Polyneuropathy is a clinical syndrome caused by nerve damage outside the central and nervous system. It usually occurs in upper or lower extremities.
It results in common presentation of sensory and motor function loss in the damaged nerve region. A flaccid weakness and wasting of muscle mass is common in motor polyneuropathy. Patient usually experiences a sock/glove numbness, pain, and hypersensitivity in the affected upper or lower extremities.
Pain is characterized by burning, shooting, jabbing, electric-like, and it usually worsens at bedtime.
Diabetes causes gradual peripheral nerve damage that usually starts in the feet and hands and spreads into the rest of the extremity in a sock/glove fashion.
Some vitamin deficiencies like B1, B6, B12, and vitamin E can result in neuropathy.
It usually results from poor dietary habits and vitamin deficiency.
Several diseases like herpes zoster and lime disease can result in nerve damage.
A detailed history and physical, along with physical exam of peripheral nervous system in the hand of an experienced physician will help the diagnosis.
A battery of blood tests, especially vitamin levels, thyroid, kidney, and liver function tests, along with blood sugar levels.
A nerve connection study usually confirms the neuropathy, especially in carpal tunnel syndromes. A selective group of patients may need a nerve biopsy.
Neuropathy is a symptom of underlined conditions, not a disease itself, so treatment is to diagnose the underlined condition and to treat it accordingly.
The symptomatic treatment of neuropathy with various anti-seizure medications like Carbamazipines, Mexiletine, Lyrica, and Neurotin works.
Topical cream like Capsaicin and Lidocaine can be helpful. Patient with a vitamin deficiency are treated multi-vitamins, especially in alcoholic neuropathy.
A selective group of patients may benefit from peripheral or spinal cord stimulators. It is like a TENS unit stimulating the nerves rather than the muscles. Please consult your physician for more details.