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Peripheral Neuropathy

Definition

Peripheral neuropathy is damage to the peripheral nerves. These are the nerves that connect your spinal cord to the rest of your body.
Peripheral Nerves of the Foot
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Causes

Many health conditions can cause peripheral neuropathy. The damage may occur due to:
Health conditions that can damage peripheral nerves include:

Risk Factors

Having certain health conditions may increase your chance of getting peripheral neuropathy.

Symptoms

Damage to the peripheral nerves often results in sensory and motor symptoms in the:
Other parts of the body can also be affected. Symptoms depend on which nerves are involved. They can range from mild to severe and may seem worse at night. Sensations and pain may occur in the upper or lower limbs and move toward the trunk, such as from the feet to the calves.
Peripheral neuropathy may cause:
If untreated, peripheral neuropathy can lead to:
If you have motor or sensory neuropathy, you may also have autonomic neuropathy. This is associated with symptoms such as:

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. It may include examining:
Additional tests may also include:

Treatment

Talk with your doctor about the best treatment plan for you. Options may include:

Treatment for the Underlying Illness or Exposure

Treating the underlying illness can decrease symptoms or make them go away. For instance, if it is caused by diabetes, controlling blood sugar levels may help. In some cases, neuropathy caused by medications or toxins is completely reversed when these substances are stopped or avoided. Correction of vitamin B12 deficiency often improves symptoms.

Physical Therapy

Certain exercises may help stretch shortened or contracted muscles and increase joint flexibility. In long-standing cases, splinting the joint may be required to protect and rest it, while maintaining proper alignment.
Orthotics, such as supports and braces, may help with:
  • Deformities
  • Balance issues
  • Muscle weakness
Maintaining physical activity is also important.

Medications

Prescription and over-the-counter pain medications are often used to ease discomfort.
Medications used to treat depression and prevent convulsions can relieve neuropathy symptoms.
For severe and potentially life-threatening cases, such as Guillain-Barre syndrome , treatment includes:

Other Therapies

These therapies are aimed at reducing symptoms:

Surgery

Surgery can relieve the pressure on nerves. For example, surgeons commonly release fibrous bands in the wrist to treat carpal tunnel syndrome .

Prevention

To help reduce your chance of peripheral neuropathy:

RESOURCES

American Chronic Pain Association http://www.theacpa.org

The Neuropathy Association http://www.neuropathy.org

CANADIAN RESOURCES

Canadian Diabetes Association http://www.diabetes.ca

Health Canada http://www.hc-sc.gc.ca

References

Baron R, Binder A, et al. Neuropathic pain: diagnosis, pathophysiological mechanisms, and treatment. Lancet Neurol. 2010;9(8):807-819.

Diabetic neuropathies: The nerve damage of diabetes. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health website. Available at: http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/index.aspx. Updated November 26, 2013. Accessed May 30, 2014.

Karlsson P, et al. Epidermal nerve fiber length density estimation using global spatial sampling in healthy subjects and neuropathy patients. J Neuropathol Exp Neurol. 2013 Mar;72(3):186-93.

Peripheral neuropathy. EBSCO DynaMed website. Available at: Available at: http://www.ebscohost.com/dynamed. Updated April 15, 2014. Accessed May 30, 2014.

12/20/2007 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: 2007 safety alerts for drugs, biologics, medical devices, and dietary supplements: Carbamazepine (marketed as Carbatrol, Equetro, Tegretol and generics). Medwatch. US Food and Drug Administration website. Available at: http://www.fda.gov/medwatch/safety/2007/safety07.htm#carbamazepine.

10/5/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Feng Y, Schlösser FJ, Sumpio BE. The Semmes Weinstein monofilament examination as a screening tool for diabetic peripheral neuropathy. J Vasc Surg. 2009;50:675-682,682.

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