various tests.
Treatment
Treatment for peripheral neuropathy depends on the cause. For example, therapy for peripheral neuropathy caused by diabetes involves control of the diabetes. In cases where nerve pain is caused by a vitamin deficiency, then correction of the deficiency is the treatment. Pain management is important for those with peripheral neuropathy. Various medications, including some drugs used to treat depression and epilepsy, can help to reduce the pain. For cases that are difficult to manage, a pain specialist may be consulted.
Prognosis
The prognosis for peripheral neuropathy varies depending on the underlying cause. Some individuals may fully recover from their symptoms and regain nerve function. Others may have a partial recovery and those with a severe neuropathy may have a significant disability.
Prevention
Prevention of peripheral neuropathy is to manage medical conditions that might cause the neuropathy. For example, people with diabetes should strive for good blood sugar control, and those with nutritional deficiencies should correct their deficiencies.