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Peripheral Neuropathy

Overview

Peripheral neuropathy is a common neurological disorder resulting from damage to the peripheral nerves. Peripheral nerves, located outside of the brain and spinal cord, provide the means of communication between the brain and other parts of the body, including muscles, skin, internal organs and blood vessels. Neuropathies affect at least 20 million people in the United States.

If one nerve is damaged, the condition is referred to as mononeuropathy. If many nerves are involved, it is called polyneuropathy.

Causes of Peripheral Neuropathy

Although there are some cases in which the cause is unknown, peripheral neuropathies have many well-defined causes, including:

  • 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

Our Approach to Peripheral Neuropathy

Our experts treat peripheral neuropathy by focusing on the underlying cause. We offer advanced diagnostic techniques as well as surgical and nonsurgical treatments. We also provide education, support and outreach programs for patients living with these disorders.

Awards & recognition

  • U S  News and World Report badge recognizing UCSF as part of its 2024-2025 Honor Roll

    Among the top hospitals in the nation

  • U S  News and World Report badge recognizing UCSF as number 3 in the country for neurology and neurosurgery for 2024 to 2025

    Best in the West and No. 3 in the nation for neurology & neurosurgery

Signs & symptoms

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.
  • Computed 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.

Treatments

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.

UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.

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