Peripheral Neuropathy
Peripheral Neuropathy is a disorder of nerve endings, which begins at the tips of the feet and hands and progresses up the limbs. Typical symptoms are a numb or prickly feeling and it may be painful. When it is more severe, it may lead to balance difficulties, weakness, loss of muscle mass, cramping, spasms, heat and cold intolerance as well as erectile dysfunction, dry eyes and mouth, sweating abnormalities.
The Neuropathy Association estimates in the US, 5-10% of the population (about 30 million people) has a neuropathy. There are many causes. Most commonly neuropathy is inherited or can be caused by immune system mediated disorders (such as lupus), infections (such as HIV), metabolic disorders (like diabetes), cancer, blood disorders, toxin exposure (including chemotherapy for cancer) or of no identifiable cause.
The diagnostic studies for this disorder are commonly an electromylogram with nerve conduction study to confirm the diagnosis, and blood work and glucose tolerance test to evaluate for some of the more common causes. Rarely, imaging studies such as an MRI or CAI scan may be indicated if there is suspicion for specific causes. Occasionally nerve or muscle biopsies, spinal taps, tilt table tests and other tests may be indicated.
Treatment is aimed first at treating any cause if known. For example: if diabetes if found to be the cause, proper management of the diabetes would prevent or decrease the progression of the peripheral neuropathy. Second, treatment is to alleviate pain associated with the neuropathy when it is present. Third, physical therapy and occupational therapy are frequently used, (gait training for balance) may be used to prevent injun from falls. Also, orthoses, like ankle braces, can be utilized if there is muscle weakness. Ambulation aids like canes, walkers, and wheelchairs may be needed in advanced cases.
Peripheral neuropathy is frequently progressive, or it may be stable and not change much after its onset. Recently the development of Anodyne therapy (infra-red light therapy! has been shown to induce healing of the nerves involved to a variable degree. This is exciting, as some patients' improvement may eliminate the need for a cane or walker. This treatment is covered by most insurances and is available as a home care unit if it is shown to be effective for a patient. Speak with your health care professional for information on what treatments would be appropriate for you.
For more information about peripheral neuropathy, you may want to visit the websites below;
www.neuropathy.org
www.neuropathy-trust.org
www.nlm.nih.gov/medlineplus/ency/article/000593.htm
