Neuropathy is a relatively common nerve disorder. It is sometimes called peripheral neuropathy because it usually causes a problem with peripheral nerves, rather than the brain and spinal cord (the central nervous system). Each type of neuropathy comes with its own array of causes, symptoms, and treatments. Although all of them can result from a number of underlying medical conditions, diabetes accounts for a large percentage, as about 50% of diabetics have diabetic neuropathy. Unfortunately, about 30% of neuropathy cases are idiopathic, which means there is no exact cause doctors can pinpoint as the reason it developed in the first place.
The main nerves affected are the autonomic nerves, motor nerves, or sensory nerves, thus the three types of neuropathy. When only one type of nerve is troubled, this is considered mononeuropathy. However, two or even all three types can occur at the same time, in which case the patient has polyneuropathy.
Sensory
Sensory nerves are in charge of feeling sensations, like heat, pain, or softness. Sensory neuropathy may result in painful or weak extremities, a tingling and numb sensation, or a pins and needles feeling. It may become difficult to tell when things get warmer or colder. In addition, ulcers may develop on the feet or legs, leading to serious infection and sometimes gangrene. The quality and texture of skin, hair, or nails may also change with sensory neuropathy.
Autonomic
The autonomic nerves are the ones in the body that do their job without being told. They control systems of the body that work automatically. When these nerves are damaged, the signal between these systems and the brain are disrupted, causing problems and changes in things like digestion, perspiration, heart rate, or blood pressure.
Specific symptoms vary, but common issues include fainting due to a quick decrease in blood pressure, urinary incontinence, erectile dysfunction in men, inability to be aroused or orgasm in women, digestive disruption, inability to properly regulate body temperature, decreased pupil reaction time, and exercise intolerance when the heart rate does not rise and fall according to activity level. It may be caused by an abnormal protein buildup, autoimmune diseases, diabetes, nerve injuries, medication, and other illness (such Parkinson's disease, leprosy, and some inherited disorders).
Motor
The motor nerves control intentional movement and strength. When the motor nerves develop neuropathic problems, it becomes difficult for signals to travel between your arms and legs and your brain. The feet or hands may become weak, and some twitching or cramping may occur. In more severe cases, symptoms may make daily tasks become difficult to perform, even things as simple as eating or getting dressed. Other people may barely notice the problem is there most of the time, and symptoms may be so mild as to not even require treatment.
Exercises and treatments can make the muscles stronger, so that they begin to work better again. One successful treatment involves intravenous immunoglobulin (IVIg) injections. Most people feel improvement within six weeks, but the IVIg eventually wears off. Many people have their doctor teach them how to give themselves injections, so they needn't schedule an appointment when it's time for another injection. Cyclophosphamide, a medication used to treat cancer, has also been effective. Unfortunately, it can have very serious side effects, so doctors generally try other alternatives first.
