Peripheral neuropathy is common, affecting at least 20 million people in the United States. Nearly 60% of all people with diabetes suffer from diabetic neuropathy. Peripheral neuropathy is a nerve disorder and may cause numbness, tingling, burning, pain, itching, cramping, and even weakness of the limbs or balance and gait difficulties. It will typically affect the feet first and then the hands. This is often called a “stocking-glove” pattern. Other body parts may also be affected. Most people who develop peripheral neuropathy are over the age of 55, but people can be affected at any age.
Peripheral neuropathy has many different sub-types and the causes of the disorder are extensive. The most common cause in America is diabetes. Other common causes are alcohol abuse, poor nutrition, autoimmune processes (where the bodies own immune system attacks the nerves), vasculitis (inflammation of nerves), and genetic causes. However, after an extensive evaluation, a specific cause cannot be found in up to a third of all cases. Direct pressure or compression of a single nerve, such as carpal tunnel syndrome, may cause the nerve to malfunction. Once a thorough evaluation is performed by a neurologist, electrical tests such as an EMG /NCV may be necessary to further characterize the neuropathic process.
Most types of peripheral neuropathy develop and progress slowly. But some types can come on quickly. Guillain-Barre syndrome (GBS) is a peripheral neuropathy in which the signs and symptoms appear suddenly and progress rapidly. In GBS, an autoimmune process attacks the covering of the nerves. The peripheral nerves are the ones that leave from the brainstem and spinal cord, and these nerves have the capacity to heal and regenerate. There are various effective treatments for GBS and fortunately patients often get substantially better.
Once an underlying disease can be identified (i.e. Diabetes), the treatment focus is often to treat the underlying condition. In autoimmune neuropathies, the treatment is directed on controlling the autoimmune process. There are effective treatments to control the symptoms of peripheral neuropathy. The burning and pain seen in neuropathy are very amenable to drug treatment. Treatments include but are not limited to antiepileptic medication, analgesics, antidepressants, capsaicin, and lidocaine.
If you would like to learn how to care for this disease or any other neurological condition, please call 609-653-9595 or 609-463-8009. My office is conveniently located at 4 Village Drive in Cape May Court House and 160 Shore Road in Somers Point. Please visit my website at www.stzorfas.com
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