Peripheral Neuropathies

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What is Peripheral Neuropathies?

Peripheral neuropathies refer to a diverse group of disease affecting the motor sensory and autonomic nerves lying outside the central nervous system. This can cause a wide variety of symptoms, such as weakness, numbness or sensitivity to touch.

The peripheral nerves make up a vast network that transmit information from the brain and spinal cord (the central nervous system) to every other part of the body. Peripheral nerves also send sensory information back to the brain and spinal cord, for example a message that the feet are cold or a finger is burned.

Who gets Peripheral Neuropathies?

Peripheral neuropathy is fairly common, but frequency varies with the cause of the condition.

Up to one half of patients with diabetes mellitus have a neuropathy depending on the criteria used for diagnosis. The reported incidence of Guillain-barre syndrome varies between 0.6-2.4 cases per 100,000 per year. It is the most common acute polyneuropathy.

Predisposing Factors

Peripheral neuropathy may be either inherited or acquired. There are many different causes of peripheral neuropathies, which vary in terms of symptoms and severity.

Possible causes include:

Alcohol

Nutritional deficiencies (vitamin B1,6,12 and E)

Toxins (carbon disulfide, acrylamide)

Endocrine causes (diabetes, thyroid disease)

Metabolic causes (renal failure)

Infections (HIV, Lyme disease, Leprosy)

Connective tissue disease (scleroderma, SLE, sarcoidosis)

Cancer

Medications/Drugs

Inherited conditions (Charcot-Marie-Tooth syndrome)

Progression

The course of the peripheral neuropathy will depend on the underlying cause. In acute neuropathies, such as Guillain-Barre syndrome, symptoms appear suddenly, progress rapidly, and resolve slowly as damaged nerves heal.

In chronic forms, symptoms begin subtly and progress slowly. Some people may have periods of relief followed by relapse. Others may reach a plateau stage where symptoms stay the same for many months or years. Some chronic neuropathies worsen over time, but very few forms prove fatal unless complicated by other diseases. Occasionally the neuropathy is a symptom of another disorder.

Recovery from peripheral neuropathy is usually slow. Depending on the type of peripheral neuropathy, the patient may fully recover without residual effects or may partially recover and have sensory, motor, and vasomotor (blood vessel) deficits. If severely affected, the patient may develop chronic muscular wasting.

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