Peripheral Neuropathy

Peripheral Neuropathy and other movement disorders are treated at Upstate Neurology's Neuromuscular clinic.

Definition

Peripheral neuropathy is damage to the nerves that connect the spinal cord to the rest of the body.

Peripheral Nerves of the Foot

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Causes

Nerve damage may be from:

• Trauma due to:
• Some medicines, such as chemotherapy for cancer
• Lack of certain vitamins
• Exposure to toxins and heavy metals, such as lead, mercury, or pesticides
• Exposure to cold or radiation
• Alcohol use disorder

Health problems that can damage these nerves are:

• Diabetes
• Infections, such as Lyme disease and tuberculosis
• Kidney failure
• Autoimmune disorders, such as rheumatoid arthritis
• Acute or chronic demyelinating polyneuropathy
• Porphyria
• Certain problems from cancerous tumors
• Hereditary syndromes, such as Charcot Marie Tooth disease

Risk Factors

Having certain health problems may raise the risk of getting peripheral neuropathy.

Symptoms

Nerve damage may cause problems with feeling and movement in the arms, hands, legs, and feet. Other parts of the body may also have problems. It depends on which nerves are affected.

Problems may be mild and then get worse over time. They may be worse at night. A person may have:

• Numbness or lack of feeling
• Tingling
• Pain, often a burning or sharp, or cutting feeling
• Sensitivity when touched
• Muscle spasms
• Muscle weakness
• Problems walking
• Loss of coordination or balance

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. Blood and urine tests will be done to rule out other problems or possible causes.

Nerves will be tested. This can be done with:

• Electromyography (EMG)
• Nerve conduction studies (NCS)

Other tests to look for possible causes may be:

• CT scan
• MRI scan
• Lumbar puncture to test the fluid around your spine
• Nerve or muscle biopsy

Treatment

Treatment depends on what is causing the neuropathy. This can ease symptoms or make them go away. Other treatment options may be:

Physical Therapy

Exercises may be given to help with flexibility. It may help make walking easier.

Medicine

Pain medicine is often used. Botulinum toxin A injections may also ease pain.

Medicines used to treat depression and prevent seizures can ease some symptoms.

People with severe problems may need:

• IV immunoglobulins to suppress the immune system
• Plasma exchange of the blood to ease swelling and suppress the immune system

Prevention

Manage long term health problems, such as diabetes. This may prevent some forms of peripheral neuropathy.

References

• Barrell K, Smith AG. Peripheral Neuropathy. Med Clin North Am. 2019 Mar;103(2):383-397.
• Peripheral neuropathy. EBSCO DynaMed website. Available at: http://www.dynamed.com/condition/peripheral-neuropathy.
• Peripheral neuropathy fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/patient-caregiver-education/fact-sheets/peripheral-neuropathy-fact-sheet.