By Dr.Manvir Bhatia & Saunri-18th January 2021

Peripheral Neuropathy (PNP)

Peripheral neuropathy is a term used for a group of conditions that cause damage to the peripheral nerves. It affects between 5 to 2400 per 10000 people in India. Peripheral Neuropathy can be of two types, axonal neuropathy or demyelinating neuropathy. Depending on the duration of the symptoms, it can be further divided into acute, subacute, and chronic neuropathy.

Common Symptoms

The symptoms of Peripheral Neuropathy depend on which nerves are affected.

Sensory nerves: Symptoms such as pain,  numbness, burning, and sensitivity in peripheral regions like the foot

Motor nerves: Symptoms such as weakness and atrophy of muscles, twitching of muscles, and paralysis

Autonomic nerves: Symptoms such as dry eyes and mouth, constipation, loss of bladder control, sexual dysfunction, excessive sweating, etc.

What are the common causes?

Metabolic conditions

•          Diabetes mellitus is the most common cause of peripheral neuropathy worldwide. High blood sugar levels weaken the walls of the capillaries that supply the nerves of oxygen and deplete them of nutrients` thus damaging the nerves.

•          Chronic Kidney Disease (CKD) has been found to cause 65% of the cases of Peripheral Neuropathy in Andhra Pradesh.

Hereditary disorders

•          Charcot-Marie-Tooth disease (CMT) causes hereditary motor sensory neuropathy due to mutations in the genes involved in neuron and myelin sheath structure and function.

•          Hereditary sensory neuropathy (HSAN), hereditary motor neuropathies (HMN), and small-fiber neuropathies (SFN) also cause peripheral neuropathy.

Exposure to toxins

•          Arsenic exposure may occur due to drinking water contamination, and work-related activities such as mining.

•          Lead exposure may occur from consumption of illicit whiskey, lead-containing food, herbal medications, and even food contaminated by ceramic glaze in dishes.

Immune-mediated conditions

•          Guillain-Barre syndrome also called   Acute Inflammatory Demyelinating Polyneuropathy or AIDP is an autoimmune condition in which the immune system attacks the myelin sheath covering the peripheral nerves.

•          Chronic Inflammatory demyelinating polyneuropathy is an autoimmune condition that occurs slowly and increases progressively.

Treatment

Immune-mediated neuropathies such as GBS and CIDP are treated with the help of corticosteroids, immunosuppressants. A procedure called plasmapheresis is also performed as a temporary solution. IVIg can also be injected. Tricyclic compound drugs, anticonvulsants, some creams that contain capsaicin may be given.

It is important to acknowledge and report the symptoms of any of these neuropathies and report immediately to a doctor. The doctor may perform nerve conduction studies to give a definitive diagnosis. Early-stage treatment may help to reduce the damage or slow down the progression of peripheral neuropathy.

To seek help or know more about peripheral neuropathies you can visit the Neurology and Sleep Centre, the 1st sleep centre in the country accredited by the Indian Board of Sleep Medicine at L-23, Hauz Khas Enclave, New Delhi, Delhi-110016 (INDIA)

Or give a call on +91-11-46070321, +91-9643500270,

Finding the cause of Peripheral Neuropathy and treating it can reduce pain, numbness, burning symptoms.

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