Peripheral neuropathy

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Nervous system

Central nervous system

Peripheral neuropathy

Alternative Names:

Peripheral neuritis; Neuropathy - peripheral; Neuritis - peripheral
Symptoms:

The symptoms depend on which type of nerve is affected. The three main types of nerves are sensory, motor, and autonomic. Neuropathy can affect any one or a combination of all three types of nerves. Symptoms also depend on whether the condition affects the whole body or just one nerve (as from an injury).

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SENSATION CHANGES

Damage to sensory fibers results in changes in sensation, burning sensations, nerve pain, tingling or numbness, or an inability to determine joint position, which causes incoordination.

For many neuropathies, sensation changes often begin in the feet and progress toward the center of the body with involvement of other areas as the condition worsens.

MOVEMENT DIFFICULTIES

Damage to the motor fibers interferes with muscle control and can cause weakness, loss of muscle bulk, and loss of dexterity. Sometimes, cramps are a sign of motor nerve involvement.

Other muscle-related symptoms include:

lack of muscle control
difficulty or inability to move a part of the body (paralysis)
muscle atrophy
muscle twitching (fasciculation) or cramping
difficulty breathing or swallowing
falling (from legs buckling or tripping over toes)
lack of dexterity (such as being unable to button a shirt)

AUTONOMIC SYMPTOMS

The autonomic nerves control involuntary or semi-voluntary functions, such as control of internal organs and blood pressure. Damage to autonomic nerves can cause:

blurred vision
decreased ability to sweat
dizziness that occurs when standing up or fainting associated with a fall in blood pressure
heat intolerance with exertion (decreased ability to regulate body temperature)
nausea or vomiting after meals
abdominal bloating (swelling)
feeling full after eating a small amount (early satiety)
diarrhea
constipation
unintentional weight loss (more than 5% of body weight)
urinary incontinence
feeling of incomplete bladder emptying
difficulty beginning to urinate (urinary hesitancy)
male impotence

Signs and tests:

A detailed history will be needed to determine the cause of the neuropathy. Neurologic examination may reveal abnormalities of movement, sensation, or organ function. (See also entries on the specific nerve dysfunction.) Changes in reflexes and muscle bulk may also be present.

Tests that reveal neuropathy may include:

EMG (a recording of electrical activity in muscles)
Nerve conduction tests
Nerve biopsy
Blood tests to screen for medical conditions, such as diabetes and vitamin deficiency, among others.

Tests for neuropathy are guided by the suspected cause of the disorder, as suggested by the history, symptoms, and pattern of symptom development. They may include various blood tests, x-rays, scans, or other tests and procedures.
References:

Delalande S, de Seze J, Fauchais AL, et al. Neurologic manifestations in primary Sjogren syndrome: a study of 82 patients. Medicine (Baltimore). 2004 Sep;83(5):280-91.

Mori K, Iijima M, Sugiura M. Sjogren's syndrome associated painful sensory neuropathy without sensory ataxia. J Neurol Neurosurg Psychiatry. 2003 Sep;74(9):1320-2.