What is Neuropathy?


Neuropathy, or peripheral neuropathy, results from damaged or dysfunctioning nerves. It is also commonly known as peripheral neuropathy because it can damage your peripheral nervous system. The peripheral nervous system is the network of nerves that exist outside of one’s brain and spinal cord. More specifically, neuropathy occurs as a result of damaged or destroyed nerve cells, called neurons, which disrupt synaptic transmission, or the communication of signals within the brain. It can also simultaneously take place in multiple body parts, such as one’s hands or feet  (Neuropathy (Peripheral Neuropathy). 

Neuropathy can be classified as mononeuropathy, the dysfunction of one nerve or nerve type, multifocal neuropathy, the dysfunction of a combination of nerves in a specific area, or polyneuropathy, the dysfunction of many peripheral nerves all throughout the body (Neuropathy (Peripheral Neuropathy) ). Symptoms that span across all classifications of peripheral neuropathy include gradual numbness, tingling in one’s feet or hands, sharp, throbbing, or burning pain, sensitivity to touch, lack of coordination, muscle weakness, and, if motor nerves are affected, paralysis. However, if the autonomic nerves that control blood pressure, heart rate, digestion, and bladder function are affected, symptoms such as heat intolerance, excessive or lack of sweating, digestive problems, and dizziness due to changes in blood pressure can occur as well (Peripheral neuropathy – Symptoms and causes ). 

Although there are three main classifications of neuropathies, there are also different subtypes. A major cause of a certain subtype of neuropathy called distal symmetric polyneuropathy is diabetes. Distal symmetric polyneuropathy is characterized by a loss in sensory function in the lower extremities. At least 50% of diabetics will develop distal symmetric polyneuropathy, making it an epidemic in places such as India. The physiology known so far behind distal symmetric polyneuropathy involves the retraction of the terminal sensory axons in the periphery, while the perikarya, or cell bodies, remain preserved. Experimental evidence has also demonstrated that the entire neuron may be targeted with diabetes, however, this evidence remains to be debated. A study has found that the incidence of distal symmetric polyneuropathy is higher in those with type II diabetes than those with type I diabetes, mainly due to greater glucose control in those with type I diabetes compared to those with type II. When examining trends in the incidence of distal symmetric polyneuropathy, however, one must also consider the duration of diabetes, hemoglobin levels, hypertension, obesity, drug abuse, gender, impaired renal function, and more (Feldman et al., 2019).

 Distal symmetric polyneuropathy is one of many types of neuropathies making diabetes an important risk factor. Other risk factors include alcohol abuse, vitamin B deficiencies, genetics, and certain infections such as Lyme disease, shingles, Epstein-Barr virus, HIV,  and Hepatitis B and C. Although there are many diverse risk factors of neuropathy, there are some beneficial prevention methods, including medications such as antidepressants, anti-seizure medications, topical and narcotic medications, physical therapy, occupational therapy, surgery of resulting conditions such as a herniated disc or carpal tunnel syndrome, and more (Peripheral neuropathy – Symptoms and causes ). 

References

Feldman, E., Callaghan, B., Pop-Busui, R., Zochodne, D., Wright, D., & Bennett, D. et al. (2019). Diabetic neuropathy. Nature Reviews Disease Primers, 5(1). doi: 10.1038/s41572-019-0097-9

Cleveland Clinic. (2019). Neuropathy (Peripheral Neuropathy). https://my.clevelandclinic.org/health/diseases/14737-neuropathy 

Mayo Clinic. (2019). Peripheral Neuropathy-Symptoms and Causes. https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061 

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