CMMC Neuroscience Center

Neuropathy

Basic Information

Neuropathy is a general term for disease of the nerves. It may take many forms. Most common is what is called peripheral neuropathy, which generally starts in the feet and then spreads to the hands. Symptoms include numbness, weakness, loss of balance, and autonomic dysfunction. There are other forms of neuropathy, one being a local compression of the nerve. The most common form is carpal tunnel syndrome and ulnar nerve compression. Other neuropathies include a patchy compression of multiple nerves, inflammation of nerve endings, Bell's (facial) palsy, and other manifestations. It is important to realize that neuropathy simply implies that nerves are being damaged or are diseased. It does not imply any specific cause, as there are many causes of neuropathy. Most neuropathies are secondary, i.e., due to some other disease process that effects nerves as a by product. The most common causes of secondary neuropathy are diabetes, thyroid disease, alcohol abuse, and age-related. Other neuropathies may be due to vitamin B12 deficiency, Lyme disease, and other such conditions. Finally, some neuropathies may be primary, in that the disease begins initially in the nerve and there is no other affected organ. Neuropathies may come on suddenly, gradually, or very slowly over years.

Symptoms

• Diffuse numbness in the hands and feet, sometimes rapidly ascending numbness.
  
• Weakness in the hands, feet or legs. Sometimes weakness of the facial muscles or eye muscles.
  
• Autonomic symptoms such as frequent lightheadedness, irregular bowels, and rapid heart rhythms.
  
• Painful burning of the feet or hands.
  
• Persistent numbness in one hand, frequently seen with carpal tunnel syndrome.
  
  

Treatment Available

• Most treatments depend on the underlying cause. For secondary causes such as diabetes, it is critical to treat the diabetes effectively.
  
• Vitamin replacement, thyroid replacement, and other such treatments are important.
  
• Neuropathies due to toxic substances such as alcohol or heavy metals require change in lifestyle.
  
• Primary neuropathies that are often inflammatory, will require immunosuppressant therapy such as cyclophosphamide or IVIG.
  
• Plasma exchange (clearing the blood of antibodies) is a treatment for some other conditions.
  
• Unfortunately, hereditary neuropathies are also common and have no specific treatment presently.
• Neuroprotective agents, such as Coenzyme Q10, vitamin E, and folic acid.
  
  

Research
· Exploring the underlying causes of neuropathy.
· Finding better ways to treat diabetic neuropathy in particular.
· Exploring the genetic basis of neuropathy.
· Approaches to prevention and neuro protection.

Web Site: The Neuropathy Association