Peripheral Neuropathy

Peripheral Neuropathy

Introduction:

The peripheral nervous system is that part of your nervous system located outside the brain and spinal cord and sends the information from your brain and spinal cord to all your body parts. Peripheral neuropathy is a problem resulting from damage in nerves known as peripheral nerves located outside the brain and spinal cord. The nerves transfer information between your brain and the rest of your body. It badly affects the proper functioning of the body, including blood circulation, urination, and digestion. Peripheral neuropathy is usually caused due to metabolic problems, infections, traumatic injuries, toxins exposure, and inherited disorders. Diabetes is one of the prime reasons behind this disease. 

Causes:

Peripheral neuropathy is caused due to nerve damage and by many different diseases and problems:

  • Diabetes is one of the most ordinary reasons behind peripheral neuropathy.
  • Some inherited disorders, such as Charcot-Marie-Tooth disease 
  • Some autoimmune diseases such as lupus, Guillain-Barre syndrome, Sjogren’s syndrome, Vasculitis, and rheumatoid arthritis 
  • Some viral and bacterial infections such as Epstein-Barr virus, Diptheria, shingles, Hepatitis B and C, HIV, and Lyme disease are reasons behind peripheral neuropathy.
  • Tumors, either it is malignant or benign, can cause peripheral neuropathy.
  • Bone marrow disorder
  • Many diseases, such as liver disease, kidney disease, connective tissue disorder, and underactive thyroid, can also be the reason behind peripheral neuropathy.  

Other conditions and lifestyle habits which lead to peripheral neuropathy include:

  • Use of chemotherapy medicines usually used to treat cancer
  • Poor dietary condition and use of alcohol leads to vitamin deficiencies in the body
  • Exposure to toxic substances such as industrial chemicals and heavy metals
  • Deficiences of vitamin E, B(B-1, B-6 and B-12) and niacin
  • Specific injuries such as falls, sports injuries, and motor vehicle accidents can cause damage to peripheral nerves. 

Types of peripheral nerves:

There are three types of peripheral nerves:

  • Autonomic nerves: These nerves play an essential role in heartbeat, digestion, and breathing processes.
  • Motor nerves: These nerves play an essential role in using arms and hands as well as help in walking, talking, and other muscle movements
  • Sensory nerves: These nerves help to transfer sensory information, such as feelings of temperature, touch, and pain. 

Symptoms:

The symptoms of peripheral neuropathy always depend on the type of nerve affected because every nerve has its specific function in the peripheral nervous system. 

Symptoms of motor neuropathy include:

  • Weakness in muscles and due to this reason, difficulty in walking and daily activities
  • Twitching in muscles or cramps
  • Paralysis in any body part
  • Insufficiency of coordination, falling

Symptoms of sensory neuropathy include:

  • Numbness or tingling in feet and hands, which further spreads to legs and arms
  • Changes in sensation and difficulty in feeling pain, temperature, or touch
  • Sharp, stabbing, or burning electric-like pain 
  • Insufficiency of balance and coordination

Symptoms of Autonomic neuropathy include:

  • Abnormal heartbeat
  • Lightheadedness, fainting, and dizziness due to low blood pressure
  • Problems in the bowels which leads to constipation and diarrhea
  • Difficulty in digestion that causes vomiting and nausea
  • Too much sweating or not enough sweating according to the temperature 
  • Sexual function problems
  • Loss of weight
  • Issues in the bladder such as difficulty in urination

When to get medical help?

Get immediate medical help if you notice the above mention symptoms in your body. Because when the disease is diagnosed in the acute stage, it is easy to treat it as compared to the chronic stage. Early diagnosis and treatment of the disease help control symptoms and avoid further damage to the peripheral nervous system.

Diagnosis:

During diagnosis, the doctor will be asked about family history, medical history, and symptoms. Then your doctor will conduct a physical exam. He will also ask about the medication you are taking now or before, your work, diet, lifestyle, and exposure to toxic substances. After that doctor will conduct your neurological exam in which they check your coordination, balance, muscle strength, and feeling sensation.

