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What Is Peripheral Neuropathy?

Peripheral neuropathy is a term that describes damage to the peripheral nerves, the vast communications network that transmits information from the brain and spinal cord to every other part of the body. It may be caused by diseases of the nerves themselves or as the result of several systemic illnesses. Many neuropathies have well-defined causes such as diabetes, uremia, AIDs, or certain vitamin deficiencies. In fact, diabetes is one of the most common causes of peripheral neuropathy. Other causes include mechanical pressure (such as nerve compression or entrapment); direct injury to the nerve (including contusions, fractures or dislocated bones); pressure involving the superficial nerves (ulna, radial, or peroneal), which can result from tumors or even from prolonged use of crutches or staying in one position for too long; intraneural hemorrhage; exposure to cold or radiation; or, rarely, certain medicines or toxic substances (such as alcohol).  In addition, vascular or collagen disorders such as atherosclerosis, systemic lupus erythematosus, scleroderma, sarcoidosis, rheumatoid arthritis, and polyarteritis nodosa may also cause peripheral neuropathies. A common example of entrapment neuropathy is carpal tunnel syndrome, which has become more common because of the increasing use of computers. Although the causes of peripheral neuropathy are diverse, they produce common symptoms including weakness, numbness, paresthesia (abnormal sensations such as burning, tickling, pricking or tingling) and pain in the arms, hands, legs and/or feet. A large number of cases have unknown causes.

Therapy for peripheral neuropathy differs depending on its cause. For example, therapy for peripheral neuropathy caused by diabetes involves controlling the diabetes. In cases where a tumor or ruptured disc is the cause, therapy may involve surgery to remove the tumor or to repair the ruptured disc. In entrapment or compression, neuropathy treatment may include splinting or surgically decompressing the affected nerves. Peroneal and radial compression neuropathies may require avoiding pressure. Physical therapy and/or splints may help prevent contractures (a condition in which shortened muscles around joints cause abnormal and sometimes painful positioning of the joints).  Managing idiopathic neuropathies (those whose causes are unknown) may be more challenging and may involve combinations of several treatment modalities and several rounds of trial and error. 

Recovery from peripheral neuropathy is usually slow. Depending on the type of peripheral neuropathy, the patient may fully recover without residual effects or may partially recover, with varying degrees of sensory, motor, and vasomotor (blood vessel) deficits. If severely affected, the patient may develop chronic muscular atrophy.

Created: 9/10/2004  -  Donnica Moore, M.D.

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