Peripheral Neuropathy

What is peripheral neuropathy?

Peripheral neuropathy refers to the many conditions that involve damage to the peripheral nervous system, which sends signals between the brain and spinal cord and all other parts of the body.

Neuropathy means damage to one or more nerves, especially the peripheral nerves. More than 100 types of peripheral neuropathy have been identified, each with its own characteristic set of symptoms and prognosis. Impaired function and symptoms depend on the type of nerves that are damaged.

Symptoms of neuropathy range from mild to disabling and may include a loss of reflexes, problems feeling pain or changes in temperature, numbness and tingling, and pain that is often worse at night.

Symptoms may develop over days, weeks, or years. In some cases, the symptoms improve on their own and may not require advanced care.

Causes of neuropathy include: diabetes, physical injury (trauma), vascular and blood problems, autoimmune disorders, nutritional or vitamin imbalances, alcoholism, exposure to toxins, certain chemotherapy drugs, and infections.

Most instances of neuropathy are either acquired, meaning the neuropathy isn’t present from the beginning of life, or genetic. Acquired neuropathies are either symptomatic (the result of another disorder or condition) or idiopathic (meaning it has no known cause).

Is there any treatment?

Treatments depend entirely on the type of nerve damage, symptoms, and location.

No medical treatments exist that can cure inherited peripheral neuropathy. However, there are therapies for many other forms.

In general, a healthy lifestyle—such as maintaining optimal weight, avoiding exposure to toxins, following a physician-supervised exercise program, eating a balanced diet, correcting vitamin deficiencies, and limiting or avoiding alcohol consumption and smoking—can reduce the physical and emotional effects of peripheral neuropathy.

Strict control of blood glucose levels has been shown to reduce neuropathic symptoms in people with diabetic neuropathy.

Inflammatory and autoimmune conditions leading to neuropathy can be treated using immunosuppressive drugs and plasmapheresis (a procedure in which blood is removed, cleansed of immune system cells and antibodies, and then returned to the body).

Medications can treat pain or block nerve conduction. Surgery is recommended for some types of neuropathies.

What is the prognosis?

In acute neuropathies, such as Guillain-Barré syndrome, symptoms appear suddenly, progress rapidly, and resolve slowly as damaged nerves heal.

In chronic forms, symptoms begin subtly and progress slowly. Some people may have periods of relief followed by relapse. Others may reach a plateau stage where symptoms stay the same for many months or years.

Some chronic neuropathies worsen over time, but very few forms prove fatal unless complicated by other diseases. Occasionally the neuropathy is a symptom of another disorder.

What research is being done?

Current research projects funded by the National Institute of Neurological Disorders and Stroke (NINDS) involve investigations of genetic factors associated with hereditary neuropathies, studies of biological mechanisms involved in diabetes-associated neuropathies, and exploring how the immune system contributes to peripheral nerve damage.

The Inherited Neuropathies Consortium seeks to better understand the several different forms of neuropathy and identify genes that modify clinical features in these disorders.

Some research focuses on immune system peripheral nerve damage, such  as seen in Guillain-Barré syndrome. Other NINDS-sponsored studies hope to identify biomarkers (signs that can indicate the diagnosis or progression of a disease) for the peripheral neuropathies and to develop more effective therapies for these diseases.

Other scientists are investigating the pathways by which pain signals reach the brain and hope to identify substances that will block this signaling.