What is peripheral neuropathy?
Peripheral neuropathy is a common neurological disorder in the nerves outside the central nervous system which begins with a burning pain and a tingling feeling in the feet and fingertips. The condition can subsequently expand to other regions, including internal organs, and in a later stage can develop into arm and leg muscle weakness. Peripheral neuropathy is a widespread disorder, and there are many underlying causes. Some of these causes are common, such as diabetes, and others are extremely rare, such as acrylamide poisoning and certain inherited disorders. The most
common worldwide cause of peripheral neuropathy is leprosy. Leprosy is caused by the bacterium Mycobacterium leprae, which attacks the peripheral nerves of affected people. According to statistics gathered by the World Health Organization, an estimated 1.15 million people suffer from leprosy worldwide. Leprosy is extremely rare, where diabetes is the most commonly known cause of peripheral neuropathy. It has been estimated that more than 17 million people in the United States and Europe suffer from diabetes-related polyneuropathy. Many neuropathies are idiopathic, meaning that no known cause can be found. The most common of the inherited peripheral neuropathies in the United States is Charcot-Marie-Tooth disease, which affects approximately 125,000 persons.
Another of the better known peripheral neuropathies is Guillain-Barré syndrome, which arises from complications associated with viral illnesses, such as cytomegalovirus, Epstein-Barr virus, and human immunodeficiency virus (HIV), or bacterial infection, including Campylobacter jejuni and Lyme disease. The worldwide incidence rate is approximately 1.7 cases per 100,000 people annually. Other well-known causes of peripheral neuropathies include chronic alcoholism, infection varicella-zoster virus, botulism, and poliomyelitis. Peripheral neuropathy may develop as a primary symptom, or it may be due to another disease. For example, peripheral neuropathy is only one symptom of diseases such as amyloid neuropathy, certain cancers, or inherited neurologic disorders. Such diseases may affect the peripheral nervous system (PNS) and the central nervous system (CNS), as well as other body tissues.
Nerve cells are the basic building block of the nervous system. In the PNS, nerve cells can be threadlike--their width is microscopic, but their length can be measured in feet. The long, spidery extensions of nerve cells are called axons. When a nerve cell is stimulated, by touch or pain, for example, the message is carried along the axon, and neurotransmitters are released within the cell. Neurotransmitters are chemicals within the nervous system that direct nerve cell communication.
Certain nerve cell axons, such as the ones in the PNS, are covered with a substance called myelin. The myelin sheath may be compared to the plastic coating on electrical wires--it is there both to protect the cells and to prevent interference with the signals being transmitted. Protection is also given by Schwann cells, special cells within the nervous system that wrap around both myelinated and unmyelinated axons. The effect is similar to beads threaded on a necklace. erve cell axons leading to the same areas of the body may be bundled together into nerves. Continuing the comparison to electrical wires, nerves may be compared to an electrical cord--the individual components are coated in their own sheaths and then encased together inside a larger protective covering.
The nervous system is classified into two parts: the CNS and the PNS. The CNS is made up of the brain and the spinal cord, and the PNS is composed of the nerves that lead to or branch off from the CNS. he peripheral nerves handle a diverse array of functions in the body. This diversity is reflected in the major divisions of the PNS--the afferent and the efferent divisions. The afferent division is in charge of sending sensory information from the body to the CNS. When afferent nerve cell endings called receptors are stimulated, they release neurotransmitters. These neurotransmitters relay a signal to the brain, which interprets it and reacts by releasing other neurotransmitters.
Some of the neurotransmitters released by the brain are directed at the efferent division of the PNS. The efferent nerves control voluntary movements, such as moving the arms and legs, and involuntary movements, such as making the heart pump blood. The nerves controlling voluntary movements are called motor nerves, and the nerves controlling involuntary actions are referred to as autonomic nerves. The afferent and efferent divisions continually interact with each other. For example, if a person were to touch a hot stove, the receptors in the skin would transmit a message of heat and pain through the sensory nerves to the brain. The message would be processed in the brain and a reaction, such as pulling back the hand, would be transmitted via a motor nerve.
