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About Neuropathy

Peripheral neuropathy is a disorder of the peripheral nerves—the motor, sensory and autonomic nerves that connect the spinal cord to muscles, skin and internal organs. It usually affects the hands and feet, causing weakness, numbness, tingling and pain. Peripheral neuropathy’s course is variable; it can come and go, slowly progressing over many years, or it can become severe and debilitating. However, if diagnosed early, peripheral neuropathy can often be controlled.

Frequently Asked Questions About Neuropathy

  1.   Why have we heard so little about Peripheral Neuropathy?
      Is it a new disease?
  2.   What is Peripheral Neuropathy?
  3.   What causes Peripheral Neuropathy?
  4.   What are the symptoms of Peripheral Neuropathy?
  5.   How is Peripheral Neuropathy diagnosed?
  6.   Can Peripheral Neuropathy be cured?

About Neuropathy

1) Why have we heard so little about Peripheral Neuropathy? Is it a new disease?

Peripheral neuropathy is common. It is estimated that upwards of 20 million Americans suffer from this illness. It can occur at any age as children and young adults are affected. The disease is more common among adults 40 and up.

Peripheral neuropathy has always been present, but has not received much attention. Its extent and importance have not yet been adequately recognized. It is apt to be misdiagnosed, or thought to be merely a side effect of another disease like diabetes, cancer or kidney failure. The development of new therapies has unfortunately been slow and underfunded. Increased research is critical to understand Peripheral Neuropathy. Back to top

2) What is Peripheral Neuropathy ?

Peripheral neuropathy is not a single disease. It is a general term for a series of disorders that result from damage to the body's peripheral nervous system. The peripheral nervous system sends messages from the brain and spinal cord (central nervous system) to the rest of the body: the arms and hands, legs and feet, internal organs, joints and even the mouth, eyes, ears, nose, and skin. Peripheral nerves also relay information back to the spinal cord and brain from the skin, joints, and other organs. The symptoms of peripheral neuropathy occur when peripheral nerves are damaged or destroyed. Peripheral neuropathy’s course is variable; it can come and go, slowly progressing over many years, or it can become severe and debilitating. However, if diagnosed early, peripheral neuropathy can often be controlled. This is why we need increased research to find better treatments. Back to top

3) What causes Peripheral Neuropathy ?

There are many causes of peripheral neuropathy, including diabetes, hereditary disorders, inflammation, infections or autoimmune diseases, protein abnormalities, compression or physical trauma, exposure to toxic chemicals, poor nutrition, kidney failure, chronic alcoholism, and certain medications - especially those used to treat cancer. In some cases, however, even with extensive evaluation, the cause of a person's peripheral neuropathy remains unknown - this is called idiopathic neuropathy. Approximately 30% of neuropathies are “idiopathic,” or of an unknown cause. Through better research the number of those diagnosed as “idiopathic” must be reduced! Back to top

4) What are the symptoms of Peripheral Neuropathy?

While every person’s experience with peripheral neuropathy can be as unique as the individual, there are some common neuropathy symptoms and signs.

At first, you may notice numbness, tingling, abnormal sensations, or pain in your feet. Some people feel like they have socks on, even though they are barefoot. Over time, this feeling spreads to your legs and hands.

You may find it harder and harder to walk. Your legs feel heavy. You have to drag yourself up the stairs. You find yourself losing your balance, not being exactly sure where your feet are; so, you stumble into things or fall. To keep your balance, you are likely to widen your way of walking, and walking becomes less rhythmic or fluid.

As for your hands, you think you have a good grip on something, like your keys, but they drop right out of your hands. In the worst cases, you can end up in a wheelchair. Some neuropathies can be fatal.

Peripheral neuropathy symptoms and signs can vary in how they begin. Some neuropathies come on suddenly; others gradually over many years. There are three types of peripheral nerves affected, and symptoms depend on these nerves and their location:

   * Sensory Nerves: affect sensation

   * Autonomic Nerves: affect internal organ functions; and,

   * Motor Nerves: affect muscles.

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5) How is Peripheral Neuropathy diagnosed?

Diagnosing peripheral neuropathy is often difficult because the symptoms are highly variable. A thorough neurological examination is required and involves taking an extensive patient history (including the patient’s symptoms, work environment, social habits, exposure to any toxins, history of alcoholism, infectious diseases and family history of neurological diseases.

A general physical examination and related tests may reveal the presence of a systemic disease causing nerve damage. Blood tests can detect diabetes, vitamin deficiencies, liver or kidney dysfunction, other metabolic disorders, and signs of abnormal immune system activity. An examination of cerebrospinal fluid that surrounds the brain and spinal cord can reveal abnormal antibodies associated with neuropathy. More specialized tests may reveal other blood or cardiovascular diseases, connective tissue disorders, or malignancies. Tests of muscle strength, as well as evidence of cramps or facsiculations, indicate motor fiber involvement. Evaluation of a patient’s ability to register vibration, light touch, body position, temperature, and pain reveals sensory nerve damage and may indicate whether small or large sensory nerve fibers are affected.

Based on the results of the neurological exam, physical exam, patient history, and any previous screening or testing, additional testing may be ordered to help determine the nature and extent of the neuropathy. Back to top

6) Can Peripheral Neuropathy be cured?

Some types of peripheral neuropathy can be cured, yet most cannot. However, many patients can be helped. Therapy is directed at treating the underlying disease and at improving the symptoms with the right medications. An experienced neuromuscular neurologist can help patients feel more comfortable, and their quality of life can be greatly improved. But it is extremely important to get to an experienced neurologist as soon as you notice the symptoms before the disease has a chance to cause severe permanent damage. The fact is, we desperately need more research! Back to top

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