Neuropathy refers to a number of diseases of the peripheral nervous system. However, disorders of the central nervous system such as vegetative dysfunctions also come under this name. Sometimes the neuropathy is the result of other diseases such as diabetes or the consequence of using neurotoxic substances such as alcohol or medication.
What is neuropathy?
Concerning the etiology of the primary neuropathies: The primary neuropathies arising from the nerves themselves are usually inherited. The primary neuropathies include hereditary motor-sensory neuropathies (affecting motor function), hereditary sensory neuropathies, hereditary sensory-autonomic neuropathy (disorders of the sense of pain and temperature), hereditary motor neuropathies and hereditary neuropathies with a tendency to pressure lesions. See nonprofitdictionary for Multiple Personality Disorder (abbreviated as MPD).
The etiology of secondary neuropathies: These include inflammatory diseases, autoimmune diseases, e.g. Guillain-Barré syndrome (the immune system attacks the body, especially the nerves), metabolic diseases (metabolic disorders of the nervous system) and the consequences of Intake of neurotoxic substances (such as benzene, phenol, drugs, alcohol, or chemotherapy drugs).
The causes: The nervous system is divided into the central nervous system (brain and spinal cord) and the peripheral nervous system (these are the nerves from the spinal cord to the corresponding organs to be supplied).
The main task of the nerves is to transmit motor impulses sent out by the brain – for example as movement of a muscle or information and sensations to the brain. Nerve damage such as in neuropathy leads to disorders of these functions. The causes are manifold and range from circulatory disorders, inflammation, poisoning to diseased genetic material or metabolic disorders.
Diabetes can also trigger neuropathy: Due to the higher blood sugar level, the walls of the veins thicken, which enrich the peripheral nerves in the arms and legs with blood – this leads to circulatory disorders in the nerve fibers. Other causes of neuropathies are hyperthyroidism and hypothyroidism, liver disease, acromegaly, neuritis, and malnutrition.
Symptoms, Ailments & Signs
The symptoms that neuropathies cause depend on the underlying disease and the nerves affected. Symptoms often vary in type, intensity, and frequency. Peripheral neuropathies mainly lead to nerve damage in the arms, legs, hands and feet.
Nerve pain is very distressing for those affected. It is described as stabbing, burning, tingling, shooting or radiating. It tends to occur spontaneously at rest and often subsides with activity. Sensory disturbances are perceived as disturbing. The skin feels furry to numb.
The recognition of touch and temperature as well as the sense of touch can be impaired. Some patients report muscle weakness or cramps. Paralysis sometimes occurs, leading to unsteady gait and balance disorders.
Autonomic neuropathies cause symptoms in bodily functions that cannot be consciously controlled. Circulatory and heart rhythm changes can occur. The functions of the entire digestive system can be disturbed. Discomfort in the urinary and genital organs is also possible. Excessive perspiration promotes dry, cracked skin in the area of the feet and lower legs. Water retention sometimes occurs.
The primary neuropathies are congenital and inherited. They are rare and appear before the age of twenty. Possible signs include movement or sensory disturbances and pain. Disorders of internal organs, as well as the absence of pain sensations, are less common.
Diagnosis & History
Diagnosis and course: Following the anamnesis, a clinical examination is carried out by the neurologist. The patient’s neurological status is assessed. This is followed by a detailed anamnesis.
Reflexes, coordination, motor skills and sensitivity are tested. An electromyography, in which an examination of the muscles takes place, allows one to find out more about the peripheral paralysis.
With this method you can differentiate between muscle atrophy caused by nerves and your own muscle diseases. Electroneurography can also be informative. The course of the disease and the duration of the diseases vary and are difficult to predict.
Like the causes of neuropathy, its effects can also vary. Often, addressing the underlying cause is enough to restore nerve function. However, this is not always possible. This is the case when the nerve cells have already been irrevocably destroyed. In these cases, discomfort and numbness persist.
However, since neuropathy can affect any organ, the nature of the complications that arise often depends on the organ affected. In addition to cardiac arrhythmias, stool or urinary incontinence can also occur as a complication. A well-known complication of a neuropathy is the so-called diabetic foot. Diabetic polyneuropathy is the main problem in the diabetic foot.
It impairs the care of the foot, so that the slightest injury can result in massive wound healing problems. Initially, the polyneuropathy causes muscle paralysis in the foot muscles, which causes incorrect foot posture. The bony foundation of the metatarsal sinks constantly due to incorrect loading. First, larger corneal layers develop, which lead to tears in the skin over time.
However, these wounds are often not noticed by those affected because they do not feel any pain due to the restricted nerve functions. Poorly healing wounds can then develop unnoticed, which in the long term sometimes even lead to necrosis of the foot. In extreme cases, the affected foot may even have to be amputated.
When should you go to the doctor?
