Peripheral Neuropathy (PN)

Peripheral neuropathy (PN) is a result of damaged peripheral nerves, where they cannot send information from the brain and spinal cord (central nervous system, CNS) to the body. Peripheral neuropathy often causes pain, weakness cramps, twitches, muscle loss, bone degeneration, dizziness, tingling, pins-and-needles, and numbness, usually in the hands and feet, but other parts of the body can be affected, too. Traumatic injuries, vitamin deficiencies, infections, genetics/inherited causes, metabolic problems and exposure to toxins can cause peripheral neuropathy. One of the most common causes of neuropathy is diabetes.

Sometimes, antibiotics such as metronidazole and those belonging to the fluoroquinolone class (e.g. ciprofloxacin, levaquin, avelox) may also cause PN. Sometimes, there is no known cause of PN (“idiopathic”). Occasionally, neuropathy can affect just one nerve, where it is called “mononeuropathy”. Neuropathy that affects the same areas on both sides of the body is known as “symmetrical polyneuropathy” or “polyneuropathy”, whilst neuropathy affecting two or more disparate nerves on different parts of the body is called “mononeuritis multiplex”, “multifocal mononeuropathy” or “multifocal neuropathy”. “Neuritis” is the term for the inflammation of a nerve or the peripheral nervous system (PNS) in general. Neuropathy is often chronic, and can affect the motor nerves that control muscles, sensory nerves or autonomic nerves (nerves that control heart rate, body temperature and breathing).

Approximately 20 million people in the United States suffer from some sort of neuropathic pain. The causes of this neuropathic pain are diverse, and so they must be treated differently. For neuropathic pain associated with diabetes, controlling one’s blood-sugar levels can alter the course of neuropathy. For those with vitamin deficiencies, a course of high vitamin supplements is given and a vitamin-rich diet is recommended. For neuropathy arising from autoimmune disorders, immunoglobulin therapy (replenishing the body’s antibodies) and steroids.

Common medication used for neuropathic pain include antidepressants, especially tricyclic antidepressants and serotonin-norepinephrine reuptake inhibitors (SNRIs) such as duloxetine, are used. Antiepileptic medications such as gabapentin, pregabalin and sodium valproate are used. Capsaicin cream may also be used to beat nerve pain. Transcutaneous electrical nerve stimulation therapy may also be useful for people with diabetic neuropathy.




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