Understanding Peripheral Neuropathy

Answer 1

Peripheral neuropathy is a degenerative nerve condition most common in patients with uncontrolled Diabetes, although it can be due to a number of other diseases such as Alcoholism, drug or toxin exposure, certain infections such as HIV and hepatitis, thyroid or kidney dysfunction, autoimmune diseases, trauma, or vitamin deficiencies.

In peripheral neuropathy, nerves extending from the spinal cord to supply the organs and limbs become damaged, leading to a constellation of symptoms including numbness and incoordination. Generally, the longest nerve tracts are most vulnerable to damage, including the nerves that lead to the fingertips and toes. This can lead to loss of sensation in these areas, which can sometimes result in injuries to the feet that go undetected until a complication (such as infection) develops. In addition to loss of sensation and clumsiness, peripheral neuropathy is often associated with sharp pains in the affected limbs that are often described as a jolt of electricity coursing through the extremity.

In addition to its effect on motor and sensory functioning, peripheral neuropathy can have significant consequences on the autonomic nervous system. The autonomic nervous system is responsible for regulating the behavior of the heart, gut, sweat glands, bladder, and sexual organs. Damage to the autonomic nervous system can lead to "silent" heart attacks that do not cause the usual symptom of chest pain, nausea, bloating, constipation, incontinence, impotence, and excessive sweating.

Recovery from peripheral neuropathy depends on the extent of nerve damage and the underlying cause. In cases of poorly controlled diabetes, improved glucose control can result in some recovery of nerve function. Cases of peripheral neuropathy attributable to drug or toxin exposure can be ameliorated through removal of the offending agent. In cases of vitamin deficiency, nerve function can be regained by supplying the missing nutrient. Treatment of an underlying infection causing the peripheral neuropathy can also result in recovery of nerve function.

Certain medications used to treat seizures can be useful in relieving the pain associated with peripheral neuropathy, such as gabapentin and topiramate. Other medications traditionally used to treat depression, known as tricyclic antidepressants, have also been shown to be of some benefit in treating neuropathic pain.