Summary about Disease
Peripheral neuropathy is a condition resulting from damage to the peripheral nerves, which transmit information between the central nervous system (brain and spinal cord) and the rest of the body. This damage can interfere with nerve signals, causing a variety of symptoms, most commonly weakness, numbness, and pain, usually in the hands and feet. It can be caused by a number of things, including diabetes, infections, injuries, and exposure to toxins.
Symptoms
Symptoms of peripheral neuropathy vary depending on the type of nerves affected (sensory, motor, or autonomic). Common symptoms include:
Gradual onset of numbness, prickling, or tingling in your feet or hands, which can spread upward into your legs or arms.
Sharp, throbbing, freezing or burning pain.
Extreme sensitivity to touch.
Lack of coordination and falling.
Muscle weakness.
Feeling as if you're wearing gloves or socks when you're not.
Paralysis if motor nerves are affected.
Heat intolerance.
Changes in blood pressure.
Dizziness.
Bowel, bladder or digestive problems.
Causes
Peripheral neuropathy has many potential causes, including:
Diabetes: High blood sugar levels can damage nerves. This is the most common cause.
Autoimmune diseases: Conditions like lupus, rheumatoid arthritis, and Sjögren's syndrome.
Infections: Certain viral or bacterial infections, including Lyme disease, shingles, Epstein-Barr virus, hepatitis B and C, and HIV.
Inherited disorders: Charcot-Marie-Tooth disease and other hereditary neuropathies.
Tumors: Both cancerous (malignant) and noncancerous (benign) tumors can affect nerves.
Bone marrow disorders: These include abnormal protein in the blood (monoclonal gammopathies), a form of bone cancer (myeloma), lymphoma and amyloidosis.
Kidney disease: When the kidneys fail, toxic levels of substances can accumulate and damage nerves.
Exposure to toxins: Including heavy metals, some chemicals, and certain medications (chemotherapy drugs).
Alcoholism: Poor dietary choices associated with alcoholism can lead to vitamin deficiencies.
Injuries/Trauma: Accidents, sports injuries, or surgery can damage nerves.
Vitamin deficiencies: Especially B vitamins (B1, B6, B12).
Medicine Used
Medications used to manage peripheral neuropathy aim to relieve pain and address the underlying cause, if possible. Common medications include:
Pain relievers:
Over-the-counter pain relievers like NSAIDs (ibuprofen, naproxen). These may provide some relief for mild symptoms.
Prescription pain relievers: Tramadol or opioid medications (should be used cautiously due to the risk of dependence).
Anti-seizure medications: Gabapentin and pregabalin are often used to treat nerve pain.
Antidepressants: Certain antidepressants, such as tricyclic antidepressants (amitriptyline, nortriptyline) and serotonin-norepinephrine reuptake inhibitors (SNRIs) like duloxetine and venlafaxine, can help with nerve pain.
Topical treatments: Capsaicin cream or lidocaine patches.
Treatments for underlying conditions: Medications to control blood sugar in diabetes, antibiotics for infections, or immunosuppressants for autoimmune diseases.
Is Communicable
Peripheral neuropathy is not communicable. It is not contagious and cannot be spread from person to person.
Precautions
Precautions for people with peripheral neuropathy include:
Foot care: Inspect feet daily for cuts, blisters, or sores. Wear appropriate footwear.
Avoid injuries: Be careful when walking or participating in activities that could lead to falls or injuries.
Temperature awareness: Use caution with hot water or heating pads due to reduced sensation.
Blood sugar control: If diabetic, maintain strict control of blood sugar levels.
Limit alcohol consumption: Excessive alcohol use can worsen neuropathy.
Healthy diet: Ensure adequate intake of vitamins and nutrients.
Regular exercise: Exercise improves blood flow and can help manage pain.
Quit smoking: Smoking can worsen neuropathy.
How long does an outbreak last?
Peripheral neuropathy is not an outbreak but rather a chronic condition, although symptom severity can fluctuate. The duration depends on the underlying cause and its treatability.
Reversible Neuropathy: If the underlying cause can be treated effectively (e.g., vitamin deficiency, medication side effect), the neuropathy may improve over weeks to months.
Chronic Neuropathy: If the underlying cause is difficult to treat or irreversible (e.g., diabetes, some genetic conditions), the neuropathy may be a lifelong condition, and symptoms may persist indefinitely. With good management, symptoms can be controlled.
How is it diagnosed?
Diagnosis of peripheral neuropathy involves:
Medical history and physical examination: A doctor will ask about symptoms, medical history, and medications. A physical exam will assess muscle strength, reflexes, and sensation.
Neurological examination: Testing reflexes, muscle strength and tone, ability to feel certain sensations, posture and coordination.
Nerve conduction studies (NCS): These tests measure the speed and strength of electrical signals transmitted by nerves.
Electromyography (EMG): This test measures the electrical activity of muscles.
Blood tests: To check for diabetes, vitamin deficiencies, kidney or liver problems, autoimmune diseases, and other underlying conditions.
Nerve biopsy: In some cases, a small sample of nerve tissue may be taken for examination under a microscope.
Imaging tests: MRI or CT scans may be used to look for tumors or other abnormalities that could be affecting the nerves.
Timeline of Symptoms
The timeline of symptoms can vary widely depending on the cause and severity of the neuropathy.
Gradual onset: Most commonly, symptoms develop gradually over weeks, months, or even years. Numbness and tingling in the feet or hands are often the first symptoms.
Progressive worsening: As the neuropathy progresses, pain may develop, and muscle weakness may occur. Symptoms may spread up the limbs.
Fluctuations: Symptoms may fluctuate in intensity over time.
Acute onset: In some cases (e.g., Guillain-Barré syndrome), symptoms can develop rapidly over days or weeks.
Important Considerations
Early diagnosis and treatment are crucial: Addressing the underlying cause of neuropathy can help prevent further nerve damage.
Pain management is important: Effective pain management can improve quality of life.
Lifestyle modifications can help: Controlling blood sugar, maintaining a healthy diet, avoiding alcohol and smoking, and exercising regularly can help manage symptoms.
Complications: Untreated neuropathy can lead to complications such as falls, injuries, infections, and foot ulcers.
Multidisciplinary approach: Management of peripheral neuropathy often requires a team approach involving doctors, physical therapists, occupational therapists, and pain specialists.