Neuropathy is the term used to describe a problem with the nerves, usually the ‘peripheral nerves’ as opposed to the ‘central nervous system’ (the brain and spinal cord).
Neuropathy is seen with a number of varying underlying medical conditions. It can also exist without the cause being possible to diagnose, when doctors called it ‘idiopathic.’
CAUSES
Many different conditions can lead to peripheral neuropathy:
- Diabetes is the most common cause of chronic peripheral neuropathy. In people with poorly controlled diabetes, high blood sugar levels can damage nerves.
- B12 or folate vitamin deficiencies can cause nerve damage and peripheral neuropathy.
- Drugs such as some chemotherapy medication and medicines used to treat HIV can cause damage to peripheral nerves.
- Poisons (toxins) – Insecticides and solvents can cause peripheral nerve damage.
- Cancers – Peripheral neuropathy can occur in people with some cancers, like E.G: lymphoma and multiple myeloma.
- Alcohol excess – High alcohol levels in the body cause nerve damage.
- Chronic kidney disease – If the kidneys are not functioning normally, an imbalance of salts and chemicals can cause peripheral neuropathy.
- Injuries – Broken bones and tight plaster casts can put pressure directly on the nerves.
- Infections – Damage can be caused to peripheral nerves by some infections, including shingles, HIV, and Lyme disease.
- Guillain-Barré syndrome – The name given to a specific type of peripheral neuropathy triggered by infection.
- Connective tissue diseases – Such as rheumatoid arthritis, Sjögren’s syndrome, and systemic lupus erythematosus.
- Certain inflammatory conditions – Conditions including sarcoidosis and coeliac disease can also cause peripheral neuropathy.
- Hereditary diseases such as Charcot-Marie-Tooth syndrome and Friedreich’s ataxia.
- Idiopathic causes – When no specific cause for peripheral neuropathy is found, it’s called idiopathic peripheral neuropathy.
TYPES OF TESTS
Nerve Conduction Studies:
- Nerve conduction studies check the speed with which nerves send messages.
- Special electrodes are placed on the skin over the nerve being tested.
- These electrodes give off tiny electrical impulses that feel like small, electric shocks and stimulate the nerve.
- Other electrodes record the electrical activity of the nerve.
- The distance that the impulses travel to the other electrodes and the time that this takes allows the speed of the nerve impulse to be calculated.
- In peripheral neuropathy, this speed is reduced.
Electromyography:
- This test looks at the electrical activity of the muscles.
- A very thin needle with an electrode attached is inserted through the skin into a muscle.
- This is connected up to a recording machine called an oscilloscope.
- The way that the muscle responds when it is stimulated by nerves can then be monitored using the oscilloscope and recorded.
- In peripheral neuropathy, the electrical activity will be abnormal.
Nerve Biopsy:
This is the removal of a small part of a nerve so that it can be examined under a microscope.
Skin Biopsy:
- This is a new technique that has been developed to examine the peripheral nerves.
- It can be used to look for early peripheral neuropathy and also to monitor progression of neuropathy and response to treatment.
- Among other things, the density of nerve fibers in the area of skin is measured.
- In peripheral neuropathy, the density of the peripheral nerves is reduced.
ADDITIONAL INFORMATION
Please call our podiatry office at 847-390-7666 if you have any additional questions about neuropathy to the foot and testing for it. We will be happy to provide you with all the information that you may need.
