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Peripheral Neuropathy

This relates to the nerves that are connected to the spinal cord and other body parts. The nerve cells consist of three main parts – axons, cell body and dendrites (nerve/muscle junctions). Any part of the nerve can be affected, but damage to axons is most common. The axon transmits signals from nerve cell to nerve cell or muscle. Most axons are surrounded by a substance called myelin, which facilitates signal transmission.

Peripheral neuropathy can be associated with poor nutrition, a number of diseases (including diabetes), and pressure or trauma. Many people suffer from the disorder without ever identifying the cause.

Types of Peripheral Neuropathy

There are different types of peripheral neuropathy with varied causes and parts of the body that it could occur. The three nerves that make up the peripheral nervous system are: sensory nerves, autonomic nerves and motor nerves. The nerve areas are classified as mononeuropathy, polyneuropathy and symmetric neuropathy.

Symptoms

The symptoms are dependent on the nerve or nerves affected … a number of nerves could be damaged. Two areas define your nervous system; these are the central nervous system which consists of your spinal cord and brain, and the peripheral nervous system which carries all other nerves. The nerves affected by peripheral neuropathy are:

• The sensory nerves which are supposed to be sensitive to heat, pain or touch. Sensory nerve damage can also cause tingling and numbness.

• The autonomic nerves which usually control blood pressure, digestion, heart rate and bladder function. Damage to this nerve also causes constipation, abnormal blood pressure readings, incontinence (bladder dysfunction), sexual dysfunction, reduced ability to perspire, and abnormal heart rate.

• The motor nerves, which control muscle mobility. Motor nerve damage leads to cramps, muscle weakness, spasms and in some instances poor coordination and or loss of balance.

Risk Factors and Causes

Several factors can contribute to peripheral neuropathy. Among them are disease; nerve compression, entrapment, or laceration; exposure to toxins; or inflammation. However, in many cases no cause can be determined, especially in people over the age of 60.

Various conditions are associated with peripheral nerve damage and can be classified as acquired, hereditary or idiopathic neuropathy, they encompass the following:

• Carpal tunnel syndrome

• Diabetes

• Trauma or pressure on the nerve(s)

• Bell’s palsy

• Inherited disorders

• Cancer (especially if doing chemotherapy)

• Alcoholism

• Infectious diseases such as Lyme disease, HIV/AIDS, hepatitis B and C,   leprosy and shingles

• Medications

• Exposure to poisons

• Autoimmune disorders, examples of which are rheumatoid arthritis, Guillain-Barre syndrome and lupus

• Tumors

• Herniated discs in the back

• Other diseases – liver and kidney disease as well as thyroid disorders

• Charcot Marie Tooth Disease

• Deficiencies of Vitamin B and E

Complications

• Permanent loss of nerve function, tissue damage, and muscle atrophy.

• Reduced feeling, since parts of your body may be numb; you may then be less likely to feel temperature changes or an injury.

• Chronic pain, which can cause sleeplessness and a decline in quality of life. Pain sufferers often experience a disruption in their ability to perform daily tasks and may suffer from depression.

• Infection, in your feet as well as any other areas lacking usual sensation is not unusual.

Diagnosis

From the symptoms listed above, ensure that you visit a neurologist, your family doctor or a foot health specialist to determine what your particular problems are. Early detection could possibly prevent severe nerve damage.

Different tests could be done to assess your condition, these include:

• Nerve conduction velocity (NCV) studies – this records electrical responses and impulses

• Electromyography (EMG) – determines electrical activity in muscle tissue and detects whether or not it is neuropathy

• Blood and urine tests

• Imaging tests (MRI and CT scans) – to assess the underlying cause of the condition. These shows whether certain conditions like tumors or herniated discs are detected.

• Electroencephalography (EEG) – determines electrical activity in the brain; detects seizures and evaluates the brain function.

• Nerve biopsy – where a small portion of nerve is removed and checked.

Other simple tests that could be performed are testing of muscle strength and tone, tendon reflexes, testing ability to feel certain sensations, and checking of posture and coordination.

Treatments

On discovering symptoms of neuropathy, it is extremely important to take immediate action.

Two main goals of treatment are: firstly to manage the condition causing your neuropathy. If the underlying cause is corrected, the neuropathy often improves on its own. The second goal is to relieve the painful symptoms. Types of treatment that can be used to relieve the pain associated with the condition are as follows:

• Pain relievers. Mild symptoms may be relieved by over-the-counter pain medications. For more severe symptoms, your doctor may recommend prescription painkillers. Drugs containing codeine, can lead to dependence, constipation or sedation, so these drugs are generally prescribed only when other treatments fail.

• Anti-seizure medications. Some were originally developed to treat epilepsy. However, doctors often also prescribe them for nerve pain. Side effects may include drowsiness and dizziness.

• Antidepressants. Was originally developed to treat depression. However, they have been found to help relieve pain by interfering with chemical processes in your brain and spinal cord that cause you to feel pain.

• Electrical nerve stimulation. In this therapy, gentle electric current is delivered through the electrodes at varying frequencies. It has to be done frequently; many people report this therapy improves their symptoms.

Your feet mirror your general health . . . cherish them!

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