Peripheral neuropathy.
Peripheral neuropathy is a Greek medical term and indicates a  damage or malfunction of a single or a group of nerves which transmit signals
from and to the spinal cord and brain.
The condition is described as mononeuropathy or polyneuropathy respectively. Peripheral neuropathy results in pain (neuralgia), impairment or loss of sensation (hypesthesia) and loss of muscle control (paresis or paralysis), since either the nerve itself or the neuromuscular junction may be affected. Digestion problems and abnormal blood pressure may occur due to damage of relevant nerves as well.
Peripheral neuropathies may be described as autonomic, symmetrical, generalized, focal or multi-focal, according to the organs, the systems and the areas of the body that have been affected.
Although diabetes mellitus is the most prominent cause of peripheral neuropathy, motor neuron disease, nutritional deficiencies, especially lack of vitamin B12, alcoholism, genetic or metabolic disorders, HIV, herpes zoster, renal failure, ischemia, hepatitis, syphilis, diphtheria, seizures, tumors, excessive amounts of radiation, too low temperatures, toxic substances, chemotherapy agents, surgery and traumatic injuries may lead to peripheral neuropathy, as well. In some cases, there is a hereditary predisposition for peripheral neuropathy.
Symptoms of peripheral neuropathy.
The range of peripheral neuropathy symptoms is wide, since they vary, depending on the damaged nerves and consequently, on the affected tissues, organs and systems. It has to be mentioned that many diabetics, although they present signs of peripheral neuropathy in examination, they have no symptoms at all. The symptoms of peripheral neuropathy that may occur include:
 Numbness or insensitivity to pain or temperature.
Tingling, burning, itching or prickling sensation.
Sharp muscle pain (myalgia), fasciculations or cramps.
Extreme sensitivity even to a slight touch.
Tremor and impaired muscle coordination.
All the above symptoms are often worse overnight. Other possible manifestations can be:
Damage to the motor fibers can cause loss of muscle bulk, atrophy, loss of dexterity, weakness and loss of reflexes, especially at the ankle, leading to gait imbalance.
Difficulty in breathing or swallowing.
Foot deformities, such as hammer toes and the collapse of the mid-foot.
All the autonomic neuropathy symptoms.
Complications of peripheral neuropathy.
The consequences of peripheral neuropathy vary, depending on the damaged nerve and the relevant systems affected.
As it has been mentioned already, the inability to feel or notice injuries, especially in feet, may lead to ulceration, infection, gangrene and amputation. Other complications include poor healing, tissue waste, deformity, partial or total immobility, loss of sensation, dysphagia, gastrointestinal malfunction and difficult in breathing.
Treatment for peripheral neuropathy.
In every case, early diagnosis of peripheral neuropathy increases the possibility of effective treatment. The original, underlying cause must be identified, treated and cured, if possible. However, in severe peripheral neuropathy cases, nerve damage can be irreversible, even if the cause is treated properly. In people with diabetes and in alcoholics, strict blood glucose control and discontinuation of drinking respectively are of vital importance. Diabetes medication must be taken faithfully, as well.
The second consideration for a physician is to keep the symptoms under control and to make sure the patient has the maximum independence and self-care ability. Reasonable physical activity may maintain adequate muscle strength and control. If necessary, painkillers must be prescribed.
Devices such as wheelchairs, braces, and splints may improve function of an affected limb.
Safety must be the most significant concern for individuals suffering from peripheral neuropathy. Impairment or absence of muscle control and reduced sensation increase the risk for falls and injuries. Especially the latest may remain unnoticed, because of lack of pain due to a nerve failure. Therefore, people with decreased sensation due to peripheral neuropathy should check their feet or other affected areas for bruises and sores on a regular basis. This is extremely important for diabetics, since wounds in feet, if unnoticed and neglected, may get infected and lead to ulcers and potential amputation. Experts estimate that half of all such amputations are preventable, if minor, common diabetes foot problems are treated promptly. Foot care is a major issue and it should never be underestimated. Comfortable and soft shoes are essential. Soft materials for shoe comfort, foot health aids and
foot skin care preparations will be vary handy, as well.
People with peripheral neuropathy are susceptible to new nerve damage at pressure points, such as knees and elbows, for instance. Thus, they should avoid prolonged pressure on a particular area of their body.
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