Neuropathy or peripheral neuropathy is a pathology of the nerves and nervous ganglia that form the peripheral nervous system and that carry information from the brain and spinal cord to the rest of the body and vice versa. It is very common and there are many types and causes. It is normally a disease associated with diabetes.
Neuropathy has several possible causes:
– Suffer from diabetes.
– Celiac disease.
– Have non-celiac gluten sensitivity.
– Herpes zoster infection.
– Cancer.
– Side effect of chemotherapy.
– Exposure to neurotoxins. Neurologically destructive toxins.
– Hereditary.
– Lupus.
– Rheumatoid arthritis.
– Infections such as HIV, herpes or hepatitis C.
– Low levels of vitamin B1, B6 or B12.
– Poor blood flow in the legs.
– Hypothyroidism.
– Trauma or poorly placed casts, splints and/or splints.
– Alcoholism.
– Pressure on a nerve.
– Long-term exposure to cold temperatures.
Some types of neuropathies are:
– Diabetic neuropathy. Inadequate blood glucose levels combined with high blood pressure, hypercholesterolemia and other factors can alter nerve fibers in any location of the body; mainly, producing a sensory-motor neuropathy. But it can also be autonomic neuropathy and mononeuropathies.
– Autonomic neuropathy. It affects the autonomic nerves that control the bladder, intestinal tract, and genitals. Nerve damage also interferes with the messages exchanged between the brain and other organs such as the heart, blood vessels, and sweat glands.
– Mononeuropathy. Damage to a single nerve resulting in loss of movement. Carpal tunnel syndrome is probably the best known mononeuropathy or compressive mononeuropathy.
– Charcot joint or neuropathic arthropathy. It usually occurs in the foot, which loses almost all sensation, and occurs when a joint is damaged by a nerve problem.
– Cranial neuropathy. It affects the twelve pairs of nerves that control vision and are connected to the brain. Vision, eye movement, hearing and sense of taste are compromised.
– Femoral neuropathy. It causes sudden weakness or pain due to involvement of a nerve or group of nerves. It can cause paralysis on one side of the face, pain in the front thigh or in other parts of the body.
– Thoracic or lumbar radiculopathy. Similar to the femoral but affects the torso. It affects a band of the chest or the abdominal wall.
– Unilateral foot drop. The foot cannot be flexed upward due to damage to the peroneal nerve, a branch of the sciatic nerve that supplies movement and sensation to the lower leg, foot, and toes. The cause may be due to compression of the blood vessels or disease thereof.
Symptoms of neuropathy usually include:
– Abnormal and unpleasant tactile perception; It is often a pain. (Dysesthesia).
– Abnormal perception of pain (allodynes) to an external stimulus.
– Neuropathic pain. Produced by stimuli that are usually not painful. It is perceived as a permanent burning, punctures or an electrical ‘shock’. Senses such as touch, heat, cold… or other sensations that the spinal cord and brain do not expect to receive in that area are also activated.
– Neuralgia. Pain without affecting motor function.
– Numbness.
– Muscle problems.
– Problems digesting food.
– Difficulty moving a part of the body.
– Problems performing tasks such as buttoning a shirt.
– Muscle spasms or cramps.
– Leaking urine or not realizing that the bladder is full.
– Inability to empty the bladder.
– Sweat a lot or very little.
– Erection problems in men and vaginal dryness in women.
The description of symptoms, medical history, blood tests and tests to check muscle activity such as electromyography are the first steps towards diagnosis. It is also likely that nerve conduction studies will be performed to check the speed of transmission of small electrical currents through the nerves under study.
Specific tests will also be performed on affected organs or systems such as the heart or digestive system, bladder, intestinal tract and genitals.
Treatment of neuropathy depends, of course, on the cause. If it is a diabetic neuropathy, the diabetes must be stabilized by strictly following the guidelines prescribed by the specialist. Analgesics, anti-inflammatories, anticonvulsants or local anesthetics can also be administered. If there is no response, small currents can be applied (transcutaneous electrical stimulation -TENS-) to prevent the transmission of pain information sent by the affected nerve roots.
If it is a low level of vitamins, supplements or injections will be administered.
If it is a compression neuropathy, surgery may be necessary to remove pressure on the nerve.
Exercises will also be programmed to improve strength and muscle control. Orthopedic aids can improve the movement or ability to use a limb if neuropathy affects one.
Psychotherapy, the prescription of pain medications, antidepressants or anticonvulsants are options in the treatment of neuropathy.
Treatment may be referred to a pain specialist.
There are no preventive measures against neuropathies or have been described. However, if you suffer from neuropathy, there are a series of measures that must be taken into account as precautionary measures:
– Remove loose cables and rugs in transit areas.
– Do not walk barefoot and check your shoes before putting them on to avoid injuries due to the presence of stones, friction, etc.
– Fix uneven areas of the floor.
– Try to have well-lit environments.
– Place handrails in bathtubs, showers, toilets and non-slip mats.
– Monitor the skin to check for wounds, especially on the feet. This must be done every day. Check the temperature of the water, wash with warm water and mild soap, dry well and moisturize the skin with cream once dry.
– Do not press the painful area for a long time.