When an individual suffers from a peripheral neuropathy, nerves of the PNS have been damaged. Nerve damage can arise from a number of causes, such as disease, physical injury, poisoning, or malnutrition. These agents may affect either afferent or efferent nerves. Depending on the cause of damage, the nerve cell axon, its protective myelin sheath, or both may be injured or destroyed.
Peripheral neuropathy often affects people with diabetes and autoimmune diseases such as rheumatoid arthritis and lupus. Certain vitamin deficiencies, some medications and alcoholism can also damage peripheral nerves. The areas of the body most commonly affected by peripheral neuropathy are the feet and lower and upper legs, although the hands and outer arms can also be affected with this type of nerve damage. Neuropathy in the feet can result in a loss of foot sensation, increasing the risk of foot problems.
Treating the underlying condition may relieve some cases of peripheral neuropathy. In other cases, treatment may focus on managing pain. Peripheral nerves have a remarkable ability to regenerate themselves, and new treatments using nerve growth factors or gene therapy may offer even better chances for recovery in the future. Therapy for peripheral neuropathy differs depending on the cause. For example, therapy for peripheral neuropathy caused by diabetes involves control of the diabetes. In cases where a tumor or ruptured disc is the cause, therapy may involve surgery to remove the tumor or to repair the ruptured disc. In entrapment or compression neuropathy treatment may consist of splinting or surgical decompression of the ulnar or median nerves. Peroneal and radial compression neuropathies may require avoidance of pressure. Physical therapy and/or splints may be useful in preventing contractures (a condition in which shortened muscles around joints cause abnormal and sometimes painful positioning of the joints).
Recovery from peripheral neuropathy is usually slow. Depending on the type of peripheral neuropathy, the patient may fully recover without residual effects or may partially recover and have sensory, motor, and vasomotor (blood vessel) deficits. If severely affected, the patient may develop chronic muscular atrophy.
More information on peripheral neuropathy and neuropathy - autonomic neuropathy, mononeuropathy, diabetic neuropathy, polyneuropathy, lower back pain
What is peripheral neuropathy? - Peripheral neuropathy is a common neurological disorder characterized by sensory loss, pain, muscle weakness and wasting of muscle in the hands or legs and feet.
What types of peripheral neuropathies are there? - To aid in diagnosis and treatment, the symptoms are classified into principal neuropathic syndromes based on the type of affected nerves.
What causes peripheral neuropathy? - Peripheral neuropathy is nerve damage caused by a systemic illness such as diabetes. Neuropathy involves damage to the axon of the nerve cell or the myelin sheath.
What're the risk factors for peripheral neuropathy? - Diabetes is the biggest risk factors for peripheral neuropathy. Other risk factors including include nutritional deficiencies, medications and chemical exposures.
What're the symptoms of peripheral neuropathy? - Symptoms of a peripheral neuropathy include sensory loss, pain, muscle weakness and wasting of muscle in the hands or legs and feet.
How is peripheral neuropathy diagnosed? - Diagnosis of peripheral neuropathy is based on clinical syndrome. Exact diagnosis requires a combination of medical history, medical tests, and process of exclusion.
What're the treatments for peripheral neuropathy? - Treatment goals for peripheral neuropathy may be to determine underlying cause and treat it, cure of the disorder, and control of symptoms.
Is peripheral neuropathy preventable? - Steps that a person can take to prevent peripheral neuropathy include vaccines against diseases that cause neuropathy.
What's the prognosis of peripheral neuropathy? - Prognosis for neuropathy depends on the underlying cause. The outcome for peripheral neuropathy depends heavily on the cause.
What is neuropathy? - Neuropathy is disease or disorder affecting the cranial nerves or the peripheral or autonomic nervous systems. Neuropathy is a disturbance in the function of a nerve or particular group of nerves.
What types of neuropathy are there? - Types of neuropathies include peripheral neuropathy, polyneuropathy, neuropathic arthropathy, cranial neuropathy, autonomic neuropathy, compression mononeuropathy.
