Why does neuropathy spread

Even if you already have some form of peripheral neuropathy, healthy lifestyle steps can help you feel your best and reduce the pain and symptoms related to the disorder. In some cases, non-prescription hand and foot braces can help you make up for muscle weakness. Orthotics can help you walk better. Relaxation techniques, such as yoga, may help ease emotional as well as physical symptoms. Want to boost your overall health with diabetes? A Johns Hopkins expert offers healthy strategies to help you control your blood sugar, protect your heart and more.

Johns Hopkins researchers find that common preservative may thwart pain and damage of peripheral neuropathy. Health Home Conditions and Diseases. Peripheral Neuropathy Causes Peripheral neuropathy has many different causes. Peripheral Neuropathy Types There are more than types of peripheral neuropathy, each with its own set of symptoms and prognosis. To help doctors classify them, they are often broken down into the following categories: Motor neuropathy.

Peripheral Neuropathy Symptoms The symptoms of peripheral neuropathy vary based on the type that you have and what part of the body is affected. Muscle weakness Cramps Muscle twitching Loss of muscle and bone Changes in skin, hair, or nails Numbness Loss of sensation or feeling in body parts Loss of balance or other functions as a side effect of the loss of feeling in the legs, arms, or other body parts Emotional disturbances Sleep disruptions Loss of pain or sensation that can put you at risk, such as not feeling an impending heart attack or limb pain Inability to sweat properly, leading to heat intolerance Loss of bladder control, leading to infection or incontinence Dizziness, lightheadedness, or fainting because of a loss of control over blood pressure Diarrhea, constipation, or incontinence related to nerve damage in the intestines or digestive tract Trouble eating or swallowing Life-threatening symptoms, such as difficulty breathing or irregular heartbeat The symptoms of peripheral neuropathy may look like other conditions or medical problems.

Peripheral Neuropathy Diagnosis The symptoms and body parts affected by peripheral neuropathy are so varied that it may be hard to make a diagnosis. These may include: Blood tests Spinal fluid tests Muscle strength tests Tests of the ability to detect vibrations Depending on what basic tests reveal, your healthcare provider may want to do more in-depth scanning and other tests to get a better look at your nerve damage.

William Loughran retired from his job as a bank director in northeast Maryland in , when he was Like many new retirees, he vowed to ramp up his exercise routine. For months, he spent almost all of his time at home, in bare feet. Loughran had developed peripheral neuropathy, a condition shared by hundreds of thousands of Americans. Peripheral neuropathy often begins with damage to the unmyelinated small-fiber nerves, resulting in numbness, tingling and lightninglike shooting pains, most commonly in the feet and hands.

The best-known causes of peripheral neuropathy are type 2 diabetes and chemotherapy, but there are several other potential culprits. Roughly one-fifth of peripheral neuropathy cases have no clear cause at all. After several false starts with physical therapists, podiatrists and other specialists, Loughran realized that he needed to see a neurologist. He searched online and learned that Johns Hopkins has a prominent research program in peripheral neuropathy.

In early , Loughran found himself in the Johns Hopkins office of Mohammad Khoshnoodi , an assistant professor of neurology.

Here at last he received a thorough workup. And he took three skin biopsies from my leg. But if that was what was required, he was game. The technique of using skin biopsies to assess peripheral neuropathy was pioneered at Johns Hopkins in the early s by Justin McArthur , who now chairs the Department of Neurology, and the late John Griffin , one of the best-known neurologists in Johns Hopkins history.

A major advantage of these biopsies is that they permit objective, quantifiable measurement of nerve damage. Sequential skin biopsies have become an increasingly powerful tool for uncovering the mysteries of neuropathy. The study considered skin biopsies that were taken sequentially from 52 patients with neuropathy at Johns Hopkins between and , along with biopsies from 10 healthy volunteers for purposes of comparison.

The sequential skin biopsy study should be a wake-up call, he says. Left unattended, Polydefkis says, peripheral neuropathy can advance to more severe kinds of neurological dysfunction, including problems with balance, blood pressure regulation and difficulties in walking.

In this study, 14 of 52 patients with small-fiber neuropathy progressed to mild large-fiber neuropathy, meaning that their ankle reflexes were reduced and they were less sensitive to the vibrations of a tuning fork. Such problems are often a prelude to more severe deficits in motion and sensation. Though Loughran arrived at Johns Hopkins too late to take part in that particular sequential skin biopsy study, the three specimens taken from his ankle confirmed that his skin had a significantly reduced density of small-fiber nerves—the classic sign of small-fiber peripheral neuropathy.

Surgery is the recommended treatment for some types of neuropathies. Trigeminal neuralgia on the face is also often treated with neurosurgical decompression. Injuries to a single nerve mononeuropathy caused by compression, entrapment, or rarely tumors or infections may require surgery to release the nerve compression. Polyneuropathies that involve more diffuse nerve damage, such as diabetic neuropathy, are not helped by surgical intervention.

