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Alternative namesPeripheral neuritis; Neuropathy - peripheral; Neuritis - peripheral
Peripheral neuropathy is failure of the nerves that carry information to and from the brain and spinal cord. This produces symptoms like pain, loss of sensation, and inability to control muscles.
("Neuro" = nerves, "pathy" = abnormal; "peripheral" = nerves beyond the brain and spinal cord.)
Causes, incidence, and risk factors
The peripheral nerves are responsible for relaying information from your central nervous system (brain and spinal cord) to muscles and other organs. Peripheral nerves also relay information back to your spinal cord and brain from your skin, joints, and other organs. Peripheral neuropathy occurs when these nerves fail to function properly, resulting in loss of sensation, pain, or inability to control muscles.
In some cases, failure of nerves controlling blood vessels, intestinal function, and other organs results in abnormal blood pressure, digestion, and loss of other basic involuntary processes. Peripheral neuropathy may involve damage to a single nerve or nerve group ( mononeuropathy ) or may affect multiple nerves (polyneuropathy).
There are numerous reasons why nerves may not function properly. In some cases, no cause can be identified. Damage to nerves can result from one of the specific conditions associated with neuropathy including:
Peripheral neuropathy is very common. Because there are numerous types and causes of neuropathy, the incidence varies greatly, depending on the type of neuropathy, geographic region, and many other factors. As scientists don't always agree on the same definition of neuropathy, the exact incidence can not be determined precisely.
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).
Damage to sensory fibers results in changes in sensation, ranging from abnormal sensations (burning, nerve pain , or tingling ), numbness , or an inability to determine joint position in the area, 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.
Damage to the motor fibers interferes with muscle control and can cause weakness, loss of muscle bulk, and loss of dexterity. Sometimes, cramps are a sign of motor nerve involvement.
Other muscle-related symptoms include:
The autonomic nerves control involuntary or semi-voluntary functions, such as control of internal organs and blood pressure. Damage to autonomic nerves can cause:
Signs and testsA 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:
The goal of treatment may be to identify and treat the underlying cause, cure the disorder (if possible), give the patient maximum independence and self-care ability; and/or control the symptoms. As a rule, treatment of the underlying medical problem (e.g., diabetes) or removal of a causative agent (e.g., alcohol) are the first steps.
Adjusting position, using frames to keep bedclothes off of a tender body part, or other measures may also be helpful to reduce pain.
Additional information can be obtained from the
The outcome greatly depends on the cause of the neuropathy. In cases where a medical condition can be identified and treated, the prognosis 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 have a benign (harmless) prognosis, while others progress more rapidly and may lead to permanent, severe complications.
The inability to feel or notice injuries can lead to infection or structural damage. Changes include ulcer formation, poor healing, loss of tissue mass , scarring, and deformity. Other complications include:
Calling your health care providerCall your health care provider if symptoms of peripheral neuropathy are present. In all cases, early diagnosis and treatment increases the possibility that symptoms can be controlled. Nerve pain, such as that caused by peripheral neuropathy, can be difficult to control; if pain is severe, see a pain specialist to ensure that you get the best and most up-to-date pain treatment.
Emergency symptoms include irregular or rapid heartbeats, difficulty breathing , difficulty swallowing and fainting .
If a prolonged procedure or immobility is expected, appropriate measures (such as padding vulnerable areas) can done beforehand to reduce this risk.
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, limited exposure to alcohol, and maintaining good control of diabetes and other medical problems, if present.
Update Date: 11/3/2002Joseph V. Campellone, MD; Division of Neurology, Cooper Hospital/University Medical Center, Camden, NJ. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT