Neuropathies And Other Nerve Related Disorders

Neuropathies And Other Nerve Related Disorders

What is Peripheral Neuropathy?

Peripheral neuropathy refers to the conditions that result when nerves that carry messages to and from the brain and spinal cord from and to the rest of the body are damaged or diseased.

Peripheral neuropathy can affect one nerve (mononeuropathy), two or more nerves in different areas (multiple mononeuropathy) or many nerves (polyneuropathy). Carpal tunnel syndrome is an example of mononeuropathy. Most people with peripheral neuropathy have polyneuropathy.

What are signs and symptoms of Peripheral Neuropathy?

1. Gradual onset of numbness, prickling or tingling in your feet or hands, which can spread upward into your legs and arms
2. Sharp, jabbing, throbbing, freezing or burning pain
3. Extreme sensitivity to touch
4. Lack of coordination and falling
5. Muscle weakness or paralysis if motor nerves are affected
6. Heat intolerance and altered sweating, Bowel, bladder or digestive problems, Changes in blood pressure, causing dizziness or lightheadedness id autonomic nerves are affected

What are causes of Peripheral Neuropathy?

1. Diabetes – Most common cause 
2. Autoimmune diseases-  Sjogren's syndrome, lupus, rheumatoid arthritis, Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy and necrotizing vasculitis.
3. Exposure to poisons - heavy metals or chemicals.
4. Medications - Chemotherapy
5. Infections - Lyme disease, shingles, Epstein-Barr virus, hepatitis C, leprosy, diphtheria and HIV.
6. Alcoholism
7. Inherited disorders- Charcot-Marie-Tooth disease
8. Trauma or pressure on the nerve
9. Tumors – Compressive or paraneoplastic syndrome.
10. Vitamin deficiencies. B vitamins — including B-1, B-6 and B-12 — vitamin E
11. Bone marrow disorders. Monoclonal gammopathies, osteosclerotic myeloma, lymphoma and amyloidosis.
12. Other diseases- kidney disease, liver disease, connective tissue disorders and an underactive thyroid (hypothyroidism)

How to evaluate a case of Peripheral Neuropathy?

1. Blood Tests – Vitamin levels, Sugar, Immune profile etc.
2. Nerve Conduction study and Electromyography
3. Nerve Biopsy

What are the treatment options available?

Symptomatic treatment- Neuropathic pain medicine, topical agents Plasma exchange and intravenous immune globulin - These procedures, which help suppress immune system activity, might benefit people with certain inflammatory conditions.

What is Guillain-Barré syndrome?

Guillain-Barré syndrome (GBS) is a rare neurological disorder in which the body's immune system mistakenly attacks part of its peripheral nervous system—the network of nerves located outside of the brain and spinal cord.

GBS can range from a very mild case with brief weakness to nearly devastating paralysis, leaving the person unable to breathe independently.

GBS can be diagnosed clinically with help of NCS, CSF analysis. GBS can be treated with plasmapheresis or intravenous immunoglobulin(IVIg). Fortunately, most people eventually recover from even the most severe cases of GBS.  After recovery, some people will continue to have some degree of weakness.