The following discussion is for general informational purposes only and is not meant to provide the reader with specific medical advice. Please consult with your personal physician, or with a neurologist, for specific advice, guidance and information regarding your particular circumstances.
Neuropathy is more appropriately named peripheral neuropathy or polyneuropathy. Peripheral neuropathy refers to malfunction of the ends or peripheral part of many nerves, usually in the lower extremities. Peripheral neuropathy is not a disease of the brain or the spinal cord. The nerve endings most commonly affected are in the toes or the feet.
There are many causes of peripheral neuropathy, including medical disease, exposure to toxins or chemicals, infections and inherited diseases. The two most common causes of peripheral neuropathy are diabetes mellitus and exposure to alcohol. Other causes which are not as seen as commonly include vitamin B12 deficiency, Lyme disease and lead poisoning. In 30 to 40% of the patients who present with peripheral neuropathy, no exact cause can be discovered. In these cases, the peripheral neuropathy is termed "idiopathic" which means there is no known cause.
Symptoms vary from person to person and are dependent upon the nerves involved. The most common presentation of peripheral neuropathy is numbness and/or tingling in the toes and feet. This problem generally involves both of the feet symmetrically. In addition, some individuals complain of pain, particularly a burning pain, in the feet. Less commonly, people may experience weakness of the muscles in their feet, and may experience an increased number of falls for no apparent reason.
A careful medical history and neurologic examination are necessary to assess for possible causes for peripheral neuropathy. Laboratory studies may be ordered to evaluate for the presence of problems such as diabetes mellitus, B12 deficiency and Lyme disease. Frequently, a test called electromyography and nerve conduction studies (EMG/NCV) is used to diagnose, quantify and categorize the type and extent of the peripheral nerve disease. Very rarely, a small nerve or skin biopsy may also be necessary in order to identify the cause of the peripheral neuropathy.
Once the diagnosis of a peripheral neuropathy is established, a variety of treatments are available. If a cause for the peripheral neuropathy is discovered, treatment will be focused on correcting this difficulty.
Often times, the individual's primary care physician also needs to be involved in controlling diseases such as diabetes mellitus. Vitamins, particularly the B12 vitamins can also be very useful in treating peripheral neuropathy. There are also many medicines available to help treat neuropathic pain. The prognosis for an individual with peripheral neuropathy is generally very good.