Peripheral Neuropathy

Peripheral nerves carry messages from the brain and spinal cord to muscles, organs, and other body tissues. Damage or disease of these nerves are called peripheral neuropathy. Sometimes one nerve or a group of related nerves is involved in neuropathy; in polyneuropathy, multiple nerves are affected in different areas of the body. Because nerves are made up of several different types of nerve fibers affecting sensation, movement, pain transmission, or balance, symptoms and signs are based on the involved type of nerve fiber. The March 5, 2008, issue of JAMA includes an article about neuropathy related to alcohol consumption.

TYPES AND CAUSES OF NEUROPATHY

Diabetic neuropathy

Trigeminal neuralgia involves a nerve that brings sensation to the face, jaw, and eye area

Inherited neuropathy (present from birth)

Autonomic neuropathy (involving involuntary body functions, such as breathing, intestinal function, and regulation of blood pressure)

Vitamin deficiency

Medication effects

Traumatic injury

Excessive alcohol use

Infections, including human immunodeficiency virus (HIV)

Immune system diseases

Diabetic neuropathy is the most common type of neuropathy and affects up to two-thirds of patients with type 1 and type 2 diabetes. Diabetic neuropathy often involves the feet and legs and is responsible for lack of sensation, ease of injury, and infections.

SIGNS AND SYMPTOMS

Pain
Numbness
Burning sensation
Tingling
Lancinating (shooting) pain
Hypersensitive areas of the skin
Hair loss on the affected part
Shiny skin
Weakness
Muscle atrophy (loss of muscle tissue)

DIAGNOSIS AND TESTING

A detailed medical history and physical examination can identify causes of neuropathy. Blood testing, measurement of glucose levels, an electromyogram (EMG, an electrical test of muscle function), nerve conduction studies, and lumbar puncture may all be part of the evaluation of neuropathy.


TREATMENT

Most neuropathies are not curable but can be improved with treatment. Vitamin deficiencies, often present in patients with alcoholism, can be corrected with a healthy diet and vitamin supplementation. Treatment for alcohol-related neuropathy also includes stopping alcohol consumption. Control of blood glucose levels can slow progression of diabetic neuropathy, in addition to other benefits for individuals with diabetes. Medications may be prescribed, including some medications originally developed for treating seizures or depression, that may improve pain and other sensory symptoms in persons with neuropathies.


FOR MORE INFORMATION

National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov

Neuropathy Association
http://www.neuropathy.org

American Diabetes Association
http://www.diabetes.org