sensation followed by numbness and pain, commonly beginning
in the hands or feet and spreading toward the center of the
body. The facial muscles are also frequently affected. The
pain may be severe with diabetes mellitus or alcoholism.
bladder or bowel control.
symptoms: difficulty in breathing, paralysis.
When To Call Your Doctor
an ambulance if you or someone in your presence experiences breathing
difficulty, widespread muscle tingling or numbness, or paralysis.
doctor if you develop symptoms of peripheral neuropathy.
doctor if, after being diagnosed with peripheral neuropathy,
you develop sores or open wounds on the hands and feet.
What Is It?
Peripheral neuropathies are a group of disorders
characterized by the degeneration of the nerves involved in the
communication between the central nervous system (the brain and
spinal cord) and the rest of the body. Peripheral nerves transmit
sensory signals back to the central nervous system, and signals
from the brain to the muscles. Neuropathies are caused by a wide
variety of underlying disorders, and nerve function may be lost
in a number of ways: the nerve fibers themselves (axons) may
degenerate; the myelin sheaths that cover and protect the nerves
may erode; and in some cases there is a loss of blood supply
to a nerve.
The mononeuropathies are conditions (such as Bell's
palsy or carpal tunnel syndrome) that affect a single nerve;
polyneuropathies affect multiple nerves that may be distributed
throughout the body. Symptoms vary according to which nerves
are affected. Most often, symptoms develop gradually over months
or years; however, in Guillain-Barré syndrome, an uncommon
form of polyneuropathy, severe symptoms appear within days. (Recovery
from Guillain-Barré may also be relatively rapid in many
Peripheral neuropathies are most common in men
between the ages of 30 and 50. Symptoms may arise from degeneration
of the sensory neurons, the motor neurons, or both. Fortunately,
because these disorders often leave the cell bodies of the nerves
intact, the nerves can regenerate; thus, chances for recovery
may be good. However, prognosis and specific treatment depend
on the underlying disorder.
What Causes It?
including alcoholism, diabetes mellitus, rheumatoid arthritis,
systemic lupus erythematosus, amyloidosis, and uremia, may cause
especially a vitamin deficiency, may lead to peripheral neuropathy.
A viral infection,
rabies and flu vaccines, or surgery may sometimes be associated
A number of
medications, especially isoniazid, pyridoxine, and vincristine,
toxic chemicals, including lead, mercury, arsenic, and the chemicals
pesticides and herbicides, may lead to peripheral neuropathy.
may be caused by injuries or by repeated jarring, such as that
by operating a jackhammer.
cold temperatures can produce nerve damage.
such as multiple myeloma, lung cancer, and leukemia, may cause
of peripheral neuropathy are hereditary.
The cause is
unknown in some cases.
more than two alcoholic drinks a day. If you suspect that you
may have a drinking problem, seek help from a doctor or support
Eat a healthy,
Try to reduce
or eliminate exposure to toxic chemicals at home and in the
and physical examination are needed.
may be performed. In this procedure, needle electrodes are inserted
into various muscles to measure electrical activity associated with nerve function.
A variety of
tests may be given to evaluate reflexes and nerve performance.
nerve or muscle tissue.
How To Treat It
of diabetes through medication, diet, and exercise may allow
diabetic neuropathy to subside either partially or completely,
depending upon the extent of the nerve damage.
diabetes should practice good foot care and check their feet
every day. Peripheral neuropathy reduces sensation in affected
areas, so minor foot problems may go unnoticed and develop into
neuropathy requires complete abstinence from alcohol.
supplements may be recommended.
toxic chemicals should be eliminated or reduced as much as possible.
(a procedure that involves partial removal of blood plasma while
the blood cells are returned to circulation) may be performed
to speed recovery from Guillain-Barré syndrome by filtering
out irritating or dangerous antibodies from the bloodstream.
is recommended for treatment of Guillain-Barré syndrome
because the condition may worsen unpredictably and become life-threatening
before recovery begins. Breathing and swallowing difficulties
are treated with supplemental oxygen and intravenous feeding.
pain relievers may be taken to reduce pain.
drugs amitriptyline or desipramine or the anticonvulsant drug
gabapentin can be effective for relieving symptoms of some peripheral
is advised to help regain muscle function. Canes, walkers, or
wheelchairs may be temporarily useful, and rails near stairs
and in the bathroom are recommended to prevent falls.
Hopkins Symptoms and Remedies, the complete home medical
reference. You can order
this book now on our secure server.