Peripheral Neuropathy | Causes, Symptoms, and Treatment
What is Peripheral Neuropathy?
Peripheral neuropathy is a general term for disorders of the nervous system that affect a particular part of your nervous system. Many different conditions can cause peripheral neuropathy, which means there is a wide range of possible symptoms.
Peripheral neuropathy can also affect different parts of the body, depending on how and why it occurs.
Your nervous system is made up of two parts, the central nervous system and the peripheral nervous system. The central nervous system consists of the brain and spinal cord, while the peripheral nervous system consists of all the other nerves in your body, including the nerves that travel from the spinal cord and brain to supply the face and the rest of the body.
The term peripheral neuropathy can refer to any condition that affects the peripheral nerves. Healthcare providers often use the terms “neuropathy” and “polyneuropathy” (which means “disease of many nerves”) interchangeably with “peripheral neuropathy”.
The peripheral nerves are farthest from the central nervous system, and the early and most severe effects of these conditions often appear.
Who is affected by peripheral neuropathy?
Peripheral neuropathy can affect anyone, regardless of age, sex, race, personal circumstances, or medical history. However, some people are more susceptible to certain types of peripheral neuropathy.
Peripheral neuropathy is also very common with some age-related diseases. This means that the risk of developing peripheral neuropathy increases with age.
How common is this condition?
Peripheral neuropathy is common in part because it is a term that refers to many conditions. Approximately 2.4% of people worldwide have some form of peripheral neuropathy.
Among people aged 45 or older, this percentage rises to between 5% and 7%.
How does this condition affect my body?
To understand how peripheral neuropathy affects your body, it helps to know a little about the structure of nerve cells, a major type of cell that makes up nerves.
Nerve cells send and transmit signals throughout your nervous system using electrical and chemical signals. Each nerve cell consists of the following parts:
- Cell body: This is the main part of the cell.
- Axon: This is a long, arm-like part that extends from the cell body. At the end of the axon, there are several finger-like extensions where the electrical signal in the nerve cell is converted into a chemical signal. These extensions are known as synapses and lead to neighboring nerve cells.
- Dendrites: These are small, branch-like extensions (their name comes from the Latin word for “tree”) on the cell body. Dendrites are the receiving point for chemical signals from the synapses of neighboring nerve cells.
- Myelin: This is a thin layer made up of fatty chemical compounds. Myelin surrounds the axon of many nerve cells and acts as a protective covering.
Peripheral neuropathy can develop in two primary ways:
- Demyelinating neuropathy: This occurs when the myelin sheath that covers the nerve axon deteriorates or doesn’t form properly, affecting how signals are transmitted along the nerve cell.
- Axonal degeneration: This causes the axon to deteriorate and the nerve cell to die. The longer the nerve cell, the more severe the impact. This is why axonal degeneration tends to affect the legs and feet, which are farthest from the spinal cord and rely on connections using longer axons. Axonal degeneration is the most common pattern seen in peripheral neuropathy.
Rate of Progression of Peripheral Neuropathy
How quickly peripheral neuropathy progresses, especially the timeline of its advancement, depends largely on its underlying cause. Injuries can cause it to occur immediately or within minutes or hours. Some forms of toxic and inflammatory peripheral neuropathy can develop rapidly over days or weeks, while most other cases take months, years, or even decades to progress.
Symptoms of Peripheral Neuropathy
There are many different symptoms of peripheral neuropathy. This condition can affect a single nerve, a related group of nerves, or many nerves in multiple locations throughout your body. Symptoms also depend on the type of nerve signals affected, and multiple types of signals may be involved.
Types of symptoms include:
- Motor: Affecting movement.
- Sensory and pain: Affecting sensation and causing pain.
- Autonomic: Affecting involuntary functions.
The peripheral nervous system carries motor signals, which are commands sent from the brain to the muscles. These signals make it possible for you to move. Muscles need nerve communications with the brain to remain healthy and function properly.
