Peripheral Neuropathy: Stroke-Free But Why?

Peripheral neuropathy is a medical condition that affects the nerves outside of the brain and spinal cord. It can cause pain, numbness, and weakness, usually in the hands and feet, but it can also impact other areas of the body and functions such as digestion and blood pressure control. Peripheral neuropathy can occur without a stroke, as it has a wide range of causes, including trauma, infections, vitamin deficiencies, autoimmune diseases, and toxins. However, it is important to note that in some cases, a stroke can lead to central neuropathy, a type of nerve pain that stems from damage to the central nervous system, which includes the brain.

Peripheral neuropathy can be caused by trauma, infections, or inherited conditions

Peripheral neuropathy is an umbrella term for any condition, disease or disorder that affects your peripheral nerves—that is, all the nerves outside of your spinal cord and brain. Peripheral neuropathy can be caused by trauma, infections, or inherited conditions.

Trauma or injury to the nerves can cause peripheral neuropathy. This can be caused by swelling or stretching, and the damage is usually only in one location. Peripheral neuropathy can also be caused by a stroke, which is a serious, life-changing injury that can result in a wide variety of secondary effects, including nerve pain. Peripheral neuropathy can also be caused by a traumatic brain injury or spinal cord injury.

Infections can also cause peripheral neuropathy. For example, nerve damage from infections can be caused by viruses such as HIV or bacteria such as Borrelia burgdorferi, which causes Lyme disease. Shingles can also lead to peripheral neuropathy and lingering nerve pain.

Peripheral neuropathy can also be caused by inherited conditions. Hereditary neuropathies are passed on genetically from parent to child. Charcot-Marie-Tooth (CMT) disease is one of the most common types of hereditary neuropathies, affecting the motor and sensory nerves. CMT type 1A (CMT1A) is the most common form, affecting around 20% of people who seek medical treatment for symptoms caused by an undiagnosed peripheral neuropathy. Hereditary neuropathy with liability to pressure palsies (HNPP) is another type of hereditary neuropathy, causing extreme sensitivity to pressure.

It can be treated with medication, surgery, physical therapy, or devices and equipment

Peripheral neuropathy can be treated with medication, surgery, physical therapy, or devices and equipment.

Medication

Peripheral neuropathy can be treated with medication, including pain medication, anticonvulsants, topical pain relievers, and antidepressants. Over-the-counter pain medication may help with mild symptoms, while prescription pain medication may be necessary for more severe pain. Anticonvulsants such as gabapentin and pregabalin, which are typically used to treat seizures, can also be used to relieve nerve pain. Topical pain relievers, such as Lidocaine patches or pain relief creams, can be applied to the skin to numb the affected area and provide temporary pain relief. Antidepressants, specifically tricyclic antidepressants, have also been found to help relieve neuropathic pain.

Surgery

In some cases, peripheral neuropathy may require surgery. For example, nerve transection or compression may be addressed through surgical re-anastomosis or nerve decompression, respectively.

Physical Therapy

Physical therapy can help reduce the symptoms of peripheral neuropathy and improve a person's quality of life. Specific exercise programs can help alleviate pain, improve physical well-being, and aid in the recovery of damaged nerves. These exercises may include aerobic exercises, flexibility training, strengthening exercises, and balance exercises. It is important for individuals to work with a physical therapist, specifically a neurological physical therapist, to develop an individualized exercise program that suits their specific needs.

Devices and Equipment

Mechanical aids and assistive devices can help reduce pain and lessen the impact of physical disability and muscle weakness caused by peripheral neuropathy. These devices can aid in maintaining independence and safety. Examples of assistive devices include bath chairs, LED shower water thermometers, compression stockings, orthopedic shoes, long-handled bath tools, handrails, and canes.

It can affect the hands, feet, legs, arms, face, and internal organs

Peripheral neuropathy is an umbrella term for nerve diseases that affect a specific subdivision of your nervous system. It can affect nerves anywhere in your body, including the hands, feet, legs, arms, face, and internal organs.

The peripheral nervous system is a large communications network that sends signals between the central nervous system (CNS)—the brain and spinal cord—and all other parts of the body. Peripheral neuropathy affects millions of people in the U.S. and can cause a range of symptoms, from mild to severe.

There are over 100 types of peripheral neuropathy, each with its own causes and symptoms. The condition can affect a single nerve, a connected group of related nerves, or many nerves in multiple places throughout the body. It can disrupt the body's control of automatic processes, as well as the sense of touch and muscle control.

The types of nerves that can be affected by peripheral neuropathy include:

• Motor nerves: Control the movement of all muscles we consciously control, such as those used for walking, grasping things, or talking.
• Sensory nerves: Transmit information such as the feeling of a light touch, temperature, or pain from a cut.
• Autonomic nerves: Control muscle and organ function we don't consciously think about, such as breathing, digestion, heartbeat, and the function of glands.

