Neuropathy is when nerve damage interferes with the functioning of the peripheral nervous system (PNS). When the cause can’t be determined, it’s called idiopathic neuropathy.
The PNS carries information from the central nervous system (CNS), or brain and spinal cord, to the rest of the body.
There are three kinds of nerves within the PNS. Sensory nerves relay messages from the senses to the brain. This allows sensations of temperature and touch. Motor nerves transmit signals from the brain to the muscles. This helps the brain control the muscles. Autonomic nerves control body functions like heart rate, breathing, and digestion.
Damage to nerve cells can affect how the PNS communicates with the rest of the body. Symptoms can include numbness, pain, and balance issues.
It’s called acute neuropathy when symptoms develop suddenly. Alternately, it’s called chronic neuropathy when symptoms start slowly and increase over time.
Diagnosis involves physical examination and review of medical history. Diagnostic testing may include blood tests, nerve testing, and imaging tests.
There is no cure for idiopathic neuropathy. Treatments including medication, physical therapy, and lifestyle modifications can help you function and feel better.
Symptoms can be vague at onset and are similar to those of other conditions. Symptoms vary depending on which nerves are damaged.
Symptoms of sensory neuropathy may include:
- numbness, tingling, and burning sensation, particularly in hands and feet
- vague or strange sensations (paresthesias)
- pain, or inability to feel pain, touch, or temperature
- lack of coordination or loss of reflexes
Symptoms of motor neuropathy may include:
- muscle weakness or loss of muscle control
- trouble with balance and coordination
- muscle twitching, cramping, or spasms
- difficulty walking or moving limbs
Symptoms of autonomic neuropathy may include:
- dizziness, or fainting
- sweating abnormalities
- nausea, vomiting, or diarrhea
- abnormal heart rate or blood pressure
- sexual dysfunction
Symptoms may progress quickly and then slowly get better over time in some forms of acute neuropathy. Some chronic neuropathies cause periods of relapse followed by periods of remission.
Some conditions that cause neuropathy are hereditary. Other things that can cause it include:
- injury or infection
- nutritional or hormonal imbalances
- chemotherapy or exposure to toxic substances
- autoimmune diseases such as Lyme disease, lupus, and rheumatoid arthritis (RA)
- systemic diseases like diabetes, kidney disorders, and certain cancers
- vascular disorders
Approximately 30 percent of neuropathy cases are due to diabetes, according to the Cleveland Clinic. Between 30 and 40 percent of the remaining cases are idiopathic.
The National Institute of Neurological Disorders and Stroke estimates that approximately 20 million Americans have peripheral neuropathy. Anyone can develop neuropathy, but risk increases with age.
There is no one definitive test for neuropathy. Testing begins with a physical examination and a complete medical history. Tell your doctor about any symptoms you’re experiencing. Be sure to let them know about over-the-counter and prescription medications you’re taking. It’s also important to mention if you’ve been exposed to toxins on the job or at home.
Diagnostic testing may include:
- blood work
- nerve conduction studies (NCS)
- electromyography (EMG)
- skin, nerve, and muscle biopsies
Imaging tests may include a CT scan, X-rays, or magnetic resonance imaging (MRI).
Peripheral neuropathy can cause permanent damage to nerves if untreated. Treatment will target the cause if it can be determined.
Treatment of idiopathic neuropathy revolves around symptom management. Options include over-the-counter and prescription medications, physical therapy, and occupational therapy.
Mobility aids can help you move around safely if you’re having trouble with balance or walking. These may include special shoes, braces, and canes.
Lifestyle choices can help to improve day-to-day functioning. It’s important to maintain a healthy weight through a balanced diet rich in vitamins and nutrients. It’s also important to get plenty of rest and exercise to tone and strengthen your muscles. Quitting smoking and keeping alcohol consumption to a minimum is healthy and may also help with your neuropathy.
Living with a chronic illness can lead to anxiety and stress. It can be helpful to talk with someone who lives with the same condition. Your doctor can refer you to a local neuropathy support group for additional support.
The general prognosis for idiopathic neuropathy is good, even if your symptoms are permanent. There are many effective treatments available for keeping your symptoms in check and helping you lead a comfortable, happy life. Working with your doctor to treat any underlying condition you may have, along with your symptoms, is the ticket to your best outcome in the short and long term.