Peripheral Neuropathy

Patients often seek care when symptoms such as weakness, numbness, and pain in the hands and feet begins to interfere with daily activities. Neuropathies can affect a single nerve or several and can be acute or chronic.  

Since peripheral neuropathy is not a single disease, diagnosis begins with determine the causes of the nerve damage. After a discussion about your symptoms and medical history, your neurologist may order evaluations such as: 

• Physical, neurological and sensory exams 
• Blood, nerve function and conduction tests  
• Electromyography (EMG) 
• Imaging  
• Nerve biopsy 
• Spinal tap

Symptoms of peripheral neuropathy include:

• Extreme sensitivity to touch 
• Reduced coordination and balance 
• Muscle weakness 
• Low tolerance to heat 
• Changes in sweat patterns  
• Digestive, bowel and bladder problems 
• Dizziness  
• Paralysis 

Alcoholism, autoimmune diseases, tumors, vitamin deficiencies, bone marrow disorders, kidney and liver diseases, and certain medications may also influence peripheral neuropathy. 

Peripheral neuropathy can be caused by several factors, including: 

• Autoimmune conditions 
• Bone marrow, kidney or liver diseases 
• Diabetes 
• Certain medications  
• Exposure to toxins, including alcohol and other substances 
• Genetics 
• Infection 
• Metabolic problems 
• Tumors 
• Traumatic injury 
• Vitamin deficiencies

Two conditions are strongly associated with peripheral neuropathy: 

• Guillain-Barré Syndrome: This relatively rare disorder causes the body's immune system to attack the nerves. Weakness and tingling in the extremities are the first symptoms, and it can rapidly spread and paralyze your entire body—which is a medical emergency. This condition often follows a respiratory infection or the flu. While there is no cure, treatment can help manage symptoms. 
• Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP): This autoimmune and neurological disorder causes progressive weakness and lack of feeling in the arms and legs. The condition is caused by damage to the myelin sheath of the peripheral nerves, the fatty covering that protects the nerve fibers. Symptoms include tingling or numbness that begin in the toes and fingers, weakness in the arms and legs, loss of deep tendon reflexes and fatigue.  

More than 100 types of peripheral neuropathy have been identified, each with a unique set of symptoms, development patterns and prognoses. Based on your exams, we will determine which type of neuropathy you have and develop a treatment plan to improve your quality of life. 

Your neurologists will design a treatment plan to manage your symptoms and improve daily function. Treatment options may include: 

• Blood sugar management 
• Diet, lifestyle and behavioral modifications 
• Physical therapy 
• Medications 
• Transcutaneous electrical nerve stimulation (TENS) 
• Plasma exchange 
• Intravenous immunoglobulin 
• Plasmapharesis 
• Rehabilitation 
• Surgery