What causes neuropathy? - Diabetes is a frequent cause of neuropathy, the other causes of neuropathy are herpes zoster infection, chronic or acute trauma (including surgery) and various neurotoxins.
What're the symptoms of neuropathy? - Symptoms of neuropathy include loss of sensation, paresthesias and dysesthesias, pain, postural hypotension, impotence, abnormal sweating, and sensory ataxia.
How is neuropathy diagnosed? - Neuropathy may be diagnosed by variety of tests, including electromyography and nerve conduction studies. Nerve and muscle biopsy is useful for autoimmune or vasculitic neuropathies.
What's the treatment for neuropathy? - Treatment of neuropathy is often directed at the symptoms or the underlying cause of the neuropathy. Symptomatic treatments include medical therapy, physical and occupational therapy.
What medications relieve neuropathic pain? - A major goal of treatment for neuropathy is relieving neuropathic pain. Three major of medication are used in the treatment of neuropathic pain.
What is mononeuropathy? - Mononeuropathy is disorder of a single nerve or nerve trunk. Mononeuropathy involves damage or destruction of an isolated nerve or nerve group.
What're some of the specific mononeuropathies? - Some of the other common forms of mononeuropathy include sciatic nerve dysfunction, radial nerve dysfunction, cranial mononeuropathy, carpal tunnel syndrome.
What causes mononeuropathy? - Mononeuropathy is most often caused by damage to a local area resulting from direct trauma, prolonged pressure on the nerve and compression.
What's the treatment for mononeuropathy? - Treatment of mononeuropathy is aimed at maximizing the ability to use the affected body part. Physical therapy exercises may be useful.
What's common peroneal nerve dysfunction? - Common peroneal nerve dysfunction is a disorder caused by damage to the peroneal nerve, characterized by loss of movement of or sensation in the foot and leg.
What is radial nerve dysfunction? - Radial nerve dysfunction is a form of peripheral neuropathy involves impaired movement or sensation of the back of the arm and hand.
What is ulnar nerve dysfunction? - Ulnar nerve dysfunction involves impaired movement or sensation in the wrist and hand caused by damage to the ulnar nerve.
What is cranial mononeuropathy VI? - Cranial mononeuropathy VI is a disorder that causes double vision, associated with dysfunction of cranial nerve VI.
What is cranial mononeuropathy VII? - Cranial mononeuropathy VII is a mononeuropathy that involves the seventh cranial nerve, the nerve that controls movement of the muscles of the face.
What is cranial mononeuropathy III (compression type)? - Cranial mononeuropathy III is a disorder associated with dysfunction in the third cranial nerve, which causes double vision and eyelid drooping.
What is cranial mononeuropathy III (diabetic type)? - Cranial mononeuropathy III is a complication of diabetes caused by damage to the third cranial nerve.
What is axillary nerve dysfunction? - Axillary nerve dysfunction is a condition involving impaired movement or sensation of the shoulder because of damage to the axillary nerve.
What is distal median nerve dysfunction? - Distal median nerve dysfunction is a form of peripheral neuropathy affecting movement of or sensation in the hand, caused by damage to the distal median nerve.
What is femoral nerve dysfunction? - Femoral nerve dysfunction is a condition involving impaired movement or sensations in the leg, caused by damage to the femoral nerve.
What is tibial nerve dysfunction? - Tibial nerve dysfunction is a condition involving impaired movement or sensation in the leg, caused by damage to the tibial nerve.
What is carpal tunnel syndrome? - Carpal tunnel syndrome is a painful disorder in the hand caused by compression of a nerve in the carpal tunnel, characterized by discomfort and weakness in the hand.
What causes carpal tunnel syndrome? - Carpal tunnel syndrome is caused by the swelling of the nerve that runs through the carpal tunnel in the wrist due to repetitive and forceful movements of the wrist.
