Peripheral Neuropathy

Signs and Symptoms

Peripheral neuropathy results from damage to the peripheral nerves. This damage is caused by other illnesses, such as:

• Alcoholism
• Amyloidosis
• Autoimmune disorders, such as Guillain-Barre syndrome
• Bell's palsy
• Cancer
• Carpal tunnel syndrome
• Chronic kidney failure
• Connective tissue disease, such as rheumatoid arthritis, lupus and sarcoidosis
• Diabetes mellitus -- nearly 60 percent of all people with diabetes suffer from peripheral neuropathy
• Infectious disease, such as Lyme disease, HIV/AIDS and hepatitis B
• Liver failure
• Radiculopathy
• Vitamin deficiencies

Although there are numerous causes of peripheral neuropathies, they do share some common symptoms including:

• Weakness, numbness and pain in the hands, legs and/or feet
• Paresthesia -- a condition that causes abnormal sensations such as burning, tickling, pricking or tingling

Diagnosis

A crucial part of diagnosing neuropathy is to identify the cause of the underlying condition. Both physical and neurological exams will be performed. A number of tests may be used to determine the underlying cause of neuropathy and rule out other conditions. Along with blood and urine tests, the following also may be performed:

• Electroencephalography (EEG) -- This test records electrical activity inside the brain.

• Spinal Tap -- During this test, also called a lumbar puncture, a special needle is placed into the lower back in the spinal canal, the area around the spinal cord. A small amount of cerebral spinal fluid (CSF) is removed for testing. CSF is the fluid that bathes the brain and spinal cord.

• Computerized Tomography (CT) -- A CT scan is a series of detailed pictures of the brain, created by a computer linked to an X-ray machine.

• Magnetic Resonance Imaging (MRI) -- This scan provides pictures of the brain, using a powerful magnet linked to a computer.

• Nerve Conduction Velocity (NCV) Studies -- These studies record the speed at which impulses travel through nerves and measure electrical responses.

• Electromyography (EMG) -- This test records the electrical activity in muscle tissue and is used to distinguish neuropathy from other neurological conditions.

In addition, your doctor may suggest a nerve or muscle biopsy to confirm the diagnosis. Biopsy involves removing tissue for microscopic evaluation and chemical analysis.

Treatment

Therapy for peripheral neuropathy focuses on treating the underlying cause. For example, if the condition is caused by diabetes, therapy will aim to control diabetes. If a tumor or ruptured disc is the cause, treatment may involve surgery to remove the tumor or repair the ruptured disc. In other cases, treatment may focus on managing pain.

Fortunately, peripheral nerves have a remarkable ability to regenerate themselves. New treatments that are currently being developed and studied use nerve growth factors or gene therapy to treat peripheral neuropathy. This work may offer improved chances for recovery in the future.