PERIPHERAL

NEUROPATHY

BY
BEWAYO VICTOR (MPS)
INTRODUCTION

Your peripheral nervous system connects the nerves

from your brain and spinal cord, or central nervous
system, to the rest of your body. This includes your:
• Arms
• Internal organs
• Mouth
The job of these nerves is to deliver signals about
physical sensations back to your brain.
Intro cont’d

The three types of peripheral nerves are:

• Sensory nerves, which connect to your skin
• Motor nerves, which connect to your muscles
• Autonomic nerves, which connect to your internal
organs

Peripheral neuropathy can affect one nerve group or all

three.
Intro cont’d
Peripheral neuropathy is a disorder that occurs when
these nerves malfunction because they’re damaged or
destroyed. This disrupts the nerves’ normal
functioning. They might send signals of pain when
there’s nothing causing pain, or they might not send a
pain signal even if something is harming you. This can
be due to:
• Injury
• Systemic illness, Infection
• Inherited disorders
Types
More than 100 different types of peripheral
neuropathy exist. Each type has unique symptoms and
specific treatment options. Peripheral neuropathies are
further classified by the type of nerve damage involved
Mononeuropathy
It is a type of neuropathy that only affects a
single nerve. Diagnostically, it is important to
distinguish it from polyneuropathy because when a
single nerve is affected, it is more likely to be due to
localized trauma or infection.
The most common cause of mononeuropathy is
physical compression of the nerve, known
as compression neuropathy.
• Carpal tunnel syndrome
• Brachial neuritis
• Cranial neuritis such as Bell's palsy
• Optic neuritis
• Vestibular neuritis are examples.

Direct injury to a nerve, interruption of its blood supply

resulting in (ischemia), or inflammation also may cause
Types cont’d
Polyneuropathy
(poly + neuro + pathy)
It is a pattern of nerve damage that is quite different
from mononeuropathy, often more serious and affecting
more areas of the body.
In cases of polyneuropathy, many nerve cells in various
parts of the body are affected.
The effect of this is to cause symptoms in more than one
part of the body, often symmetrically on left and right
sides
Cont’d
Polyneuropathies usually are caused by processes that
affect the body as a whole.
Diabetes and impaired glucose tolerance are the most
common causes.
Most types of polyneuropathy progress fairly slowly,
over months or years, but rapidly progressive
polyneuropathy also occurs
Diabetic neuropathy is an example
Risk factors
• Family history
• Obesity
• High blood pressure
• Over the age of 40
• Diabetes
Causes

• Metabolic and Endocrine diseases (Diabetes, kidney

disorders, hypothyroidism)
• Vitamin deficiencies (E, B-1, B-6, and B-12)
• Injury/ physical trauma(Carpal tunnel syndrome)
• Alcohol and toxins (glue, solvents, insecticides)
• Certain medications may also cause nerve damage
(Anti-cancers, anticonvulsants, antibiotics – mainly
fluoroquinolones, antihypertesives)
Causes cont’d

• Infections (Viruses such as herpes simplex, varicella-

zoster virus, which causes chickenpox and shingles,
and Epstein-Barr virus and Bacterial infections such
as Lyme disease, Leprosy damage sensory nerves and
cause intense episodes of shooting pain)
• Autoimmune diseases (Rheumatoid Arthritis, SLE)
(Inflammatory diseases)
Symptoms
Symptoms vary depending on the types of nerve fiber
involved.
• Tingling sensations
• Pain, itching, and pins-and-needles.
• Numbness, tremors,
• Impairment of balance
• Weakness, tiredness, muscle atrophy
Diagnosis

• Neurological examination
• Electromyography
• Nerve conduction tests
• Blood tests for vitamins and sugars
• Nerve biopsy
Management
The treatment is based on treating the underlying
disorder
Most of the management is symptomatic
• Pain medications (Acetaminophen, Ibuprofen,
Tramadol)
• Corticosteroid injections (Triamcinolone)
• Antidepressants (Amitriptyline)
• Anti-epileptics (Gabapentin, pregabalin)
All above help in mgt of neuropathic pain
Mgt cont’d
• Transcutaneous electronic nerve stimulation (TENS)
(The goal of this treatment is to disrupt nerves from
transmitting pain signals to the brain)
• Many people have found relief for peripheral
neuropathy through:
• chiropractic care, Acupuncture, Massage, Meditation,
Yoga
• Moderate, regular exercise can also help lessen
discomfort.
• Vitamin supplementation
Mgt cont’d

• If you drink alcohol or smoke, consider cutting back or

stopping.
• Both alcohol and tobacco aggravate nerve pain and
can cause nerve damage when used for long periods
THANX FOR
LISTENING