Peripheral neuropathy

Peripheral neuropathy
Micrograph showing a vasculitic peripheral neuropathy; plastic embedded; Toluidine blue stain
SpecialtyNeurology
SymptomsShooting pain, numbness, tingling, tremors, bladder problems, unsteadiness

Peripheral neuropathy, often shortened to neuropathy, refers to damage or disease affecting the nerves.[1] Damage to nerves may impair sensation, movement, gland function, and/or organ function depending on which nerve fibers are affected. Neuropathies affecting motor, sensory, or autonomic nerve fibers result in different symptoms. More than one type of fiber may be affected simultaneously. Peripheral neuropathy may be acute (with sudden onset, rapid progress) or chronic (symptoms begin subtly and progress slowly), and may be reversible or permanent.

Common causes include systemic diseases (such as diabetes or leprosy), hyperglycemia-induced glycation,[2][3][4] vitamin deficiency, medication (e.g., chemotherapy, or commonly prescribed antibiotics including metronidazole and the fluoroquinolone class of antibiotics (such as ciprofloxacin, levofloxacin, moxifloxacin)), traumatic injury, ischemia, radiation therapy, excessive alcohol consumption, immune system disease, celiac disease, non-celiac gluten sensitivity, or viral infection. It can also be genetic (present from birth) or idiopathic (no known cause).[5][6][7][8] In conventional medical usage, the word neuropathy (neuro-, "nervous system" and -pathy, "disease of")[9] without modifier usually means peripheral neuropathy.

Neuropathy affecting just one nerve is called "mononeuropathy", and neuropathy involving nerves in roughly the same areas on both sides of the body is called "symmetrical polyneuropathy" or simply "polyneuropathy". When two or more (typically just a few, but sometimes many) separate nerves in disparate areas of the body are affected it is called "mononeuritis multiplex", "multifocal mononeuropathy", or "multiple mononeuropathy".[5][6][7]

Neuropathy may cause painful cramps, fasciculations (fine muscle twitching), muscle loss, bone degeneration, and changes in the skin, hair, and nails. Additionally, motor neuropathy may cause impaired balance and coordination or, most commonly, muscle weakness; sensory neuropathy may cause numbness to touch and vibration, reduced position sense causing poorer coordination and balance, reduced sensitivity to temperature change and pain, spontaneous tingling or burning pain, or allodynia (pain from normally nonpainful stimuli, such as light touch); and autonomic neuropathy may produce diverse symptoms, depending on the affected glands and organs, but common symptoms are poor bladder control, abnormal blood pressure or heart rate, and reduced ability to sweat normally.[5][6][7]

  1. ^ Kaur J, Ghosh S, Sahani AK, Sinha JK (November 2020). "Mental Imagery as a Rehabilitative Therapy for Neuropathic Pain in People With Spinal Cord Injury: A Randomized Controlled Trial". Neurorehabilitation and Neural Repair. 34 (11): 1038–1049. doi:10.1177/1545968320962498. PMID 33040678. S2CID 222300017.
  2. ^ Sugimoto K, Yasujima M, Yagihashi S (2008). "Role of advanced glycation end products in diabetic neuropathy". Current Pharmaceutical Design. 14 (10): 953–61. doi:10.2174/138161208784139774. PMID 18473845.
  3. ^ Singh VP, Bali A, Singh N, Jaggi AS (February 2014). "Advanced glycation end products and diabetic complications". The Korean Journal of Physiology & Pharmacology. 18 (1): 1–14. doi:10.4196/kjpp.2014.18.1.1. PMC 3951818. PMID 24634591.
  4. ^ Jack M, Wright D (May 2012). "Role of advanced glycation endproducts and glyoxalase I in diabetic peripheral sensory neuropathy". Translational Research. 159 (5): 355–65. doi:10.1016/j.trsl.2011.12.004. PMC 3329218. PMID 22500508.
  5. ^ a b c Hughes RA (February 2002). "Peripheral neuropathy". BMJ. 324 (7335): 466–9. doi:10.1136/bmj.324.7335.466. PMC 1122393. PMID 11859051.
  6. ^ a b c Torpy JM, Kincaid JL, Glass RM (April 2010). "JAMA patient page. Peripheral neuropathy". JAMA. 303 (15): 1556. doi:10.1001/jama.303.15.1556. PMID 20407067.
  7. ^ a b c "Peripheral neuropathy fact sheet". National Institute of Neurological Disorders and Stroke. 19 September 2012. Archived from the original on 4 January 2016.
  8. ^ Cite error: The named reference ZisHadjivassiliou2019 was invoked but never defined (see the help page).
  9. ^ "neuropathy". Online Etymology Dictionary.