Neuropathy is when nerve damage interferes with the peripheral nervous system’s (PNS’s) ability to function. When no cause can be determined, it is called idiopathic neuropathy.
The PNS carries information from the central nervous system (CNS), or brain and spinal cord, to the rest of the body.
Within the PNS are three kinds of nerves. 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. When symptoms develop suddenly, it is called acute neuropathy. When symptoms start slowly and increase over time, it is chronic neuropathy.
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, but medication, physical therapy, and lifestyle modifications can help a patient 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, loss of reflexes
Symptoms of motor neuropathy may include:
- muscle weakness, 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, fainting
- sweating abnormalities
- nausea, vomiting, diarrhea
- abnormal heart rate or blood pressure
- sexual dysfunction
In some forms of acute neuropathy, symptoms progress quickly and then slowly get better over time. 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 are:
- 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
According to The Cleveland Clinic, 30 percent of neuropathy cases are due to diabetes. Between 30 and 40 percent of the remaining cases are idiopathic (Cleveland Clinic, 2010).
The Neuropathy Association estimates that more than 20 million Americans have peripheral neuropathy (Neuropathy Association). Anyone can develop neuropathy, but risk increases with age.
There is no single, definitive test for neuropathy. Testing begins with a physical examination and a complete medical history. Doctors should be made aware of any known symptoms and any over-the-counter and prescription medications being taken by the patient. If a patient has been exposed to toxins on the job or at home, this is also important information to share.
Diagnostic testing may include:
- blood work
- nerve conduction studies (NCS)
- electromyography (EMG)
- skin, nerve, and muscle biopsies
Imaging tests may include computed tomography (CT scan), X-rays, or magnetic resonance imaging (MRI).
When no apparent cause can be determined, it is called idiopathic neuropathy.
Peripheral neuropathy can cause permanent damage to nerves if untreated. Treatment will target the cause if it can be determined.
In idiopathic neuropathy, treatment revolves around symptom management. Options include over-the-counter and prescription medications, physical therapy, and occupational therapy.
For trouble with balance and walking, mobility aids can help a patient to move around safely. These may include special shoes, braces, and canes.
Lifestyle choices can help to improve day-to-day functioning. It is important to maintain a healthy weight through a balanced diet rich in vitamins and nutrients. Plenty of rest and exercise to tone and strengthen muscles are also important. Not smoking and keeping alcohol consumption to a minimum may also help.
Living with a chronic illness can lead to anxiety and stress. Sometimes, talking with someone who lives with the same condition can be helpful. People experience trouble coping with idiopathic neuropathy can be referred to local neuropathy support groups by a hospital or doctor.
Although symptoms may be permanent, the general prognosis is good.