What is peripheral neuropathy?
This is a disorder of the peripheral nerve. These are responsible to carry out sensations of pain, hot or cold, pin-prick,, and local touch to the brain specifically from the palms and soles to the brain. They also maintain the strength of our muscles. Any inflammation, compression, or effects of certain drugs, and antibodies against these nerve cells can cause peripheral neuropathy.
What are the main symptoms?
Burning sensations or sensations of pins and needles which are generally more pronounced at night or when resting is the main symptom. In later stages, the sensation may become less and in fact there may be no sensations at all. Weakness of certain muscle groups of hands and feet may impair activities of daily living. Generally, the symptoms begin in the lower extremities.
When multiple individual nerves are clinically affected then what is the possible diagnosis?
This is mono neuropathy multiplex. This may be in bilateral compression of nerves at the wrists. But more often an internal disorder is responsible. This includes Diabetes, Hypothyroidism, and some vasculitis-associated disorders. Certain autoimmune disorders like Rheumatoid arthritis, SLE, Polyarthritis nodosa, and myeloma may be responsible.
What are the bask investigations necessary to diagnose the cause of peripheral neuropathy?
Please check for your Complete Blood Count, Blood glucose levels, B 12 levels, kidney and liver functions, and tests for myeloma and autoimmune
disorders, and HIV tests. The tests are guided by the clinical presentation and clinical assessment by your doctor. All tests are not required in every individual with peripheral neuropathy.
How is the diagnosis confirmed?
The diagnosis of peripheral neuropathy is generally done by your symptoms and phys – Burning sensation at palms and soles due to peripheral neuropathy. This is caused by many disorders. Carpel tunnel disorder, diabetes, vitamin deficiency, chronic alcoholism, side effects of certain drugs, autoimmune diseases, and certain genetic disorders are commonly associated with peripheral neuropathy. ical assessment by your doe-ton Nerve Conduction Velocity and Electromyography is done to confirm the diagnosis. NCS and EMG also help to categorize neuropathy and may predict response to treatment.
What is the approach if you have peripheral neuropathy caused by diabetes?
Attaining good control over blood glucose is the first step. Controlling blood pressure, and cholesterol levels and avoiding tobacco in any form is the second step. Certain medications like pregabalin, gabapentin, am amitriptyline may help. Small fibre neuropathy is a distressing feature of diabetes-induced peripheral neuropathy
What about B 12 deficiency and neuropathy?
This disorder is gaining more attention because of its increased frequency. This deficiency is observed in pure vegetarians. This may be associated with ulcers in the mouth and low haemoglobin. Few individuals may have darkened complexion. Correction by B 12 injections is recommended. A maintenance dose every 3 months on lifelong basis is required in most cases.
Do burning sensations at the palms that occur more at night disturbs your sleep?
This is generally diagnosed as Carpel Tunnel Syndrome. This is due to compression of nerves at the wrists. These nerves enter the palms through small tunnels at the wrist. Pregnancy, low thyroid hormone levels, and repeated trauma at the wrists are some important causes. Certain medications, local steroid injections at the wrist and de-compression surgery help. The diagnosis is confirmed by NCS and EMG.
Can peripheral neuropathy be associated with cancer?
In certain cancers, these symptoms may occur. Drugs used in chemotherapy may also be responsible. Peripheral neuropathy may be the first symptom of multiple myeloma. Importantly, the symptoms of peripheral neuropathy may come much before the diagnosis of cancer. Burning sensations in palms and soles can be caused by many disorders. Diagnosis of the underlying cause is important. Most of them can be effectively treated. Few like diabetes and cancer associated neuropathy are difficult to treat.
