Peripheral Neuropathy
Peripheral neuropathy refers to any condition that affects the nerves outside your brain or spinal cord. This can happen for several reasons, from trauma to infections to inherited conditions.
Causes of Peripheral Neuropathy
Injury
Physical trauma is a common cause of injury to the nerves. This can include car accidents, falls, or fractures. Inactivity, or holding still too long in one position, can also cause neuropathy.
Increased pressure on the median nerve, a nerve in the wrist that supplies feeling and movement to the hand, causes carpal tunnel syndrome. This is a common typeTrusted Source of peripheral neuropathy.
Alcohol can have a toxic effect on nerve tissue, putting people with severe alcohol use disorder at a higher risk of peripheral neuropathy.
Exposure to toxic chemicals like glue, solvents, or insecticides, either through chemical abuse or in the workplace, can also cause nerve damage. Additionally, exposure to heavy metals such as lead and mercury can also cause this condition.
Infections and autoimmune disorders
Certain viruses and bacteria directly attack nerve tissue.
Viruses such as herpes simplex, varicella-zoster virus (which causes chickenpox and shingles), and Epstein-Barr virus damage sensory nerves and cause intense episodes of shooting pain.
Bacterial infections such as Lyme disease can also cause nerve damage and pain if they aren’t treated. People with HIV or AIDS can also develop peripheral neuropathy.
Autoimmune diseases like rheumatoid arthritis and lupus affect the peripheral nervous system in various ways. Chronic inflammation and damage to tissues throughout the body, as well as pressure caused by inflammation, can all lead to severe nerve pain in the extremities.
Some forms of neuropathy involve damage to only one nerve (mononeuropathy). Neuropathy affecting two or more nerves in different areas is called multiple mononeuropathy or mononeuropathy multiplex. More often, many or most of the nerves are affected (polyneuropathy).
Certain medications may also cause nerve damage. These include:
- Anticonvulsants, which people take to treat seizures
- Drugs to fight bacterial infections
- Some blood pressure medications
- Medications used to treat cancer
- Peripheral Neuropathy Symptoms
The symptoms of peripheral neuropathy vary based on the type that you have and what part of the body is affected.
- Muscle weakness
- Cramps
- Muscle twitching
- Loss of muscle and bone
- Changes in skin, hair, or nails
- Numbness
- Loss of sensation or feeling in body parts
Loss of balance or other functions as a side effect of the loss of feeling in the legs, arms, or other body parts.
The most common types of tests for peripheral neuropathy (either to confirm the diagnosis or rule out other conditions) include:
Blood tests (these can detect many problems, ranging from immune system problems to toxins and poisons, especially metals like mercury or lead).
- Electromyogram.
- Nerve ultrasound.
- Nerve biopsy
Magnetic resonance imaging (MRI).
Peripheral Neuropathy Treatment
Usually, peripheral neuropathy can’t be cured, but you can do a lot of things to prevent it from getting worse. If an underlying condition like diabetes is at fault, your healthcare provider will treat that first and then treat the pain and other symptoms of neuropathy.
In some cases, over-the-counter pain relievers can help. Other times, prescription medicines are needed. Another class of medications that quiets nerve cell electrical signaling is also used for epilepsy. Common drugs include gabapentin, pregabalin, and less often topiramate and lamotrigine. Carbamazepine and oxcarbazepine are particularly effective for trigeminal neuralgia, a focal neuropathy of the face, and some classes of antidepressants, including tricyclics such as amitriptyline.
Lidocaine injections and patches may help with pain in other instances. And in extreme cases, surgery can be used to destroy nerves or repair injuries that are causing neuropathic pain and symptoms.
Diabetes and some other diseases are common preventable causes of neuropathy. People with neuropathy should ask their doctors to minimize the use of medications that are known to cause or worsen neuropathy where alternatives exist. Some families with very severe genetic neuropathies use in vitro fertilization (IVF) to prevent transmission to future generations.
By Dr. Gautam Arora MBBS MD DM Neurologist and Pain Specialist
Contact Dr. Gautam Arora
Neurology and Pain Management Clinic
Address – A 90 Kamla Nagar Delhi North 110007
Contact Number – 8595168656
