Peripheral Neuropathy is not a disease per se but a complication of certain disorders or injuries. Although there are few cases where it is debilitating, the condition is reversible, most especially if the underlying cause is highly treatable. However, awareness is still very important for early detection.
This condition occurs when there is damage to the nerves which may cause delay or even disruption of command from the brain to the periphery. Nerves are vital components of the nervous system. They are not only capable of receiving information but they can also transmit impulses to command specific organs. When there is damage to the nerves, serious physiological symptoms will surface.
Causes and Pathophysiology
Peripheral Neuropathy is often associated with Diabetes Mellitus. There are two theories that can explain why it occurs in people with diabetes.
Like any other body part, nerves also require sufficient blood supply to obtain enough nutrients and oxygen. Normally, your body transforms carbohydrates from the food you eat into a substance called glucose. It serves as the primary fuel of the body for nourishment and energy. Before glucose can enter the cells, it has to bind first with insulin. With Diabetes Mellitus, beta cells in the pancreas do not produce enough insulin, thus causing glucose to accumulate in the bloodstream. Blood becomes viscous and circulation slows down greatly . As a result, nerves located in the extremities are not supplied with enough blood and peripheral neuropathy develops over time.
Another explanation is related to the sugar alcohol called sorbitol. An enzyme called aldose reductase converts glucose into sorbitol. This process normally happens to everyone, but with diabetic patients, it occurs more rapidly. This sugar molecule is of no use to the body and is also difficult to eliminate. Over time, sorbitol builds up in the body and it depletes essential nutrients such as vitamins and minerals. Excess of this sugar also attracts water inside the cells, causing them to swell. This causes direct damage to the nerves, thus causing peripheral neuropathy.
Other causes of peripheral neuropathy include infections, autoimmune disorders, and systemic diseases. Conditions under these categories affect the entire body. Viruses and bacteria from infections attack nerves directly, causing damage. Physical injuries such as automobile and sports-related accidents and falls can also cause trauma which can compress, tear or completely detach a nerve from its location.
Procedures like chemotherapy or those that use radioactive energy can also cause harm to the nerves.
Symptoms vary from person to person depending on what type of peripheral nerve is damaged. Damage to the sensory nerves will affect sensation; for motor nerves, the movement of muscles; and for autonomic nerves, the function of body organs. Most symptoms start with mild pain but can later progress into a more severe type of pain unless medical attention is given.
The following are the common symptoms:
- Burning, Pricking, and Tickling pain – caused by nerve compression
- Numbness or inability to feel pain and touch in the upper and lower extremities – interpretation of sensory perception is disrupted due to sensory nerve damage.
Muscle weakness and wasting – nerve damage disrupts the relay of action potentials which is responsible for creating muscle contractions. As a result, muscles will atrophy.
Loss of balance and coordination – a result of motor nerve damage
Loss of Bladder Control/Urinary incontinence
Alternating Constipation and Diarrhea – related to intestinal/digestive tract nerve damage.
There are several tests for peripheral neuropathy. But before undergoing a lot of tests, your doctor will begin by obtaining a complete medical history which includes your lifestyle and existing diseases. He/she will also conduct a thorough neurological examination that includes testing tendon reflexes, the ability to recognize sensations, and the assessment of muscle strength.
After a cephalocaudal assessment, your doctor will then proceed with diagnostic tests.
The occurrence of peripheral neuropathy can be prevented. The first step is to manage underlying conditions that will predispose you to have peripheral neuropathy. If you have diabetes mellitus, then try controlling your blood sugar levels. Avoiding things that will put you at risk is also very important. Excessive alcohol intake and the use of tobacco are just a few things that you have to stay away from. Lastly, you have to start living a healthier lifestyle. A sedentary lifestyle will not help you get any better, you have to exercise regularly to improve circulation.