NPeripheral europathy is disease due to damage to the peripheral nervous system or peripheral nervous system.The damage causes disruption of peripheral nerve function in sending signals from organs to the brain or vice versa.
The peripheral nervous system functions to transmit physical sensations from all organs of the body to the brain. Peripheral nerves also transmit commands from the brain to perform certain functions, such as moving the body, sweating, increasing heart rate, and regulating blood pressure.
In patients with peripheral neuropathy, the above functions can be partially or completely impaired. Complaints experienced can vary, depending on the part and location of the affected peripheral nerves. However, the most common symptoms are pain, tingling, and muscle weakness.
Causes of Peripheral Neuropathy
Peripheral neuropathy is caused by damage to the peripheral nervous system. Damage can occur due to conditions passed down from parents or due to illness. Some conditions that can cause peripheral neuropathy include:
- Diabetes
- Bacterial or viral infections, such as HIV, smallpox, diphtheria, leprosy, and hepatitis C
- Autoimmune diseases, such as Guillain-Barre syndrome, lupus, Sjögren's syndrome, and rheumatoid arthritis
- Genetic factors, such as Charcot-Marie-Tooth . disease
- Hypothyroidism
- Deficiency of vitamins B1, B6, B12, and vitamin E
- liver disease
- Kidney illness
- Inflammation of the blood vessels (vasculitis)
- Accumulation of amyloid protein in body tissues or organs (amyloidosis)
- Nerve damage, for example from an injury or a side effect of surgery
- Blood cancer multiple myeloma
- Lymph node cancer or lymphoma
- Mercury or arsenic poisoning
- Alcohol addiction
- Tumor pressing on peripheral nerves
- Side effects of long-term use of drugs, including antibiotics (nitrofurantoin and metronidazole), chemotherapy drugs for bowel cancer, anticonvulsant drugs (eg phenytoin), thalidomide, and amiodarone
Peripheral neuropathy is also more at risk for someone who has the following conditions:
- Excess weight
- High blood pressure
- Age 40 years and over
Symptoms and Types of Peripheral Neuropathy
Symptoms of peripheral neuropathy vary, depending on the nerves affected. The following is an explanation of the types of peripheral neuropathy and their symptoms:
Nmotor europathy
Motor neuropathy is a disorder of the nerves that control body movement (motor function). Symptoms include:
- Muscle twitches and cramps
- Muscle weakness to paralysis of one or more muscles
- Legs that are limp and appear to fall when walkingfoot drop)
- Decreased muscle mass (muscle atrophy)
Nsensory europathy
Sensory neuropathy is a disorder of the nerves that send sensation signals, such as touch, temperature, or pain. Symptoms that can arise are:
- It's easy to feel pain even if you just touch it slightly (alodynia)
- A stabbing or burning pain, usually in the feet or soles of the feet
- Tingling in the affected body part
- Inability to feel pain or temperature changes, especially in the legs
- Impaired balance or coordination of body movements (sensory ataxia)
Mononeuropathy
Mononeuropathy is a type of peripheral neuropathy that occurs in only one specific peripheral nerve. Symptoms include:
- Double vision or difficulty focusing, which is sometimes accompanied by pain in the eye, if it occurs in the nerves that control eye movement (cranial nerves III, IV, or VI)
- Paralysis on one side of the face or Bell's palsy, if it occurs in the nerve that controls facial movements (cranial nerve VII)
- Fingers feel weak or tingling or ct arpalunnel ssyndrome, if it occurs on the median nerve at the wrist
Nautonomous europathyik
Autonomic neuropathy is injury to the autonomic nerves. This nerve functions to control body processes that work automatically, such as blood pressure, digestive function, and bladder function. Here are the symptoms:
- Fast heart rate (tachycardia) even at rest
- Dysphagia or difficulty swallowing
- Bloated
- Often burp
- Nauseous
- Constipation or diarrhea at night
- bowel movements that are difficult to control (fecal incontinence)
- Beser or frequent urination
- The body rarely sweats, or vice versa constantly sweats
- Sexual dysfunction, such as erectile dysfunction
- Orthostatic hypotension
When to go to the doctor
Seek immediate medical attention if you experience early symptoms of peripheral neuropathy, which include:
- Pain, tingling, or numbness in the legs
- Weak body or loss of balance
- Injuries to the feet that are not known to cause
Check with your doctor regularly if you are at risk of developing peripheral neuropathy, for example because you have diabetes. If diagnosed as early as possible, the risk of complications due to peripheral neuropathy can be prevented.