What're the risk factors for carpal tunnel syndrome? - Risk factors for carpal tunnel syndrome include diseases, some drugs, direct injury, activities that require repeated motions, and even pregnancy.
What're the symptoms of carpal tunnel syndrome? - Symptoms of carpal tunnel syndrome include burning, tingling or numbness of the fingers, difficulty gripping tools or other implements, and problems making a fist.
How is carpal tunnel syndrome diagnosed - An accurate medical history and the clinical examination will establish the diagnosis of carpal tunnel syndrome.
What's the treatment for carpal tunnel syndrome? - Carpal tunnel syndrome is initially treated with splints. Nonsteroidal anti-inflammatory drugs may be used to relieve pain.
How to prevent carpal tunnel syndrome? - Prevention of carpal tunnel syndrome is aimed at becoming aware of the repetitive motions. Early use of a splint is helpful.
What is polyneuropathy? - Polyneuropathy refers to any illness that attacks numerous nerves in the body. Polyneuropathy affects the nerves of the autonomic nervous system.
What is chronic inflammatory polyneuropathy? - Chronic inflammatory polyneuropathy is a disorder involving slowly progressive or repeated episodes of loss of movement or sensation.
What is diabetic neuropathy? - Diabetic neuropathies are neuropathic disorders that are associated with diabetes mellitus. Diabetic neuropathies occur in both type 1 and type 2 diabetes.
What types of diabetic neuropathy are there? - There are three types of neuropathy that occur in people with diabetes. They're peripheral neuropathy, autonomic neuropathy, focal neuropathy.
What causes diabetic neuropathy? - The exact causes of diabetic neuropathy are unknown, several factors may contribute to diabetic neuropathy.
What're the symptoms of diabetic neuropathy? - Symptoms of diabetic neuropathy depend on the types of neuropathy. Diabetic neuropathies are classified as peripheral, autonomic, proximal, and focal.
How is diabetic neuropathy diagnosed? - A diagnosis of diabetic neuropathy is based mostly on your medical history and physical examination.
What's the treatment for diabetic neuropathy? - The goal of treating diabetic neuropathy is to relieve discomfort and prevent further tissue damage. Analgesics may be prescribed for relief of pain.
What is autonomic neuropathy? - Autonomic neuropathy is a disease of the non-voluntary, non-sensory nervous system caused by damage to nerves supplying the internal body structures.
What causes autonomic neuropathy? - Autonomic neuropathy is a form of peripheral neuropathy affecting the autonomic portion of the peripheral nervous system. The causes are multiple.
What're the symptoms of autonomic neuropathy? - The symptoms of autonomic neuropathy depend upon what organs are affected and may include abdominal swelling, heat intolerance, nausea, vomiting.
How is autonomic neuropathy diagnosed? - Diagnosis of autonomic neuropathy can be made by eye examination and other tests guided by the suspected cause of the disorder.
What's the treatment for autonomic neuropathy? - Treatment for autonomic neuropathy is supportive and may need to be long-term. Several treatments may be attempted before a successful therapy.
What is lower back pain? - Lower back pain is pain in the low lumbar accompanied by pain radiating down one or both buttocks or legs in the distribution of the sciatic nerve (sciatica).
What causes lower back pain? - There is no single identifiable cause for an episode of back pain. Most back pain comes from the soft tissues of the spine.
What're the risk factors for lower back pain? - Lower back pain is often triggered by some combination of overuse, muscle strain, or injury to the muscles and ligaments that support the spine.
What're signs and symptoms of lower back pain? - Symptoms of the back pain will depend on the condition that's causing the pain. Pain can be constant or intermittent.
How is lower back pain diagnosed? - The diagnosis of low back pain can be complicated. Most cases are initially evaluated by primary care physicians rather than by specialists.
What're the treatments for lower back pain? - Treatment of low back pain is aimed at symptom relief or preventing interference with the processes of healing. Acute back pain is treated with nonsteroidal anti-inflammatory drugs.
