Peripheral Neuropathy - Diabetes and Peripheral Neuropa...

Peripheral Neuropathy

Peripheral Neuropathy
Standiford Helm II, MD
MedicineNet

What is a peripheral neuropathy?

Peripheral neuropathy is disorder of nerve(s) apart from the brain and spinal cord. Patients with peripheral neuropathy may have tingling, numbness, unusual sensations, weakness, or burning pain.

What causes a peripheral neuropathy?

There are many possible causes of peripheral neuropathy, including:

1. Diabetes Mellitus

2. Shingles (post herpetic neuralgia)

3.

Vitamin deficiency, particularly B12 and folate

4. Alcohol

5. Autoimmune diseases, including lupus, rheumatoid arthritis or Guillain-Barre syndrome

6. AIDS, whether from the disease or its treatment, syphilis, and kidney failure

7. Inherited disorders, such as amyloid polyneuropathy or Charcot-Marie-Tooth disease

8. Exposure to toxins, such as heavy metals, gold compounds, lead, arsenic, mercury, and organophosphate pesticides

9. Cancer therapy drugs such as vincristine (Oncovin, Vincasar), and other medications [for example antibiotics such as metronidazole (Flagyl), and isoniazid (Nydrazid, Laniazid)]

While diabetes and post herpetic neuralgia are the most common causes of peripheral neuropathy, often times no cause is found. In these situations, it is referred to as idiopathic peripheral neuropathy.

Sometimes, peripheral nerve entrapments, such as carpal tunnel syndrome, are considered peripheral neuropathies. In these cases, pressure on the nerve rather than a disease state leads to nerve malfunction.

Is there any treatment for peripheral neuropathy?

The treatment for peripheral neuropathy depends on its cause. The first step in treatment is, therefore, to look for the cause.

* Vitamin deficiencies can be corrected.

* Diabetes can be controlled, although control may not reverse the neuropathy. The goal with diabetes is early detection to prevent the occurrence of neuropathy.

* Neuropathies that are associated with immune diseases can improve with treatment of the autoimmune disease.

* Neuropathy caused by nerve entrapment can be treated by physical therapy, injections or surgery.

* Prompt treatment with sympathetic injections can minimize the chance of shingles progressing to post herpetic neuralgia.

If a specific treatment isn't available, the pain of the neuropathy can usually be controlled with medications. The simplest treatment is acetaminophen, ibuprofen, or aspirin. Tricyclic antidepressants such as amitriptyline (Elavil) and anti-seizure medications, such as carbamazepine (Tegretol) have been used to relieve the pain of neuropathy. Capsaicin, the chemical responsible for chili peppers being hot, is used as a cream to help relieve the pain of a peripheral neuropathy. Pregabalin (Lyrica) has recently been approved by the FDA for the treatment of post herpetic neuralgia and diabetic peripheral neuropathy, while duloxetine (Cymbalta) has been approved for diabetic peripheral neuropathy. The addition of these drugs to our set of tools to treat peripheral neuropathy is very exciting and indicates the interest in this area.

If you believe you have a peripheral neuropathy, you should contact your healthcare practitioner since many causes of peripheral neuropathy can be successfully treated.


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* Peripheral Neuropathy Index
* Glossary


Peripheral Neuropathy (cont.)

In this Article

* What is a peripheral neuropathy?
* What causes a peripheral neuropathy?
* Is there any treatment for peripheral neuropathy?
* Peripheral Neuropathy At A Glance
* Peripheral Neuropathy Glossary
* Peripheral Neuropathy Index

Peripheral Neuropathy At A Glance

* There are many causes of peripheral neuropathy, including many drugs, diabetes, shingles, kidney failure, and vitamin deficiency.

* Many causes of peripheral neuropathy can be successfully treated or prevented.

* The treatment for a peripheral neuropathy depends on its cause.