Neuropathy Symptoms

Neuropathy, in medical terms, is described as the disorder of the nervous system, excluding the central nervous system. It is basically a disruption in the functioning of either the motor, sensory or autonomic nerves. Even though, there are about a hundred known types of neuropathies, it can be broadly classified into the following three forms, namely, peripheral neuropathy, autonomic neuropathy, and mononeuropathy. Before knowing the symptoms of neuropathy, let's first discuss the types of neuropathy in brief.

Types of Neuropathy

• Peripheral neuropathy is a disorder of the peripheral nervous system, which includes the sensory and autonomic nerves that connect the spinal cord and muscles, skin and internal organs. It usually affects the limbs, causing numbness, prickling and pain. The signs of peripheral neuropathy are similar to those of neuropathy discussed later.
• Autonomic neuropathy affects the autonomic nerves. These nerves mainly do the job of controlling the bladder, intestines and genitals. In this case, there can be problems while urination, digestion or erection.
• Mononeuropathy or focal neuropathy occurs due to damage caused to a single nerve.

The above forms of neuropathy are most prevalent in patients suffering from diabetes. There are other types of neuropathies like cranial, distal, femoral, diabetic amyotrophy, etc., which can occur in type II diabetics as well as non-diabetic patients. Neuropathy is not constant; it can come and go. It can progress over many years, and may have severe and exhausting symptoms. However, early diagnosis of the symptoms and its treatment can help in controlling the disease.

Symptoms

The signs and symptoms of neuropathy depend on the type and location of nerve, that is motor, sensory or autonomic, involved. For example, when there's damage to the motor nerves, symptoms include weakness in limbs and muscle degeneration. Damage to sensory nerves causes loss of sensation, paresthesias and dysesthesias. These symptoms include loss of pinprick and temperature sensations, numbness, stinging, or tingling paresthesias. Autonomic nerve damage can result in postural hypotension, gastrointestinal and urinary disorders and excess sweating. Now, let's take look at the symptoms of neuropathy as a whole.

Weakness in Arms or Legs: This is caused by damage to the motor nerves and symptoms include difficulty in walking, legs feeling heavy, and lot of effort required while climbing stairs. Cramps in muscles are also commonly seen. The patients may experience difficulty, while carrying things in their arms, turning and opening jars and door knobs. A common sign observed in these patients, is frequently dropping things.

Numbness, Prickling and Pain: Sensory nerves may cause spontaneous sensations, called paresthesias, which causes numbness, prickling, electric shock feeling, etc.

Impaired Sense of Position: There's a lack or lessening of sensation, also known as anesthesia. Loss of ability to feel the limbs, poor and unorganized activity, the patient may not be sure where his feet will land while walking, etc.

Dysesthesias: This is a symptom of neuropathy, wherein the patient experiences unpleasant, abnormal sensations while touching something.

Glove and Stocking Sensation: Patients may have a funny feeling of wearing stockings or gloves, when, in fact, his hands and feet are completely bare.

Feeling of Autonomic Damage: Unexplainable nerve damage can also lead to hypothermia and dizziness, while standing. Constipation, diarrhea and thinning of the skin are some other symptoms of neuropathy.

In diabetic neuropathy, the most distal or the longest nerves are affected first. Thus, the symptoms typically start from the toes, and then ascend. The arms are affected later. The abdomen and the head may be affected, if the case is severe. Some symptoms like gait ataxia, restless legs syndrome (RLS) and periodic leg movement of sleep (PLMS) are often neglected by the patient, until the condition becomes serious.

Causes

There are as many causes as there are types of neuropathy. Here we discuss the broad range of causes. They are as follows:

Diabetes: Almost 30% of the peripheral neuropathy cases are caused by diabetes. Such a type of neuropathy is known as diabetic neuropathy, symptoms of which have already been discussed above.

Metabolic or Endocrine Disorders: Hypothyroidism, liver failure, amyloidosis and chronic renal failure may also lead to neuropathy.

External Triggers: Alcohol and drug abuse, overdose of heavy metals like mercury or lead, and excess intake of vitamin B₆ have also been considered as causes of neuropathy.

Inflammatory diseases: A huge chunk of neuropathy patients have also been victims of leprosy, which is a serious inflammatory disease. Guillain-Barre syndrome characterized by descending paralysis and auto immune disorders like systemic lupus erythematosus, an inflammatory collagen disease affecting the connective tissue are also known to be prone to neuropathy.

Deficiency of Vitamins: Vitamin deficiency, especially of vitamin B₁₂, vitamin A, vitamin E and vitamin B₁ are risk factors for neuropathy.

Physical Trauma: Pinching, cutting, bullet wound, strokes and prolonged occlusion of blood flow are amongst other common causes of neuropathy.

Treatment

Treatment is dependent on the symptoms and causes. There has been research on animals that has shown that neurotrophin-3 can curb the loss of myelin. Drugs originally intended as antidepressants and antiepileptic that act on the central nervous system, have been found to be useful against neuropathic pain. Use of tricyclic antidepressants, such as gabapentin or sodium valproate, has been known to be beneficial in some cases, and are relatively low cost.

The best way to curb diabetic neuropathy is to control diabetes. Optimum blood sugar and insulin levels can prevent or even treat diabetic neuropathy. As a non-pharmacological treatment, TENS (Transcutaneous Electrical Nerve Stimulation) is effective, in some cases. It simply involves administering small levels of electric current to the skin to give relief from pain. This treatment is free from adverse side-effects.

Recent studies have shown some natural therapies to be safe. Alpha-lipoic acid, an anti-oxidant found in many foods, is an effective remedy for relieving pain in peripheral neuropathy. Patients have shown appreciable improvement in health, by following techniques like yoga, meditation and deep-breathing.

If an early diagnosis of the symptoms of this disease is done, the complications can be avoided. Proper treatment given at the right time, can prevent permanent damage to the nerves.