If pain in the limbs and muscles, calf cramps or abnormal sensations occur, neuropathy may be the cause. Medical advice is needed if these symptoms persist over a long period of time or become rapidly more severe. If no clear cause can be assigned to the symptoms, a doctor must be consulted. Twitching or abnormal sensations indicate an advanced neuropathy and should be clarified quickly. If in doubt, the sick person must be taken to a hospital, where a physical examination is carried out and the condition is diagnosed and treated.
Risk groups include people with chronic infections, kidney damage or long-term nutrient deficiencies. Diabetes mellitus patients and people who suffer from a tumor or have come into contact with a neurotoxin must also speak to the responsible doctor if they have the symptoms mentioned. In addition to the family doctor, the neuropathy is treated by various internists as well as dermatologists, nephrologists and other specialists. Serious illnesses always require inpatient therapy in a specialist clinic.
Treatment & Therapy
On the therapy of neuropathies: Depending on the pattern of infestation, a distinction is made between mononeuropathy, polyneuropathy, autonomic neuropathy, mononeuritis multiplex and radical neuropathies. And the therapy depends on the infestation pattern, the underlying disease.
In the case of congenital neuropathies, only symptomatic therapy is possible. If a bacterial infection is the cause, antibiotic therapy is used. Toxic poisons can heal if omitted. Natural healing methods, homeopathic and alternative medical methods such as magnetic field therapy or acupuncture can also help. If the neuropathy is metabolic, such as due to diabetes, controlling blood sugar levels with medication can help.
Advanced neuropathies can usually no longer be completely reversed, but can be suppressed well with painkillers, which are also effective against depression or epilepsy. Smoking and alcohol should be avoided at all costs.
If paralysis with muscle atrophy occurs, physiotherapy with light strength training is a treatment method. Malpositions of the joints should be avoided. A careful massage and breathing training can also help a lot.
In an advanced stage of the disease, patients must consult their doctor about which aids, such as orthopedic shoes, walkers or wheelchairs, should be used. In severe cases, patients may be bedridden. Then a nursing service is to be commissioned.
Outlook & Forecast
The prognosis of neuropathy depends on the underlying causes of the health disorder. In the case of a congenital disease, there is no prospect of a cure. In medical care, the individually pronounced symptoms are treated in the best possible way. The best long-term success is achieved when therapy is started as early as possible. Nevertheless, there is a relapse as soon as the initiated medical measures are discontinued.
If the cause of the neuropathy is bacterial, the pathogens are administered medication to try to prevent them from spreading and kill them. The organism can then independently transport and excrete the germs. There is a gradual improvement in the health situation until freedom from symptoms can be documented.
In many patients, an alleviation of the symptoms can also be observed through the use of alternative healing methods. In the field of naturopathic treatment, there are various approaches that have proven themselves in the past. However, this is to be assessed on the basis of the overall situation at hand.
If the causes of the disorder can be traced back to an irregularity in the metabolism, drug treatment can lead to a significant improvement in health. In addition, the way of life should be optimized so that complaints are reduced. If the neuropathy is severe, the person affected needs daily care and support in coping with everyday life.
Prophylaxis: What has a preventive effect is moderate exercise, a healthy diet and controlling blood sugar if this is necessary due to a pathological change. Especially if a family disposition is recognizable, one should be careful with nerve toxins such as alcohol and medication. Diabetes patients must be particularly careful and check their blood sugar levels immediately.
In most cases, those affected with neuropathy have only very few and usually only very limited aftercare measures available. For this reason, the affected person should consult a doctor at an early stage in order to prevent and also limit the occurrence of other complications. The sooner a doctor is contacted, the better the further course of the disease.
Therefore, a doctor should be consulted at the first symptoms and signs of this disease. Most patients with this disease are dependent on taking various medications to permanently relieve the symptoms. The person concerned should always ensure that the medication is taken regularly and also on the prescribed dosage.
In the event of side effects or if anything is unclear, a doctor should be consulted first. Physiotherapy measures are often necessary to alleviate the symptoms. Many of the exercises can also be carried out at home, which could speed up the treatment. The person concerned should avoid alcohol and smoking as much as possible. Life expectancy may also be limited due to the neuropathy.
You can do that yourself
The causes of nerve damage are extremely varied. The most effective form of self-help here is a mindful, healthy lifestyle. Everything that literally “gets on your nerves” should be avoided. These include in particular smoking and excessive consumption of alcohol.
There are alternatives to drug pain therapy. Impressive results were achieved with electrical, transcutaneous stimulation of the nerves (TENS). Blood sugar and blood pressure values must be checked regularly, as optimal adjustment is extremely important in polyneuropathy. It may also be possible to reduce this naturally through a diet. Diabetics are advised to have their feet professionally cared for regularly – and to examine their feet themselves with a small mirror every day. Anyone who suffers from the “multi-nervous disease” should wear good walking shoes that have a good footbed and protect against injuries.
Sports that put a strain on the feet, such as running, jogging or playing tennis, are not recommended. More appropriate sports for all patients with neuropathy are cycling or swimming. Because of the prevalence of neuropathy, there are many support groups for patients to seek advice and support.