What It Is and How You Get It

Millions in this country and elsewhere have peripheral neuropathy in different forms and to various degrees. The number usually cited in the U.S. is two million. Yet a study of its incidence just among specific population groups, for example among people with diabetes or with HIV infections, would suggest a much larger number.

It can strike any age group in any social or cultural strata. Many, perhaps most, victims do not realize what ails their aching soles and numb toes, as well as their tingling fingers, throbbing hands or weakening muscles. The shame of this is that without early action based on knowledge of their afflictions, the pain and other symptoms experienced by these sufferers almost invariably gets worse. Moreover, their neuropathies often tend to advance in their bodies, causing more and more areas to be affected. Another problem is that if attention is delayed certain neuropathies can become more difficult to treat.

Hope in Motion. Without Hope we have nothing. Choose Hope!





PERIPHERAL NEUROPATHY EXPLAINED





Perhaps because it's poorly understood and not commonly discussed, peripheral neuropathy is sometimes called the "silent disease" (though it has company using this tag!).

Yet it affects more people than rheumatoid arthritis-a much better known ailment-with just as severe consequences in its worst form.

To start with, it should be understood PN is not really a disease at all. Rather it's a complex of disorders in the peripheral nervous system resulting from damage to the nerves' protective coating or from damage to the nerves themselves.

Our peripheral nervous system is made up of nerve fibers bundled together in nerve trunks. They run from the brain and spinal cord (which make up the central nervous system) to other parts of our body. The fibers are shielded by a coating or membrane called the myelin sheath. Like wires protected by insulation, the coated fibers carry "electrical" impulses from receptors located in internal organs, muscles a skin, back to our brain through our spinal cord. When an injury to our peripheral nerves or their protective coating occurs which interferes with the transmission of impulses from these receptors, one of two things (or sometimes both) occurs depending on the receptors and nerve fibers involved. Either the brain simply acknowledges and registers the abnormal transmission as pain or some other unpleasant sensation, or it prompts a response back to the muscle or organ from which the original impluse emanated. In the latter case the response may result in decreased muscle movement or changes in organ functioning.

Peripheral neuropathy (particularly sensory neuropathy) seems in most cases to initially occur at the extremities of the longest nerves farthest from the spinal cord and brain. Consequently the feet being at the end of the line, are usually the first to be hit. Frequently the hands are next. Over time the affliction can spread to ankles, legs and arms if the underlying cause is not addressed.







Types



Most of the disorders are called "polyneuropathies." This means that they are multiple and usually (but not always) symmetric, affecting both feet, for example, or both hands, in the same way. A term often used to describe this condition is "distal symmetrical polyneuropathy." In contrast "mononeuropathy" refers to the injury of a single nerve such as in carpal tunnel syndrome, where only one hand and wrist may be affected, or Bell's palsy, involving a single nerve to facial muscles.

Other neuropathy classifications are based on whether the sensory, motor or autonomic nerve fibers are involved. Damage to sensory fibers, concerned with feeling and touching, results either in abnormal paresthesias (sensations) such as tingling, numbness, electrical shocks, or in outright pain. Damage to motor fibers, which are responsible voluntary movements such as fist clinching, may result in bodily changes such as muscle weakness or atrophy, or cramps and spasms. Damage to autonomic fibers, which affect involuntary or semi-voluntary functions such as control of internal organs, can cause such changes as decreased ability to sweat, loss in blood pressure (with or without dizziness), constipation, bowel and bladder problems, and sexual dysfunction.

Somewhat rarer neuropathies and attendant complications include:





Chronic Inflammatory Demyelinating Polyneuropathy (CIDP is a chronic autoimmune disorder-the immune system itself is attacking the myelin sheath-and is characterized by muscle weakness and burning sensations);



Guillain-Barre syndrome (GBS is also autoimmune, oftentimes resulting in paralysis of the legs, arms and breathing muscles);



Charcot-Marie-Tooth disease (CMT is a complex of hereditary nerve disorders of various types frequently involving the myelin sheath); and



"Restless Legs Syndrome" (RLS is a complication of neuropathy-as well as f iron deficiency anemia-manifested by creeping, crawling sensations accompanied by motor restlessness, most often experienced at night).



The Neuropathy Association publishes an excellent booklet written by Dr. Norman Latov (Professor of Neurology at Columbia University) and Mary Ann Donovan (President of the Association) as a primer on peripheral neuropathy. It lists a number of neuropathic disorders in terms of whether they are "acquired" or "inherited."

I hope this information helps. This information was from "Numb Toes and Aching Soles." by John Senneff. I highly recommend. GB until next time.