Motor symptoms include:
- Muscle weakness and paralysis: Nerve deterioration due to peripheral neuropathy leads to weakness in the connected muscles. This can cause paralysis, which may result in difficulty moving the toes, foot drop, or weakness in the hands. Weakness can also affect muscles in the thighs, arms, and other areas.
- Muscle atrophy: Loss of nerve communication can cause muscles to shrink in size as well as weaken. This is particularly noticeable in the feet, lower legs, and hands with peripheral neuropathy. Sometimes deformities in the feet and hands may occur due to muscle loss.
- Uncontrolled muscle movements: Sometimes nerves that lose connection with the brain due to peripheral neuropathy become overactive on their own, causing twitches.
- Sensory symptoms: Peripheral nerves transmit information about the external world into nerve signals. These signals are then sent to the brain, which processes them into what you perceive from the world around you. Peripheral neuropathy can disrupt what your senses pick up from the external world or the ability of those senses to communicate with your brain.
Sensory symptoms of peripheral neuropathy include:
- Tingling: This happens when there’s a problem with the nerves that carry signals to the brain. It’s similar to the static noise you hear on the radio when you’re far from a radio station.
- Numbness: This occurs when nerves can’t send or transmit sensory signals, leading to a loss of specific types of sensations. An example is holding a cold drink can but not feeling the smoothness or coldness of the can, or not being able to feel the texture of the carpet or the heat of the floor under your feet.
- Loss of balance and coordination: Nerves also carry sensations that your brain uses to track the position of your hands and feet. You’re not consciously aware of these sensations, but they’re vital for maintaining balance and coordination. Without these sensations, you may experience loss of balance, especially in the dark, and lack of coordination in your hands.
- Pain: Nerve damage from peripheral neuropathy can cause a disruption in how and when nerves send pain signals, making pain signals more intense (hyperalgesia) or occur more easily (allodynia). Nerves may even generate pain signals on their own, leading to persistent unexplained pain.
Autonomic Symptoms
Autonomic nerves, those that control life processes you don’t consciously regulate, also form part of the peripheral nervous system. Peripheral neuropathy can disrupt these processes, leading to:
- High or low blood pressure: This occurs because peripheral neuropathy can cause blood vessels to not respond properly. This can lead to low blood pressure, causing dizziness or lightheadedness, especially when standing up quickly. It can also cause high blood pressure or worsen existing high blood pressure.
- Abnormal heart rate or irregular heart rhythm: Peripheral neuropathy can cause the heart to beat too fast or too slow. It can also cause heart rhythm disturbances (arrhythmias), causing symptoms like palpitations or fainting.
- Changes in sweating: Peripheral neuropathy can cause excessive sweating (hyperhidrosis) or decreased sweating (hypohidrosis).
- Digestive problems: Peripheral neuropathy can cause cramps and spasms in the digestive system, causing constipation or diarrhea. It can also cause problems with nutrient absorption.
- Bladder and sexual problems: Peripheral neuropathy can affect the ability to control the bladder (incontinence) and can cause difficulty urinating or sexual dysfunction.
Causes of Peripheral Neuropathy
Peripheral neuropathy can occur due to many causes. It can be inherited or acquired. Common causes include:
- Diabetes: Diabetic neuropathy is one of the most common types of peripheral neuropathy.
- Injuries: Such as burns, fractures, or surgical injuries.
- Toxins: Such as exposure to heavy metals.
- Nutritional deficiencies: Such as deficiencies in vitamins B12 and E.
- Autoimmune and inflammatory diseases: Such as Guillain-Barré syndrome.
- Cancers: Some tumors can release substances that damage nerves.
- Viral and bacterial infections: Such as HIV and hepatitis.
You need to consult a doctor for an accurate diagnosis and to develop a suitable treatment plan based on the specific causes and symptoms of your condition.
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