Symptoms of peripheral neuropathy can include:

• Muscle weakness and paralysis.
• Muscle atrophy (shrinkage).
• Uncontrolled muscle movements or cramps.
• Tingling.
• Numbness.
• Imbalance and clumsiness.
• Pain.
• Blood pressure changes.
• Excessive or insufficient sweating.
• Bowel and bladder problems.
• Sexual dysfunction.
• Skin colour changes, swelling, changes in pupil size, and blurry vision.

Peripheral neuropathy can be caused by various factors, including:

• Type 2 diabetes.
• Alcohol use disorder.
• Vitamin and nutrient deficiencies (especially copper, and vitamins B1, B6, B9, B12, folic acid, and E).
• Autoimmune and inflammatory conditions, such as lupus, rheumatoid arthritis, and Guillain-Barré syndrome.
• Medications and toxins, including chemotherapy drugs, antibiotics, and certain heavy metals and industrial chemicals.
• Tumours, both malignant and benign.
• Genetic conditions, such as amyloidosis, Fabry disease, and Charcot-Marie-Tooth disease.
• Infections, including viruses (e.g., HIV, Lyme disease) and bacteria (e.g., Borrelia burgdorferi, which causes Lyme disease).
• Trauma and surgery, including injuries and damage directly to nerves.
• Vascular disorders (circulation-related problems), such as lack of blood flow.
• Idiopathic neuropathy, where the cause is unknown.

Treatment for peripheral neuropathy depends on the underlying cause and can include medications, surgery, physical therapy, devices and wearable equipment, podiatry and foot care, and other pain treatments.

It can cause muscle weakness, paralysis, atrophy, and uncontrolled muscle movements

Peripheral neuropathy can cause muscle weakness, paralysis, atrophy, and uncontrolled muscle movements. These motor symptoms are caused by nerve deterioration, which weakens the connected muscles and disrupts the body's control of automatic processes.

Nerve deterioration from peripheral neuropathy can lead to muscle weakness and paralysis. This can cause difficulty in moving the toes, foot drop, and hand weakness. The weakness may also extend to the thighs, arms, and other parts of the body.

Peripheral neuropathy can also result in muscle atrophy, where the loss of nerve connection causes muscles to shrink in size and weaken. This commonly occurs in the feet, lower legs, and hands, sometimes leading to deformities in these areas.

In some cases, peripheral neuropathy may cause uncontrolled muscle movements, as the nerves that lose their connection to the brain become hyperactive and cause cramps.

Peripheral neuropathy refers to any condition affecting the nerves outside the brain or spinal cord. It can develop due to various reasons, such as trauma, infections, or inherited conditions. The symptoms and treatment options for peripheral neuropathy depend on its underlying causes and the specific nerves affected.

It can be caused by type 2 diabetes, alcohol use disorder, vitamin deficiencies, and autoimmune conditions

Peripheral neuropathy can be caused by several factors, including type 2 diabetes, alcohol use disorder, vitamin deficiencies, and autoimmune conditions.

Type 2 diabetes can lead to nerve damage, known as diabetic neuropathy, which is a serious and potentially painful complication. High blood sugar can injure nerves throughout the body, and diabetic neuropathy often affects the legs, feet, hands, digestive system, urinary tract, blood vessels, and heart. Diabetic neuropathy can cause numbness, tingling, sharp pains, extreme sensitivity to touch, and serious foot problems, such as ulcers, infections, and bone and joint damage. Consistent blood sugar management and a healthy lifestyle can help prevent or slow the progression of diabetic neuropathy.

Alcohol use disorder (AUD) is also a contributing factor to peripheral neuropathy. Alcoholic neuropathy results from excessive alcohol consumption, damaging nerve tissue and causing pain, tingling, and numbness in the limbs. According to research, up to 66% of people with AUD experience some form of alcohol-related neuropathy. Abstaining from alcohol and seeking treatment for AUD can help improve symptoms and prevent further nerve damage, although some alcohol-induced nerve damage may be permanent.

Vitamin deficiencies, particularly deficiencies in vitamins B1, B6, B12, E, and copper, can also lead to peripheral neuropathy. These deficiencies can impact the nervous system and cause sensory and motor dysfunction. Correcting vitamin deficiencies through dietary changes, supplements, and, in some cases, parenteral supplementation can help manage peripheral neuropathy.

Additionally, autoimmune diseases, such as Sjogren's syndrome, lupus, and rheumatoid arthritis, can cause peripheral neuropathy. In these cases, the immune system attacks the body's own tissues, leading to nerve damage. Symptoms can include numbness, tingling, pricking sensations, muscle weakness, and, in severe cases, burning pain, muscle wasting, paralysis, or organ dysfunction. Most people recover from autoimmune-related peripheral neuropathy, but severe cases can be life-threatening.

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