Author: Adekola Taylor
The collection of disorders that occurs as a component of many rare and several common diseases when the nerves of the peripheral nervous system are damaged is known as neuropathy (Martyn & Hughes). This condition is generally referred to as peripheral neuropathy and it is characterized by numbness and pains in the feet and hands. Any damage to the nerve axons would lead to peripheral neuropathy. Peripheral neuropathy varied in severity, heterogeneous in aetiology and diverse in pathology, the term peripheral neuropathy entails multiple and single mononeuropathy, symmetric polyneuropathy and radiculopathy.
Causes and Effects
It can further be classified depending on a combination of genetic, pathological, aetiological and other phenomenological features. There are a wide range of causes associated with neuropathy for instance it may be caused as a result of infections, metabolic disorders, exposure to toxins or even traumatic injuries. One of the most popular causes of neuropathy is diabetes; however the condition is often related to a number of diseases, poor nutrition and trauma. More importantly many cases of neuropathy have no known causes; this is referred to as idiopathic neuropathy.
The idiopathic neuropathy accounts for almost 30% cases and another 30% can be attributed to diabetes. In the western world, diabetes mellitus is believed to be the most common cause of neuropathy and it is evident that about 50% of diabetes patients develop some kind of neuropathy, a cohort of 4400 diabetes patients was studied for 20 to 25 years and it was found out that 45% of these patients during the course of their disease developed neuropathy (Backonja et al). Other causes of neuropathy can be grouped under acquired neuropathy which has several possible causes. Some causes of acquired neuropathy are trauma, pressure on nerves, vitamin deficiencies especially lack of B vitamins, nutritional problems, tumors, autoimmune diseases (lupus and rheumatoid arthritis), inherited disorders (amyloid polyneuropathy and Charcot-Marie-Tooth disease), poison exposure, and heavy metal toxins. Certain medications and cancer treatment may also cause acquired neuropathy. Charcot-Marie-Tooth disease is a type of hereditary neuropathies that affects the anterior horn cells of the spinal cord and the peripheral nerves and it is the most common inherited form of peripheral neuropathy (Martyn & Hughes). It is a well known fact that peripheral nervous system is vulnerable to toxic heavy metals such as arsenic, lead and thalium and also occupational exposures to toxic solvents such as carbon methyl-nbutylketone, disulphide and n-hexane are accounted for many cases of neuropathy.
The autonomic, sensory and motor nerves are the three major nerves being affected by neuropathy. When it affects the motor nerve, it results to cramps, spasms and muscle weakness which may lead to loss of coordination and balance. The ability to do routine tasks like opening of jars and carrying of bags may be difficult if there is a damage to arm nerves. Moreover, tingling, numbness, impaired sense of position, pinching and pains are all characteristics of damage to the sensory nerve. The associated pains with neuropathy may be described as freezing, burning and electric-like and these sensations may be worsened especially in the night. According to Ewing and Clarke, the damage to autonomic nerves may result to impotence, abnormal heart rate, constipation, and urinary retention, the thinning of the skin, bladder dysfunction, diarrhea and postural hypotension.
Backonja Miroslav et al. 1998. “Gabapentin for the Symptomatic Treatment of Painful Neuropathy in Patients with Diabetes Mellitus. JAMA 280:1831-1836 http://jama.jama network.com/article.aspx?articleid=188227
Ewing D.J., & Clarke B. F. 1982. “Diagnosis and Management of Diabetic Autonomic Neuropathy” British Medical Journal 285:916-918 http://www.ncbi.nlm. /PMC15000 18/pdf/bmjcred00626-0012.pdf
Martyn C. N., & Hughes R. A. C. 1997. “Epidemiology of Peripheral Neuropathy” Journal of Neurology and Psychiatry 62:310-318 http://www.ncbi.nlm.nih. gov/pmc/articles/PM C1074084/pdf/jnnpsyc00004-0006.pdf
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