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Peripheral neuropathy is a condition that causes nerve damage, resulting in numbness or pain. It can affect a single nerve, a connected group of related nerves, or multiple nerves throughout the body. The symptoms depend on the type of nerve fibres affected and the severity of the damage. Neuropathy can cause acute symptoms such as a stabbing pain or burning sensation, and chronic symptoms such as muscle weakness. The condition is commonly associated with diabetes and can lead to problems with walking, grasping objects, and general muscle weakness. Treatment options include medication, acupuncture, electrical nerve stimulation, injections, and surgery.
| Characteristics | Values |
|---|---|
| Type of neuropathy | Peripheral neuropathy, Proximal neuropathy, Motor neuropathy, Focal nerve, Mononeuritis multiplex, Multifocal motor neuropathy, Sensory neuropathy, Polyneuropathy |
| Symptoms | Muscle weakness, Muscle pain, Muscle twitch or cramp, Muscle loss, Muscle movement problems, Stabbing pain, Tingling, Numbness, Burning sensation, Lack of sensation, Loss of mobility, Dizziness, Loss of bladder control, Bowel changes, Swelling in hands and feet, Blurred vision, Sexual problems, Digestive problems, Irregular heart rate, Trouble swallowing, Trouble breathing |
| Causes | Genetic conditions, Underlying medical conditions, Autoimmune disorder, Diabetes, Alcohol, Medication, Infection, Pressure from blood vessel, Tumor, Ligament, Bone, Injury, Chronic kidney disease, Multiple sclerosis, Vitamin deficiency, Inflammation, Vascular issues |
| Treatment | Intravenous immunoglobulin (IVIg), Immunosuppressive therapy, Antiseizure drugs, Antidepressant drugs, Acupuncture, Transcutaneous electrical nerve stimulation, Surgery, Therapy, Supplements, Injections, Genetic counselling, Spinal cord stimulator |
| Diagnosis | Needle exam, Nerve biopsy, Neurodiagnostic skin biopsy, Physical exam, Neurological exam, Medical history |
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Peripheral neuropathy
There are more than 100 types of peripheral neuropathy, and symptoms vary depending on the type of nerves (motor, sensory, or autonomic) that are damaged. Motor nerves control the movement of muscles that we consciously control, such as those used for walking, grasping things, or talking. Sensory nerves transmit information such as the feeling of a light touch, temperature, or pain from a cut. Autonomic nerves control muscle and organ function that we don't consciously think about, such as breathing, digesting food, heartbeat, and the function of glands. Most neuropathies affect all three types of nerve fibres to varying degrees, while others mostly affect one or two types.
The symptoms of peripheral neuropathy include numbness or tingling in the hands and feet, muscle weakness that starts in the feet and moves up the body, trouble breathing or swallowing, and unusual heart rate and blood pressure shifts. Other symptoms include uncontrolled muscle movements, muscle atrophy, and deformities of the feet and hands due to muscle loss. Peripheral neuropathy can also cause soft tissue and bone changes, leading to sores and infections, especially in people with type 2 diabetes.
The treatment for peripheral neuropathy depends on the underlying cause and the severity of the symptoms. In some cases, symptoms may improve on their own without specific care or treatment. For mild symptoms, treatment may not be required at all. In other cases, treatment options include intravenous immunoglobulin (IVIg) or immunosuppressive therapy with cyclophosphamide. If pain from peripheral neuropathy does not improve with standard medications, pain specialists may offer other treatments such as acupuncture, transcutaneous electrical nerve stimulation, injections, or surgery to implant a spinal cord stimulator.
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Motor neuropathy
Peripheral neuropathy is a condition where the immune system attacks the nerves. This can cause life-threatening complications and symptoms such as numbness or tingling in the hands and feet, muscle weakness, trouble breathing or swallowing, and unusual heart rate and blood pressure. One type of peripheral neuropathy is multifocal motor neuropathy (MMN), a rare disorder where focal areas of multiple motor nerves are attacked by the person's own immune system. MMN is slowly progressive, resulting in asymmetrical weakness in the patient's limbs, particularly the upper limbs. Patients often experience weakness in their hands, causing them to drop objects or have difficulty turning keys in locks. The muscle weakness in MMN typically follows the distribution of motor nerves and does not affect the myotomes.
MMN is a chronic condition that is not curable but can be treated. It is caused by a problem in the person's immune response and is more common in men than in women, usually affecting people between the ages of 40 and 50. The treatment for MMN is intravenous immunoglobulin (IVIg), which can improve motor function in most patients. Early treatment is crucial for better effectiveness, and patients usually require repeated treatments to maintain their improvement. While MMN can cause significant challenges in performing daily tasks, early diagnosis, treatment, and a healthy lifestyle can help individuals stay active and independent.
MMN shares some similarities with motor neuron disease (MND) in terms of symptoms, but they differ in the nerves they affect. MMN affects individual nerves, while MND impacts groups of spinal nerves. Additionally, MMN does not present upper motor neuron (UMN) signs typically associated with MND, such as brisk reflexes in the knees or ankles or spasticity in the limbs.
