Peripheral neuropathy is damage to one or more peripheral nerves. It includes numerous syndromes characterized by sensitivity disorders of varying severity, pain, muscle weakness, and atrophy, decreased deep tendon reflexes, vasomotor symptoms, both individually and in combination. They are classified based on anamnesis and physical examination findings. Neurophysiological studies (study of the rate of propagation of excitation along the nerves and electromyography) can establish the localization of the lesion and determine whether it is predominantly axonal (usually metabolic damage) or demyelinating (usually autoimmune damage). Treatment of peripheral neuropathy is mainly aimed at eliminating the cause.
Peripheral neuropathy can affect:
- One nerve (mononeuropathy).
- From 2 separate nerves or more in separate areas (multiple mononeuropathies).
- Several nerves at the same time, which indicate a diffuse process (polyneuropathy).
Why is peripheral neuropathy dangerous?
Neuropathy is a time bomb in the human body. This serious disease causes degenerative-dystrophic changes in the peripheral nerves. With neuropathy, the transmission of nerve impulses is disrupted, leading to disruptions in the functioning of individual organs, tissues, and muscles. It can affect the facial, ulnar, radial, sciatic, trigeminal, and other nerves. A person develops muscle weakness, the skin over the lesion turns red and swells, a sensitivity disorder, muscle atrophy occurs. The disease is accompanied by severe pain.
The main danger of the disease is disorders of musculoskeletal functions, developing against the background of muscle atrophy and paralysis. The progression of the disease can significantly complicate a person’s life and cause permanent disability. You need to see a doctor and start treating peripheral neuropathy to avoid dire consequences at the first symptoms.
What happens if you don’t use treatments for peripheral neuropathy?
In most cases, neuropathy leads to severe complications that pose a real threat to your health, ability to work, and physical activity. Among the complications are:
- Weakness in the affected limbs.
- Loss of sensitivity.
- Impaired coordination of movements.
According to medical studies, the rate of development of these pathologies and complications has been growing rapidly in recent years.
If the patient does not take urgent measures for treatments for peripheral neuropathy or uses ineffective treatment, then powerful pathological processes will inevitably start in his body, which will lead to severe disorders of the functioning of the musculoskeletal system and other organs. A person may have problems in everyday life and the professional sphere. With a severe course of the disease, disabilities are possible. Timely prescribed treating peripheral neuropathy can help avoid serious consequences.
Peripheral neuropathy diagnostics
Peripheral neuropathy should be considered in patients with diffuse or multifocal sensory impairment and/or muscle weakness without increased reflexes. However, if initially, the symptoms were asymmetric and then became relatively diffuse, then the cause of the disease may be multiple mononeuropathies. Doctors need to ask patients in detail about the onset of symptoms to determine whether they arose symmetrically or asymmetrically. For example, the patient should be asked whether symptoms appeared in both feet at about the same time (symmetrically) or first in one foot, then in one arm, and then in the other foot (asymmetric).
If the symptoms correspond to polyneuropathy, an attempt should be made to establish whether the symptoms were initially asymmetric (which may indicate multiple mononeuropathies).
The clinical picture, especially the nature of the development of symptoms, can assist in establishing the cause of peripheral neuropathy:
- Asymmetric neuropathies indicate vasculitis.
- Symmetrical, distal neuropathies are usually caused by intoxication or metabolic disorders.
- Slowly progressive, chronic neuropathies can be hereditary or associated with prolonged exposure to toxic substances or metabolic disorders.
- Acute neuropathies suggest an autoimmune disorder, vasculitis, toxicity, infection or post-infection reaction, drug effect, or cancer.
- Rash, skin ulcers, and Raynaud’s syndrome in patients with asymmetric axonal neuropathy suggest a state of hypercoagulability, parainfectious or autoimmune vasculitis.
- Weight loss, fever, lymphadenopathy, and massive lesions suggest a tumor or paraneoplastic syndrome.
In all patients with polyneuropathy, the presence of axonopathies should be considered.
What is the treatment of peripheral neuropathy?
The brain controls absolutely all processes in the human body. Brain cells receive information from all organs and systems, analyze this information, develop the desired reaction, and transmit the corresponding orders to various human body organs through nerve cells.
Neuropathy arises from a combination of various factors. These factors lead to the malfunction of certain parts of the brain and disruption of neural connections. In other words, the brain stops giving the correct orders for the clear work of your nervous system, which leads to neuropathy and then to more serious consequences.
Peripheral neuropathies treatment is aimed at eliminating the cause of the disease. It is necessary to discontinue the drug and eliminate the toxic effects that caused the disease or correct nutritional deficiencies. While these measures can eliminate or reduce complaints, recovery is slow and may not be complete.
If the cause cannot be eliminated, then treatment of peripheral neuropathy is limited to minimizing disability and pain. A physical therapist and rehabilitation specialist may recommend appropriate orthopedic devices for the relief of neuropathic pain.
For demyelinating polyneuropathies, immunomodulatory treatment is usually used:
- Plasmapheresis or intravenous immunoglobulins for acute demyelination.
- For chronic myelin dysfunction, plasmapheresis or intravenous immune globulin, corticosteroids, and/or metabolic inhibitors are used.
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