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Peripheral Neuropathy

Steve Smith discusses peripheral neuropathy
© University of East Anglia

The brain and spinal cord make up what we refer to as the ‘Central Nervous System’ (CNS). The remainder of the nervous system, is known as the Peripheral Nervous System (PNS).

Bundles of neurones within the CNS, forming pathways through the brain and spinal cord, are known as ‘Tracts’. Bundles of neurones in the PNS, conveying signals between the CNS and the organs and muscles of the body are known as ‘Nerves’.

Some nerves are ‘sensory’, conveying signals from organs such as the skin, muscles, the eyes and ears, and many, many more, along the PNS, to the CNS. Other nerves in the PNS make up the Autonomic Nervous System (ANS) and convey signals to and from organs such as the heart and respiratory system, and sensors in the skin to do with temperature control. The brain processes the sensory information, and responds by sending signals to ‘motor’ nerves, which convey those signals to cause responses in the muscles and organs.

For example, if the brain receives sensory signals from the skin indicating the ambient temperature is cold, then pores may be closed, hairs stand erect to trap a layer of air, and blood vessels near the skin surface are constricted so that less heat from the blood escapes to the surface (so we look paler than if we were warm).

Peripheral nerves can be damaged by a viral infection such as shingles, or by an injury, or by drinking excessive alcohol. But most commonly a condition known as peripheral neuropathy- deterioration of peripheral nerves happens at the body’s extremities and is caused by diabetes (both type 1 and type 2). Near the extremities (feet and hands for example, especially toes and fingers) peripheral nerves are vulnerable to damage if there is a high sugar level in the blood as occurs in diabetes if not well controlled.

Signs of peripheral neuropathy that indicate the need for medical intervention include tingling, pain, numbness or a loss of sensation typically in toes and feet or fingers, a loss of balance, muscle weakness, especially in the feet, and or a wound that is not healing quickly.

Treatment may include managing the underlying cause, for example, help to control sugar levels in diabetes. Analgeasia might be prescribed to manage pain. Physiotherapy and / or occupational therapy might be accessed to help address problems associated with muscle weakness, for example, mobilising.

A healthy lifestyle reduces the risk of peripheral neuropathy, for example, a healthy diet, regular moderate exercise, and avoiding smoking and excessive alcohol.

It is very important to manage peripheral neuropathy early to avoid potential serious complications such as blindness, gangrene leading to eventual loss of a foot or limb through necessary amputation, and heart and circulatory disease.

© University of East Anglia
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