How to relieve acute lower back pain? - Acute back pain is treated with nonsteroidal anti-inflammatory drugs (NSAIDs). Applications of heat or cold compresses help to relieve lower back pain.
How to relieve chronic low back pain? - Patients with chronic low back pain are treated witha combination of medications, physical therapy, andoccupational or lifestyle modification.
What's the physical therapy for low back pain relief? - Types of treatment used by the physical therapist will depend on the nature of low back pain being treated.
What's lower back pain exercise? - Low-stress aerobic exercise can prevent debilitation due to inactivity during the first month of symptoms and thereafter may help patients relieve lower back pain.
How to prevent low back pain? - Low back pain due to muscle strain can be prevented by lifestyle choices, including regular physical exercise and weight control, avoiding smoking.
What is sciatica? - Sciatica is pain, tingling, or numbness produced by an irritation of the sciatic nerve. The sciatic nerve supplies the back of the leg and buttocks.
What causes sciatica? - Sciatica is a form of peripheral neuropathy. Of the identifiable causes of sciatic pain, lumbosacral radiculopathy and back strain are the most frequently suspected.
What're the symptoms of sciatica? - The symptoms of sciatica vary widely, the most common symptom is pain that radiates through one buttock and down the back of that leg.
How is sciatica diagnosed? - Diagnosis of sciatica involves a straight-leg-raising test, magnetic resonance imaging (MRI) and computed tomography scans (CT scans).
What's the treatment for sciatica? - Most cases of sciatica can be effectively treated by physical therapy and appropriate changes in environment. Initial treatment for sciatica focuses on pain relief.
How to prevent sciatica? - Once the pain of sciatica passes, there are exercises, stretches and other measures that may prevent it from returning.
What is brachial plexus injury? - brachial plexus injury is an injury to the nerves that travel from the neck and down the arm. These peripheral nerves are called the brachial plexus nerves.
What causes brachial plexus injury? - A brachial plexus injury is caused when the head and neck are forcibly moved or hit to one side, stretching the brachial plexus on the opposite side.
What're the symptoms of brachial plexus injury? - A brachial plexus injury usually causes intense pain from the neck down to the arm. Loss of strength in the affected arm or hand is a common symptom
How is brachial plexus injury diagnosed? - To diagnose a brachial plexus injury, a doctor may ask the patient about his or her symptoms and examine the head, neck, shoulder, arm and hand.
What's the treatment for brachial plexus injury? - The goal of treatment for brachial plexus injury is to enable the patient to return to sport or activity as soon as possible while not worsening the injury.
What's postherpetic neuralgia? - Postherpetic neuralgia is pain that persists after an episode of shingles (herpes zoster) has resolved. Postherpetic neuralgia causes pain after shingles heals.
What causes postherpetic neuralgia? - Postherpetic neuralgia results when nerve fibers are damaged. The condition is caused by damage to and then regrowth of nerves affected by shingles.
What're the symptoms of postherpetic neuralgia? - The symptoms of postherpetic neuralgia are generally limited to the area of your skin where the shingles outbreak first occurred.
What's the treatment for postherpetic neuralgia? - Treatment for postherpetic neuralgia also depends on the type of pain the patient experience. Tricyclic antidepressant medications relieve pain.
What is the thoracic outlet syndrome? - Thoracic outlet syndrome is a condition in which the nerves or vessels behind the collar bone (clavicle) become compressed or stretched.
What causes thoracic outlet syndrome? - The common underlying cause of the thoracic outlet syndrome is compression of the nerves and arteries of the arm in the Thoracic Outlet.
What're the symptoms of thoracic outlet syndrome? - Symptoms of thoracic outlet syndrome include pain, numbness and tingling, weakness and fatigue or swelling and coldness in the arm and hand.
How is thoracic outlet syndrome diagnosed? - There are no specific diagnostic tests for thoracic outlet syndromes. The diagnosis is made by ruling out other diseases.
What's the treatment for thoracic outlet syndrome? - Treatment of thoracic outlet syndrome focuses on relief of the symptoms caused by compression of the nerves and blood vessels.