More sophisticated and less damaging procedures such as electrically stimulating remaining peripheral nerve fibers or pain-processing areas of the spinal cord or brain have largely replaced these surgeries. Transcutaneous electrical nerve stimulation TENS is a noninvasive intervention used for pain relief in a range of conditions. TENS involves attaching electrodes to the skin at the site of pain or near associated nerves and then administering a gentle electrical current.

Although data from controlled clinical trials are not available to broadly establish its efficacy for peripheral neuropathies, in some studies TENS has been shown to improve neuropathic symptoms associated with diabetes.

The best treatment is prevention, and strategies for reducing injuries are highly effective and well tested. Since medical procedures ranging from casting fractures to injuries from needles and surgery are another cause, unnecessary procedures should be avoided.

The new adjuvanted vaccine against shingles prevents more than 95 percent of cases and is widely recommended for people over 50, including those who have had previous shingles or vaccination with the older, less effective vaccine. Diabetes and some other diseases are common preventable causes of neuropathy. People with neuropathy should ask their doctors to minimize use of medications that are known to cause or worsen neuropathy where alternatives exist.

Some families with very severe genetic neuropathies use in vitro fertilization to prevent transmission to future generations. The mission of the National Institute of Neurological Disorders and Stroke NINDS is to seek knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease.

NINDS-funded research ranges from clinical studies of the genetics and the natural history of hereditary neuropathies to discoveries of new cause and treatments for neuropathy, to basic science investigations of the biological mechanisms responsible for chronic neuropathic pain. Together, these diverse research areas will advance the development of new therapeutic and preventive strategies for peripheral neuropathies.

Understanding the causes of neuropathy provides the foundation for finding effective prevention and treatment strategies. Genetic mutations have been identified in more than 80 distinct hereditary neuropathies. NINDS supports studies to understand the disease mechanisms of these conditions and to identify other genetic defects that may play roles in causing or modifying the course of disease.

The Inherited Neuropathies Consortium INC —a group of academic medical centers, patient support organizations, and clinical research resources dedicated to conducting clinical research in Charcot-Marie-Tooth disease and improving the care of people with the disease—seeks to better characterize the natural history of several different forms of neuropathy and to identify genes that modify clinical features in these disorders. Knowing which genes are mutated, and what their normal function is, permits precise diagnosis and leads to new therapies that prevent or reduce nerve damage.

INC is also developing and testing biomarkers signs that can indicate the diagnosis or progression of a disease and clinical outcome measures that will be needed in future clinical trials to determine whether individuals respond to candidate treatments.

Rapid communication between the peripheral nervous system and the central nervous system often depends on myelination, a process through which special cells called Schwann cells create an insulating coating around axons. Several NINDS-funded studies focus on understanding how myelin protein and membrane production and maintenance in Schwann cells is regulated and how mutations in genes involved in these processes cause peripheral neuropathies.

Schwann cells play a critical role in the regeneration of nerve cell axons in the peripheral nervous system. By better understanding myelination and Schwann cell function, researchers hope to find targets for new therapies to treat or prevent nerve damage associated with neuropathy. Other efforts focus on immune system peripheral nerve damage. NINDS-supported researchers hope to better understand how antibodies to cell membrane components cause peripheral nerve damage and how the effects of these antibodies can be blocked.

NINDS research has helped discover that some types of small-fiber polyneuropathy appear to be immune-caused, particularly in women and children. Talk therapy may help you better understand how your pain is affecting your life. It can also help you learn ways to better cope with pain. Taking medicine, sleeping with your head raised, and wearing elastic stockings may help with low blood pressure and fainting.

Your provider may give you medicines to help with bowel movement problems. Eating small, frequent meals may help. To help bladder problems, your provider may suggest that you:.

More information and support for people with peripheral neuropathy and their families can be found at:. Some nerve-related problems do not interfere with daily life. Others get worse quickly and may lead to long-term, severe symptoms and problems.

When a medical condition can be found and treated, your outlook may be excellent. But sometimes, nerve damage can be permanent, even if the cause is treated. Long-term chronic pain can be a major problem for some people. Numbness in the feet can lead to skin sores that do not heal. In rare cases, numbness in the feet may lead to amputation. Call your provider if you have symptoms of nerve damage. Early treatment increases the chance of controlling symptoms and preventing more problems.

Peripheral neuritis; Neuropathy - peripheral; Neuritis - peripheral; Nerve disease; Polyneuropathy; Chronic pain - peripheral neuropathy. Katirji B. Disorders of peripheral nerves. Bradley's Neurology in Clinical Practice.

Philadelphia, PA: Elsevier; chap Smith G, Shy ME. Peripheral neuropathies. Goldman-Cecil Medicine. Updated by: Amit M. Review provided by VeriMed Healthcare Network. Editorial team. Peripheral neuropathy. Numbness may make it harder to tell where your feet are moving and can cause a loss of balance. Men may have problems with erections. Women may have trouble with vaginal dryness or orgasm. Some people may not be able to tell when their blood sugar gets too low.