The symptoms depend on the type of nerve fibers affected and the type and severity of damage. Symptoms may develop over days, weeks, or years. In some cases, the symptoms improve on their own and may not require advance d care. Unlike nerve cells in the central nervous system, peripheral nerve cells continue to grow throughout life. Some forms of neuropathy involve damage to only one nerve called 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 called polyneuropathy. Neuropathy is often misdiagnosed due to its complex array of symptoms. More than types of peripheral neuropathy have been identified, each with its own symptoms and prognosis.
Symptoms vary depending on the type of nerves—motor, sensory, or autonomic—that are damaged. Most neuropathies affect all three types of nerve fibers to varying degrees; others primarily affect one or two types. Doctors use terms such as predominantly motor neuropathy, predominantly sensory neuropathy, sensory-motor neuropathy, or autonomic neuropathy to describe different conditions.
In severe cases, such neuropathies can spread upwards toward the central parts of the body. In non-length dependent polyneuropathies, the symptoms can start more toward the torso, or are patchy. Motor nerve damage is most commonly associated with muscle weakness. Other symptoms include painful cramps, fasciculations uncontrolled muscle twitching visible under the skin and muscle shrinking.
Sensory nerve damage causes various symptoms because sensory nerves have a broad range of functions. Autonomic nerve damage affects the axons in small-fiber neuropathies.
Common symptoms include excess sweating, heat intolerance, inability to expand and contract the small blood vessels that regulate blood pressure, and gastrointestinal symptoms. Although rare, some people develop problems eating or swallowing if the nerves that control the esophagus are affected. There are several types of peripheral neuropathies, the most common of which is linked to diabetes. Common types of focal located to just one part of the body mononeuropathy include carpal tunnel syndrome, which affects the hand and the wrist, and meralgia paresthetica, which causes numbness and tingling on one thigh.
Complex regional pain syndrome is a class of lingering neuropathies where small-fibers are mostly damaged. Acquired neuropathies are either symptomatic the result of another disorder or condition; see below or idiopathic meaning it has no known cause. Genetically-caused polyneuropathies are rare. Genetic mutations can either be inherited or arise de novo , meaning they are completely new mutations to an individual and are not present in either parent.
Some genetic mutations lead to mild neuropathies with symptoms that begin in early adulthood and result in little, if any, significant impairment. More severe hereditary neuropathies often appear in infancy or childhood. Charcot-Marie-Tooth disease, also known as hereditary motor and sensory neuropathy, is one of the most common inherited neurological disorders. The small-fiber neuropathies that present with pain, itch, and autonomic symptoms also can be genetic. As our understanding of genetic disorders increases, many new genes are being associated with peripheral neuropathy.
The bewildering array and variability of symptoms that neuropathies can cause often makes diagnosis difficult. A diagnosis of neuropathy typically includes:. Muscle and nerve ultrasound is a noninvasive experimental technique for imaging nerves and muscles for injury such as a severed nerve or a compressed nerve.
Ultrasound imaging of the muscles can detect abnormalities that may be related to a muscle or nerve disorder. Certain inherited muscle disorders have characteristic patterns on muscle ultrasound.
Treatments depend entirely on the type of nerve damage, symptoms, and location. Your doctor will explain how nerve damage is causing specific symptoms and how to minimize and manage them. With proper education, some people may be able to reduce their medication dose or manage their neuropathy without medications. Definitive treatment can permit functional recovery over time, as long as the nerve cell itself has not died.
If you have other symptoms associated with peripheral neuropathy, these may need to be treated individually. For example, treatment for muscle weakness may involve physiotherapy and walking aids.
The outlook for peripheral neuropathy varies, depending on the underlying cause and which nerves have been damaged. Some cases may improve with time if the underlying cause is treated, whereas in some people the damage may be permanent or may get gradually worse with time.
If the underlying cause of peripheral neuropathy is not treated, you may be at risk of developing potentially serious complications, such as a foot ulcer that becomes infected. This can lead to gangrene if untreated, and in severe cases may mean the foot has to be amputated.
Peripheral neuropathy may affect the nerves controlling the automatic functions of the heart and circulation system cardiovascular autonomic neuropathy. You may need treatment to increase your blood pressure or, in rare cases, a pacemaker. Find out more about complications of peripheral neuropathy.
Polyneuropathy is the most common type and starts by affecting the longest nerves first, so symptoms typically begin in the feet.
Over time it gradually starts to affect shorter nerves, so feels as if it's spreading upwards, and later affects the hands. Page last reviewed: 24 April Next review due: 24 April The peripheral nervous system The peripheral nervous system is the network of nerves that lie outside the central nervous system the brain and spinal cord. It includes different types of nerves with their own specific functions, including: sensory nerves — responsible for transmitting sensations, such as pain and touch motor nerves — responsible for controlling muscles autonomic nerves — responsible for regulating automatic functions of the body, such as blood pressure and bladder function Symptoms of peripheral neuropathy The main symptoms of peripheral neuropathy can include: numbness and tingling in the feet or hands burning, stabbing or shooting pain in affected areas loss of balance and co-ordination muscle weakness, especially in the feet These symptoms are usually constant, but may come and go.
As a result, you may experience persistent pain for many years after the accident. Accidents or injuries that affect the spine can cause neuropathic pain, too. Herniated discs and spinal cord compression can damage the nerve fibers around your spine. Shingles , which is caused by reactivation of the chicken pox virus, can trigger several weeks of neuropathic pain along a nerve.
Postherpetic neuralgia is a rare complication of shingles, involving persistent neuropathic pain. A syphilis infection can also lead to the burning, stinging unexplained pain.
People with HIV may experience this unexplained pain. An uncommon form of neuropathic pain called phantom limb syndrome can occur when an arm or leg has been amputated. In addition to arms or legs, phantom pain may be felt in the fingers, toes, penis, ears, and other body parts.
An important goal is that your doctor will aim to provide pain relief, help you maintain typical capabilities despite the pain, and improve your quality of life. Plus, doctors may hesitate to prescribe them for fear that a person may become dependent. Topical pain relievers can be used, too. These include lidocaine patches, capsaicin patches, and prescription-strength ointments and creams. Antidepressant medications have shown great promise in treating symptoms of neuropathic pain. Anti-seizure medications and anticonvulsants are often used to treat neuropathic pain.
Gabapentinoids are most commonly prescribed for neuropathic pain. Your doctor may inject steroids, local anesthetics, or other pain medications into the nerves that are thought to be responsible for the wayward pain signals. These blocks are temporary, so they must be repeated in order to keep working. This invasive procedure requires a surgeon to implant a device in your body.
Some devices are used in the brain and some are used in the spine. Once a device is in place, it can send electrical impulses into the brain, spinal cord, or nerves. The impulses may stop the irregular nerve signals and control symptoms. Physical, relaxation, and massage therapies are all used to relieve symptoms of neuropathic pain.
These forms of treatment can help ease muscles. For example, some people with neuropathic pain may experience increased symptoms after sitting for several hours. This might make desk jobs difficult to perform. A physical therapist or occupational therapist can teach you techniques for sitting, stretching, standing, and moving to prevent pain. If your doctor is able to identify an underlying cause for the neuropathic pain, treating it may reduce and even eliminate the pain.
For example, diabetes is a common cause of neuropathic pain. Proper diabetes care — which includes a healthy diet and regular exercise — may eliminate or reduce neuropathic pain. A combination of medications, physical therapy, psychological treatment, and even surgery or implants may be used to bring about the best results.
0コメント