Peripheral Neuropathy

Peripheral neuropathy is a type of damage to the nervous system -- more specifically, a problem with your peripheral nervous system. This is the network of nerves that transmits information from your central nervous system (your brain and spinal cord) to the rest of your body.

There are more than 100 types of peripheral neuropathy, each with its own set of symptoms and prognosis. To help doctors classify them, they are often broken down into the following categories:

• Motor neuropathy. This is damage to the nerves that control muscles and movement in the body, such as moving your hands and arms or talking.
• Sensory neuropathy. Sensory nerves control what you feel, such as pain, temperature or a light touch. Sensory neuropathy affects these groups of nerves.
• Autonomic nerve neuropathy. Autonomic nerves control biological functions that you are not conscious of, such as breathing and heartbeat. Damage to these nerves can be serious.
• Combination neuropathies. You may have a combination of two or three of these other types of neuropathies, such as a predominantly motor neuropathy or a sensory-motor neuropathy.

What causes peripheral neuropathy?

Peripheral neuropathy has many different causes. Some people inherit the disorder from their parents, and others develop it because of an injury or another disorder.

In many cases, a different type of medical problem, such as a kidney condition or a hormone imbalance, leads to peripheral neuropathy. One of the most common causes of peripheral neuropathy in the U.S. is diabetes.

What are the risks for peripheral neuropathy?

The following are risk factors for peripheral neuropathy:

• Diabetes
• Kidney disease
• Hormone imbalance
• Family history of peripheral neuropathy

What are the symptoms of peripheral neuropathy?

The symptoms of peripheral neuropathy vary based on the type that you have and what part of the body is affected. Symptoms can range from tingling or numbness in a certain body part to more serious effects such as burning pain or paralysis.

• Muscle weakness
• Cramps
• Muscle twitching
• Loss of muscle and bone
• Changes in skin, hair, or nails
• Numbness
• Loss of sensation or feeling in body parts
• Loss of balance or other functions as a side effect of the loss of feeling in the legs, arms, or other body parts
• Emotional disturbances
• Sleep disruptions
• Loss of pain or sensation that can put you at risk, such as not feeling an impending heart attack or limb pain
• Inability to sweat properly, leading to heat intolerance
• Loss of bladder control, leading to infection or incontinence
• Dizziness, light headedness, or fainting because of a loss of control over blood pressure
• Diarrhea, constipation, or incontinence related to nerve damage in the intestines or digestive tract
• Difficulty eating or swallowing
• Life-threatening symptoms, such as difficulty breathing or irregular heartbeat

The symptoms of peripheral neuropathy may resemble other conditions or medical problems. Always consult your health care provider for a diagnosis.

How is peripheral neuropathy diagnosed?

The symptoms and body parts affected by peripheral neuropathy are so varied that it may be difficult to make a diagnosis. If your health care provider suspects nerve damage, he or she will take an extensive medical history and do a number of neurological tests to determine the location and extent of your nerve damage. These may include:

• Blood tests
• Spinal fluid tests
• Muscle strength tests
• Tests of the ability to detect vibrations

Depending on what basic tests reveal, your health care provider may want to perform more in-depth scanning and other tests to get a better look at your nerve damage. Tests may include:

• CT scan
• MRI scan
• Electromyography
• Nerve and skin biopsy

How is peripheral neuropathy treated?

Usually a peripheral neuropathy can't be cured, but you can do a lot of things to prevent it from getting worse. If an underlying condition like diabetes is at fault, your health care provider will treat that first and then treat the pain and other symptoms of neuropathy.

In some cases, over-the-counter pain relievers can help. Other times, prescription drugs are needed. Some of these drugs include mexiletine, a medication developed to correct irregular heart rhythms; antiseizure drugs, such as gabapentin, phenytoin, and carbamazepine; and some classes of antidepressants, including tricyclics such as amitriptyline.

Lidocaine injections and patches may help with pain in other instances. And in extreme situations, surgery can be used to destroy nerves or repair injuries that are causing neuropathic pain and symptoms.

Can peripheral neuropathy be prevented?

Lifestyle choices can play a role in preventing peripheral neuropathy. You can lessen your risk for many of these conditions by avoiding alcohol, correcting vitamin deficiencies, eating a healthy diet, losing weight, avoiding toxins, and exercising regularly. If you have kidney disease, diabetes, or other chronic health condition, it is important to work with your health care provider to control your condition, which may prevent or delay the onset of peripheral neuropathy.

Living with peripheral neuropathy

Even if you already have some form of peripheral neuropathy, healthy lifestyle steps can help you feel your best and reduce the pain and symptoms related to the disorder. You'll also want to quit smoking, not let injuries go untreated, and be meticulous about caring for your feet and treating wounds to avoid complications, such as the loss of a limb.

In some cases, non-prescription hand and foot braces can help you compensate for muscle weakness. Orthotics can help you walk better. Relaxation techniques, such as yoga, may help ease emotional as well as physical symptoms.

Key points

• Neuropathy affects the body in many different ways, including how well you're able to use your muscles, feeling and sensation in your various body parts, and other body functions that are automatic such as your heartbeat.
• Medications can improve your symptoms.
• If is important that you control any other diseases you may have to reduce your risk for peripheral neuropathy.
• If you think you may have peripheral neuropathy, it is important to talk with your health care provider.

Next steps

Tips to help you get the most from a visit to your health care provider:

• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.