Peripheral Neuropathy Diagnosis
At the time of consulting with a doctor for neurological diseases, especially for peripheral neuropathy, the doctor will ask about the symptoms felt, lifestyle, and medical history of the patient and his family. The doctor will also ask about medications that the patient is currently or regularly taking.
After that, the doctor will perform a physical and neurological examination on the patient, such as checking the patient's ability to feel certain sensations, testing muscle strength, and checking gait, posture, and body balance.
If needed, the doctor will perform other tests, such as:
- Tblood ice
Blood tests are done to find out the possibility of diabetes, impaired immune function, or certain vitamin deficiencies.
- p . testimage
CT scans and MRIs are performed to detect tumors and abnormalities in the brain or spinal cord, such as a hernia in the spinal cord (hernia nucleus pulposus).
- Nerve function test
Nerve function tests can be done with electromyography (EMG), to measure the electrical activity in the muscles, so that the nerve flow is damaged. Nerve function tests can also be done with a nerve conduction test, to measure the strength and speed of signals in nerves.
- Lumbar puncture
A lumbar puncture is performed to detect inflammation in the spine, by examining a sample of cerebrospinal fluid (fluid inside the brain and spine).
- Nerve biopsy
A biopsy is done by taking a small piece of the peripheral nerve or skin in the ankle, to be examined under a microscope. However, this examination is rarely performed.
Peripheral Neuropathy Treatment
Treatment of peripheral neuropathy depends on the underlying cause. Actions that doctors can take include:
- Give vitamin B12 in tablet or injection form, in peripheral neuropathy caused by vitamin B12 deficiency.
- Advise patients to maintain ideal body weight, exercise regularly, quit smoking, and reduce alcohol consumption, in peripheral neuropathy caused by diabetes.
- Administer corticosteroids to reduce inflammation and immune system overreaction, in peripheral neuropathy caused by autoimmune diseases.
- Perform plasmapheresis or blood plasma exchange transfusion on the patient, to get rid of antibodies or proteins that cause inflammation
- Perform surgery, on peripheral neuropathy caused by pressure on nerves, eg pressure due to tumors.
To reduce pain symptoms in patients, doctors will prescribe pain relievers, such as paracetamol, ibuprofen, and tramadol. Antidepressant drugs (such as amitriptyline or duloxetine) and anticonvulsant drugs (such as gabapentin and pregabalin) can also be used for pain.
In patients who cannot take a number of the above drugs, ointments containing capsaicin can be an option. Ointment capsaicin used 3-4 times a day, but should not be applied to inflamed skin or open wounds.
In some cases, people with peripheral neuropathy may experience excessive sweating (hyperhidrosis). This condition can be treated with injections botulinum toxin (botox). Meanwhile, in patients who have urinary problems, the doctor will recommend the use of a catheter.
To help reduce complaints, patients can undergo physiotherapy, such as low-power electrical therapy. In patients with muscle weakness, the use of a walking aid, such as a cane or wheelchair, may be necessary.
In addition to the above treatment methods, patients can also do a number of things for self-management, including:
- Doing regular exercises to relieve pain, increase muscle strength, and help control blood sugar levels, for example by taking a leisurely walk 3 times a week
- Quit smoking to prevent complications of peripheral neuropathy
- Avoid excessive consumption of alcoholic beverages so that symptoms do not get worse
- Eat healthy foods, such as fruit, vegetables, whole grains, and high-protein foods
- Check blood sugar levels regularly, especially in peripheral neuropathy patients who also suffer from diabetes
- Taking care of the feet and avoiding injuries to the feet, for patients who also suffer from diabetes, for example by wearing soft socks and soft shoes
Peripheral Neuropathy Complications
Weak muscles and decreased ability to feel your feet on the ground can cause people with peripheral neuropathy to lose balance and fall easily.
In addition, numbness in certain areas can make the sufferer unconscious if the skin in that area is injured or burned. This condition can cause infection, especially in peripheral neuropathy patients who have diabetes. As a result, wound healing becomes slower.
If it is too severe, the injury can cause gangrene or tissue death. Patients who experience this condition do not rule out having to undergo amputation.
Peripheral Neuropathy Prevention
The best way to prevent peripheral neuropathy is to avoid or control its risk factors. This can be done by living a healthy lifestyle, such as:
- Eat nutrient-rich foods, such as fruit, vegetables, and lean protein sources, to keep nerves healthy
- Exercise regularly, according to doctor's advice
- Avoid things that can cause injury to the nerves, such as repetitive movements, body positions that press the nerves, smoking habits, exposure to toxic substances, and excessive consumption of alcoholic beverages