Signs of Peripheral neuropathy (Nerve dysfunction)

Description

The brain communicates with the spinal cord. The spinal cord transmits signals to the body through the peripheral nerves. Damage can occur to these nerves that interfere with their ability to function causing numbness, weakness, and/or pain. Causes include: diabetes, heavy metal poisoning (gold, lead, arsenic, mercury), autoimmune diseases (Lupus, Gullian-Barre, Rheumatoid arthritis), kidney failure, vitamin deficiency (B12, folate), shingles, alcohol, chemotherapy, and direct compression (carpal tunnel syndrome, compartment syndrome).

Symptoms

The symptoms depend on which type of nerve is affected and the location of the nerve. The three main types of nerves are sensory, motor, and autonomic. The disorder can affect any one or a combination of these nerve types. Sensation changes include: burning, pain that increases with touching the skin, tingling or numbness, or an inability to determine position. Motor involvement: weakness, loss of muscle bulk, and loss of dexterity, muscle cramps. Autonomic changes include: low blood pressure with standing, vomiting, urinary retention, excessive sweating, no sweating.

Tests

A history and physical exam will be performed. Tests to diagnose the neuropathy may include: EMG, nerve conduction tests, and/or nerve biopsy. Blood tests to screen for medical conditions, such as diabetes and vitamin deficiency, may be done. A CT scan and/or MRI may be performed to look for other causes of the deficit.

Standard Workup

CBC
Chem 12
CT Scan
MRI

Treatment

First, the cause of the disorder must be identified then removed and/or treated aggressively. Second, the symptoms must be alleviated and therapy includes: medications (gabapentin/Neurontin, carbamazepine/Tegretol, lamotrigine/Lamictal, amitriptyline/Elavil, nortriptyline/Pamelor, tramadol/Ultram), physical therapy, and braces.