MMN can be differentiated from other conditions, such as amyotrophic lateral sclerosis (ALS), CIDP, and hereditary neuropathy with liability to pressure palsies (HNPP). While both MMN and ALS cause progressive pure motor weakness, MMN typically progresses more slowly than ALS. MMN is also distinguished from ALS by the absence of upper motor neuron findings and the sparing of respiratory and cranial muscles. Electrodiagnostic studies further help differentiate MMN from other conditions, revealing a demyelinating pattern with conduction blocks.
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Proximal neuropathy
The distinction between proximal neuropathy and peripheral neuropathy is important to note. Peripheral neuropathy commonly affects the feet, causing soft tissue and bone changes, as well as numbness or tingling sensations. It can be caused by injuries, toxic exposure, or inflammation, and it may develop rapidly or over an extended period. Peripheral neuropathy can be treated with standard medications, and in some cases, pain specialists may offer alternative treatments such as acupuncture, electrical nerve stimulation, injections, or surgery.
While proximal neuropathy specifically affects the hip, buttock, or thigh areas, it is a form of peripheral neuropathy. Peripheral neuropathy is an umbrella term for various nerve disorders that affect the peripheral nervous system, which carries signals from the brain to the muscles, enabling movement. Peripheral neuropathy can be caused by autoimmune disorders, metabolic issues, or infectious diseases, and it can result in muscle weakness, changes in reflexes, and difficulty with walking and balance.
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Neuralgia
There are several types of neuralgia, each with its own characteristics. Trigeminal neuralgia is the most common type, causing sudden jolts of shooting pain primarily on one side of the face. Even simple everyday activities like toothbrushing can trigger severe pain. This type of neuralgia is often linked to causes such as multiple sclerosis, nerve compression, or a severe dental condition. Occipital neuralgia involves irritation of the nerve at the back of the skull, resulting in a dull, throbbing pain, usually in the back of the head. Tense muscles, ligaments, or infections may be contributing factors.
Postherpetic neuralgia is associated with the reactivation of the varicella-zoster virus (chickenpox and shingles). It occurs as a complication of shingles and may affect any part of the body. Shingles is a viral infection characterised by blisters and a painful red rash, which usually appears on the back or abdomen but may also show up on the neck or face. Neuralgia can occur wherever the outbreak of shingles occurred. The pain can be mild or severe, intermittent or persistent, and may last for months or years.
Peripheral neuralgia (peripheral neuropathy) results from nerve damage in the peripheral nervous system, affecting areas like the hands, feet, arms, and legs. It can lead to pain, numbness, muscle twitching, coordination difficulties, and other symptoms. Intercostal neuralgia is caused by factors such as chest injuries, nerve pressure, or viral infections that affect the nerves beneath the ribs, causing sharp, burning chest and upper abdominal pain. Movements like breathing, coughing, or laughing may worsen the pain.
There are no specific tests for neuralgia, but there are several procedures that may be used to treat the pain, depending on its cause, location, and severity. Treatment options include medications such as antidepressants, anti-seizure drugs, and over-the-counter or prescription pain medications. Other procedures to reduce feeling in the nerve include nerve ablation using radiofrequency, heat, balloon compression, or injection of chemicals. In rare cases, a procedure called motor cortex stimulation (MCS) is tried, where an electrode is placed over part of a nerve, spinal cord, or brain and is hooked to a pulse generator under the skin. This changes how nerves signal and may reduce pain.
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Muscle weakness
Peripheral neuropathy is a term for any condition that affects the nerves outside of the brain and spinal cord, causing nerve damage. This damage can cause a range of symptoms, including muscle weakness.
When nerves deteriorate due to peripheral neuropathy, the connected muscles weaken. This can lead to paralysis and difficulty moving certain body parts, such as the toes, feet, and hands. Muscle atrophy may also occur, causing muscles to shrink in size and leading to deformities in the feet and hands. The loss of nerve connections to the brain can result in uncontrolled muscle movements and cramps.
The peripheral nervous system carries motor signals, which are commands sent from the brain to the muscles, enabling movement. When peripheral neuropathy affects these motor functions, it can cause muscle weakness and impair coordination, increasing the risk of falling and subsequent complications such as broken bones or pneumonia during recovery.
In addition to physical symptoms, muscle weakness due to peripheral neuropathy can impact an individual's ability to perform daily tasks. For example, neuropathic pain in the feet, legs, back, and hands can make sitting at a desk or lying in bed challenging.
While peripheral neuropathy can lead to muscle weakness, it is important to note that the condition presents a spectrum of symptoms, ranging from mild to severe. Treatment options are available, and addressing the underlying cause can help improve muscle strength and reduce discomfort.
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Frequently asked questions
Neuropathy is a condition that causes nerve damage. It can result in numbness or pain and affect a single nerve or multiple nerves in different places throughout the body.
Yes, neuropathy can cause muscle pain. It can also lead to muscle weakness, decreased coordination, and muscle twitching or cramping.
Treatment options for neuropathy include medication, therapy, and in some cases, surgery. Lifestyle changes such as improving nutrition, stopping alcohol consumption, and managing blood sugar levels can also help improve symptoms.