Your doctor may order the following test to diagnose your disease:

  • Genetic testing: Your doctor may order genetic testing if he suspects your disease is due to genetic conditions. 
  • Blood and imaging test: Your doctor may also order blood and imaging test such as Magnetic resonance imaging and blood tests to detect other diseases such as tumors, diabetes, thyroid problems, toxic substances, and other autoimmune diseases.
  • Electro-diagnostic assessment (EDX): Your doctor will suggest an EDX test to find your nerve damage’s actual location and degree.
  • Tissue biopsies: In a biopsy, a small tissue sample is removed from the damaged area to examine under the microscope to find out the cause of the disease for treatment.
  • Other tests include to checks your sensation and ability to measure your body temperature. 

Treatment:

The peripheral neuropathy treatment depends on the causes behind it. If this issue is due to other diseases such as diabetes and infection, the doctor first treats them. In some cases, peripheral neuropathy is treated easily, but in some, it isn’t easy to treat. The major aim of treatment is to control nerve damage and relieve symptoms. The following methods are used to treat peripheral neuropathy:

  • Medicines: Many antidepressants, anti-seizure, and narcotics treat peripheral neuropathy. These medicines contain certain chemicals that help adjust pain and signaling pathways in the peripheral and central nervous systems.
  • Physical therapy: In this treatment, the doctors recommend exercises and massage treatments to strengthen muscles, improve balance and relieve pain.
  • Surgery: Surgery is a choice for patients with compression-related neuropathy diseases such as herniated discs in the back or neck, tumors, nerve entrapment disorders, and infections.
  • Occupational therapy: In occupational therapy, patients learn to cope with the pain and emotional, social, and physical barriers due to disorders or diseases. 
  • Mechanical aids: Mechanical aids are also helpful in giving treatments with the help of many different types of equipment such as braces, splints and casts, and specially designed shoes that reduce the pain and help the patient in daily activities.
  • Proper nutrition: A healthy diet full of vegetables, fruits, and whole grains gives you energy and helps you recover from the disease.
  • Healthy lifestyle habits: Healthy lifestyle habits such as exercise, maintaining a healthy weight, and avoiding smoking and alcohol are also helpful in treating diseases. 

Risks:

The things which increase the risk of peripheral neuropathy include:

  • Family history of this disease
  • Exposure to harmful toxins
  • Excessive use of alcohol
  • Vitamin B deficiency in the body
  • Liver, kidney, or thyroids diseases
  • Diabetes
  • Repetitive motions due to specific jobs
  • Other infections such as shingles, hepatitis B and C, Epstein-Barr virus, and HIV 
  • Immune system diseases like lupus, arthritis, and rheumatoid

Complications:

Some of the following conditions patients may face if peripheral neuropathy gets complicated:

  • Loss of sensation and weakness that leads to falling and lack of balance
  • Due to changes in sensation and difficulty in feeling pain and temperature, the patient might suffer from extreme burns and injuries without feeling anything.
  • Infections in the injuries caused due to lack of sensation are challenging to treat in diabetes.

Preventions:

To prevent peripheral neuropathy, you must prevent the things that cause this disease, like rheumatoid arthritis, diabetes, and alcohol.

Some common lifestyle changes used to prevent peripheral neuropathy include:

  • Exercise regularly, not less than 30 minutes a day, three times a week. 
  • Take a healthy diet, and eat fruits, vegetables, and whole grains, which are suitable for the health of your nerves. Add those things in your diet which are good in vitamin B-12, such as dairy foods, fish, eggs, and fortified cereals.
  • Avoid exposure to toxic chemicals.
  • Avoid smoking and using alcohol.
  • Avoid exercises or workouts that pressurize the nerves, such as repetitive motion and cramped positions.

 Reference list:

  • https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061#:~:text=Peripheral%20neuropathy%2C%20a%20result%20of,including%20digestion%2C%20urination%20and%20circulation.
  • https://my.clevelandclinic.org/health/diseases/14737-neuropathy
  • https://www.healthline.com/health/peripheral-neuropathy
  • https://www.hopkinsmedicine.org/health/conditions-and-diseases/peripheral-neuropathy?amp=true
  • https://www.webmd.com/brain/understanding-peripheral-neuropathy-basics
  • https://medlineplus.gov/ency/article/000593.htm
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