NEUROPATHY

What Is Neuropathy?

The medical term “Neuropathy” refers to a condition that damages the peripheral nerves (Gebabo, Zewdie, Shagaro, & Haile, 2021). This ultimately results in numbness, tingling, muscular weakness, and pain in the afflicted area. Neuropathies commonly start in the hands and feet, but they can affect other areas of the body as well. Nerve specialists categorize Peripheral neuropathy as either acute (with a quick onset and rapid progression) or chronic (with a gradual onset and sluggish progression). “Mononeuropathy” refers to neuropathy that affects just one nerve, whereas “symmetrical polyneuropathy” or simply “polyneuropathy” refers to neuropathy that affects nerves on both sides of the body. Peripheral nerves connect the brain and spinal cord to the muscles, skin, and internal organs in a complex network. 

Peripheral nerves emerge from the spinal cord and send information throughout the body. This nervous system also sends sensory information to the CNS. Damage to these nerves usually disrupts the communication between the brain and other areas of the body, causing muscular weakness, loss of normal feeling in the arms and legs, and pain. A variety of causes, such as carpal tunnel syndrome or computer use, can result in different types of neuropathies. These factors include traumatic injuries, metabolic disturbances, genetics, infections, toxin exposure, diabetes, etc. This common condition mostly affects 25% to 30% of Americans over 55 years of age (Callaghan, Gallagher, Fridman, & Feldman, 2020). Older people possess greater risk of developing neuropathy. Some peripheral neuropathies progress slowly over months or years, whereas others progress quickly and worsen over time. Different neuropathies may develop in different ways. Depending on the kind of nerve or nerves affected and the underlying cause of the problem, the way a patient’s condition develops and how soon the patient’s symptoms appear can vary substantially.

What Are the Common Signs and Symptoms of Neuropathy?

Symptoms of neuropathy develop depending on the types of nerve fiber involved. The most common symptoms of neuropathy include loss of sensation, balance incoordination, numbness, tremor, gait abnormality, etc. Other symptoms include pain, tingling, itching, and pins-and-needles sensation, whereas the motor symptoms include tiredness, muscle atrophy, muscle weakness, muscle twitching, cramp, etc. Peripheral neuropathy also accompanies pain and paresthesia in the lower legs and feet. Patients with the involvement of the autonomic nervous system can suffer from dry mouth, difficulty urinating, constipation, and dizziness when standing. 

Different health conditions can cause peripheral neuropathy. The most common causes of peripheral neuropathy include autoimmune diseases, diabetes, inherited disorders like Charcot-Marie-Tooth disease, infections such as Lyme disease, leprosy, diphtheria, hepatitis B and C, and HIV, tumors, bone marrow disorders like myeloma, lymphoma, kidney diseases, liver problems, hypothyroidism, and many more (Gylfadottir et al., 2020). Also, almost 1/3 of idiopathic neuropathies occur for unknown reasons. Other causes of acquired neuropathies include alcoholism, deficiency of vitamin B and E, poor nutrition, certain medications like fluoroquinolone drugs, chemotherapy, exposure to poison, etc. Also, corneal neuropathy can occur in people due to LASIK surgery.

How Do Spinal Specialists Diagnose Neuropathy?

People need to get medical attention straight away after detecting unusual tingling, weakness, or pain in their hands or feet. Quick diagnosis helps to start the treatment and prevent future damage of the peripheral nerves in patients. Initial diagnosis of neuropathy requires a brief medical history and complete physical examination of the patient. Neurosurgeons will review a patient’s symptoms and ask questions regarding previous and current medications, drug exposure, habits, family history, alcohol use, etc. Neurosurgeons will check the patients muscle reflexes, coordination and balance as well as muscle strength and muscle tone during neurological examination (Lehmann, Wunderlich, Fink, & Sommer, 2020). For further diagnosis, neurosurgeons may perform the following:

  • Blood tests: This includes a complete blood test to determine the electrolyte imbalance, vitamin and mineral imbalances, presence of toxins, thyroid problems, antibodies to certain infections, etc. 
  • Imaging tests: MRI helps to detect muscle tremors and spasm. 
  • Genetic testing: Neurosurgeons perform genetic testing to determine possible hereditary causes of neuropathy.
  • Biopsy and nerve conduction test: Examination of tissue or nerve helps to reveal the exact cause of neuropathy while various electrodiagnostic assessments, such as nerve conduction study and needle electromyography, help to find the location and degree of nerve damage.

How Do Spinal Specialists Treat Neuropathy?

Treatment of neuropathy starts with identifying and treating the underlying cause of neuropathy (Tavakoli et al., 2017). Neurosurgeons usually perform the following to treat neuropathy:

  • Physical therapy: This includes regular exercise and massage to strengthen the muscle and increase balance and range of motion. Occupational therapy also helps to alleviate the pain and increase the function.
  • Medications: A number of different medications such as antidepressants, narcotic drugs, antiseizure drugs, pain relievers, etc. help to control the pain, reduce depression, and improve the condition of the patient.
  • Surgery: This includes correction of certain conditions like a herniated disc or carpal tunnel syndrome to improve compression-related neuropathy. 

Besides these, neurosurgeons also suggest an improved diet and regular exercise to improve health. For any information, please contact us.

References

Callaghan, B. C., Gallagher, G., Fridman, V., & Feldman, E. L. (2020). Diabetic neuropathy: what does the future hold? Diabetologia, 63(5), 891–897. https://doi.org/10.1007/s00125-020-05085-9

Gebabo, T. F., Zewdie, T. H., Shagaro, S. S., & Haile, F. (2021). Determinants of peripheral neuropathy among diabetic patients under follow-up in chronic care clinics of public hospitals at Gamo and Gofa zones, southern Ethiopia. PLoS ONE, 16(2 February), 1–13. https://doi.org/10.1371/journal.pone.0246722

Gylfadottir, S. S., Christensen, D. H., Nicolaisen, S. K., Andersen, H., Callaghan, B. C., Itani, M., … Finnerup, N. B. (2020). Diabetic polyneuropathy and pain, prevalence, and patient characteristics: A cross-sectional questionnaire study of 5,514 patients with recently diagnosed type 2 diabetes. Pain, 161(3), 574–583. https://doi.org/10.1097/j.pain.0000000000001744

Lehmann, H. C., Wunderlich, G., Fink, G. R., & Sommer, C. (2020). Diagnosis of peripheral neuropathy. Neurological Research and Practice, 2(1). https://doi.org/10.1186/s42466-020-00064-2

Tavakoli, M., Yavuz, Di. G., Tahrani, A. A., Selvarajah, Di., Bowling, F. L., & Fadavi, H. (2017). Diabetic Neuropathy: Current Status and Future Prospects. Journal of Diabetes Research, 2017, 2–4. https://doi.org/10.1155/2017/5825971