Peripheral Neuropathy

What is Peripheral Neuropathy?

Peripheral neuropathy is a disorder of the nervous system affecting distal nerves, most commonly those of the hands and feet.

What are some causes of Peripheral Neuropathy?

  • Diabetes Mellitus
  • Adverse effect of a medication 
  • Alcohol abuse
  • Infection 
  • HIV
  • End-stage kidney disease 
  • Hypothyroidism
  • Vitamin deficiencies such as Vitamin B12 and Folate 
  • Lyme disease 
  • Autoimmune dysfunction 
  • Exposure to chemotherapy or heavy metals
  • Hereditary disorders such as Charcot-Marie-Tooth
  • Idiopathic

What are the symptoms of Peripheral Neuropathy?

Patients with peripheral neuropathy typically present with burning, tingling, or numbness of their hands or feet. Other symptoms include:

  • Decreased sensation to the extremity-for example, decreased ability to accurately assess temperature or pain
  • Muscle weakness
  • Decreased coordination

How to diagnose Peripheral Neuropathy?

The doctor will perform a physical exam to assess for loss of sensation and/or motor function as well as checking for appropriate reflexes. In some cases, electrodiagnostic studies may be performed as well. 

Other diagnostic tests include:

  • Bloodwork such as complete blood count, comprehensive metabolic panel, erythrocyte sedimentation rate, fasting blood glucose level, thyroid-stimulating hormone level, vitamin B12 level 
  • Nerve or muscle biopsy 

How to treat Peripheral Neuropathy?

Treatment of peripheral neuropathy includes both controls of the underlying cause and symptomatic management. 

  • Medications such as Gabapentin and Tricyclic Antidepressants can help reduce pain 
  • PT evaluation for patients who experience weakness due to peripheral neuropathy 

As individuals with peripheral neuropathy are at increased risk for developing foot ulcers, it is advised that patients should schedule regular visits with the podiatrist. Other suggestions to help prevent injuries include:

  • Checking feet daily for injuries
  • Wearing wide toe shoes
  • Avoiding walking around barefoot, especially outside
  • Checking the temperature of a shower or bath to avoid burns

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