Peripheral Neuropathy

Introduction

     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.

Causes

• Mechanical injury
   

Symptoms

• Paresthesia (abnormal sensations such as burning, pricking or tingling)

• Numbness

• Decreased sensation or complete loss of sensation, usually involving the hands or feet

• Pain in the arms, legs, hands and feet

• Muscle weakness or wasting

Screening and Diagnostics

• A peripheral Neuropathy can be diagnosed by a doctor with a neurologic exam and complete medical history.  In many individuals, there will be muscle weakness and numbness, coupled with a tingling sensation.

• Electromyography and nerve conduction studies may be needed to confirm the diagnosis.

Treatment

• The treatment for peripheral Neuropathy depends on its underlying disease.

• Medications for pain control -- some anti-seizure medications and anti-depressants may relieve the pain and paresthesia.

• Physical therapy and occupational therapy to maximize the muscle power

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.

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:

• Partial or complete loss of movement (or control of movement)

• Partial or complete loss of sensation

• Difficulty breathing

• Difficulty swallowing

• Cardiac arrhythmias (uncommon)

• Decreased self esteem

• Relationship problems related to impotence

• Recurrent or unnoticed injury to any part of the body

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.