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Peripheral neuropathy

Peripheral neuropathy is the medical term for damage to nerves of the peripheral nervous system, which may be caused either by diseases of the nerve or from the side-effects of systemic illness. Peripheral neuropathies vary in their presentation and origin, and may affect the nerve or the neuromuscular junction. more...

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Major causes of peripheral neuropathy include seizures, nutritional deficiencies, alcoholism and HIV, though diabetes is the most likely cause.

Mechanical pressure from staying in one position for too long, a tumor, intraneural hemorrhage, exposing the body to extreme conditions such as radiation, cold temperatures, or toxic substances can also cause peripheral neuropathy.

Many of the diseases of the peripheral nervous system may present similarly to muscle problems (myopathies), and so it is important to develop approaches for assessing sensory and motor disturbances in patients so that a physician may make an accurate diagnosis.

Types

Peripheral neuropathies may either be symmetrical and generalized or focal and multifocal, which is usually a good indicator of the cause of the peripheral nerve disease.

Generalized peripheral neuropathy

Generalized peripheral neuropathies are symmetrical, and usually due to various systematic illnesses and disease processes that affect the peripheral nervous system in its entirety. They are further subdivided into several categories:

  • Distal axonopathies are the result of some metabolic or toxic derangement of neurons. They may be caused by metabolic diseases such as diabetes, renal failure, deficiency syndromes such as malnutrition and alcoholism, or the effects of toxins or drugs.
  • Myelinopathies are due to a primary attack on myelin causing an acute failure of impulse conduction. The most common cause is acute inflammatory demyelinating polyneuropathy (AIDP; aka Guillain-BarrĂ© syndrome), though other causes include chronic inflammatory demyelinating syndrome (CIDP), genetic metabolic disorders (e.g., leukodystrophy), or toxins.
  • Neuronopathies are the result of destruction of peripheral nervous system (PNS) neurons. They may be caused by motor neurone diseases, sensory neuronopathies (e.g., Herpes zoster), toxins or autonomic dysfunction. Neurotoxins may cause neuronopathies, such as the chemotherapy agent vincristine.

Signs and symptoms

Those with diseases or dysfunctions of their peripheral nerves can present with problems in any of the normal peripheral nerve functions.

In terms of sensory function, there are commonly loss of function (negative) symptoms, which include numbness, tremor, and gait imbalance.

Gain of function (positive) symptoms include tingling, pain, itching, crawling, and pins and needles.

Motor symptoms include loss of function (negative) symptoms of weakness, tiredness, heaviness, and gait abnormalities; and gain of function (positive) symptoms of cramps, tremor, and fasciculations.

Read more at Wikipedia.org


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Readers offer help for peripheral neuropathy
From Saturday Evening Post, 5/1/05 by Cory SerVaas

Dear Dr. SerVaas:

Not having access to a Web site (my computer is too old), this old dragon does her own research.

Many skiing injuries, falling off the third-floor fire escape in boarding school, etc., have finally caught up with me in the form of prickling, some numbness in toes and pad of both feet.

A book written by Stuart M. Berger, M.D., How To Be Your Own Nutritionist, recommends 100 mg [B.sub.1]. That is what I take, and it has helped immensely. My doctor was completely disinterested in the problem, and [B.sub.1] was okay by him.

Your magazine feedback is fantastic--the only one I subscribe to. Keep those toes wiggling ...

Jacquellyn Cameron

Camarillo, California

Vitamin [B.sub.1] is thiamine. The oral dose you are taking appears safe. In the body, thiamine helps maintain the nervous system, muscles, and heart. Thiamine-rich food sources include kidney, liver, brewer's yeast, beans, pork, salmon, soybeans, and wheat germ.

Dear Dr. SerVaas:

I am writing in regard to the letter in the Sept./Oct. '04 issue of the Post, from Marie Stevens of Peoria, Arizona, inquiring about peripheral neuropathy. Just early this year, the bottom of my feet started burning. I have discovered that before bedtime, soaking them in a pan of cold water with 1/4 to 1/2 cup of apple cider vinegar stops the burning, and I can get a good night's sleep.

In owning a skating rink, I skated every day for 20 years, so maybe that is where my problem began.

Marian King

Calhoun, Georgia

COPYRIGHT 2005 Saturday Evening Post Society
COPYRIGHT 2005 Gale Group

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