What is peripheral nervous system
The peripheral nervous system (PNS) is made up of the nerve cells and ganglia outside the brain and spinal cord. This system also refers to parts of the nervous system that includes the cranial nerves, spinal nerves and their roots and branches, peripheral nerves, and neuromuscular junctions. The peripheral nervous system is also associated with the long nerve fibres which contains the axon bundles and ganglia which made up the neural cell bodies.
The PNS is responsible for the connection of the nerves from the brain and spinal cord to the rest of your body. This includes your arms, hands, feet, internal organ. Etc.
The major roles of the peripheral nerves is to deliver signals about physical sensations from other parts of the body to the brain.
What is neuropathy?
Neuropathy is a term that generally refers to the diseases or malfunctions of any of the nerves in the body. Nerves are damaged by disease or injury to them and this affect the location and position they support in the body. However the classification of the nerves damage is particular to the part of the body they supports and the location of the body they are found.
What is Peripheral Neuropathy?
Peripheral neuropathy is a disorder or condition that that occurs when the nerves that carries information and messages from the brain and spinal cord to other parts of he body malfunction because they are damaged, destroyed or diseased. This damage or disease to the nerves interrupts the normal functions of the nerves either to cause pains when noting really is causing the pain or they might not send pain signals when pain is to be felt by the body. This can be caused due to injury, illness, infections or disorder in The body.
Damages causes to nerves interrupts communication between the brain and other parts of the body and can cause pain, affect muscle movement, affects sensations in arms, legs and fleets.
This disease peripheral neuropathies are common, among people over the age of 55, the conditions affect 3% to 4% of people in this group.The disease generally affects about 20 million people in the USA and about 1.5 million in Nigeria.
The nerves Neuropathy can affect and their functions
Sensory nerves: These nerves are associated with the control of sensation in the part of peripheral they supports, and damage to this sensory nerves comes with pain, numbness, tingling and weakness in the peripherals (feet and hands).
Motor nerves : The motor nerves are associated with power and movement, this allows for movement and manovering and damage or infection to this nerves causes weakness to hands and feet.
Autonomic nerves : Digestive system, cardiovascular system Heart rate, blood pressure and some other associated functions are control by the autonomic nervous system. The autonomic nerves control this vital body systems damage to this nerves will affect this functions they perform.
such as the digestive or cardiovascular system. Damage can affect the heart rate, blood pressure, and other functions.
Types of Peripheral Neuropathy
Peripheral neuropathy is been classified into more than 100 types which have been identified. Each of this disease has with its own symptoms and ways to which they affects the body and possible line of treatment. However peripheral neuropathies are classified according to the type of damage to the nerves and the location to which the damage also concurs.
Some forms of neuropathy involve damage to only one nerve and are called mononeuropathy, and when multiple nerves are affected, it is called polyneuropathy. Neuropathia damage can be as a result of axon damage a long thread like part of the nerve cell, also damage to the fatty protein coat that insulate the a done called myelin sheath can also be the cause of neurophaty.
Mononeuropathy
Mononeurophaty is the damage to a single peripheral nerve is called mononeuropathy. This can be caused by traumatic injuries which are the major cause. However living a sedentary lifestyle and staying in one place can cause mononeuropathy.
Diseases associated with mononeuropathy
A well known example of mononeuropathy is the overuse strain injury also called the Carpal tunnel syndrome, which is as a result of compression to the nerve of the wrist and its associated with repeated motion of the wrist and its associated with people who’s work is associated with physical Labour.
Injury or damage to the nerves that passes close to the skin of the elbow causes Ulnar nerve palsy and its resultant effect is felt with a numbing sensation which is always noticed in the 4th and 5th digit of the hands.
Another form of mononeurophaty is called the Radial nerve palsy. This disease is associated and caused by injury to the nerve that runs along the underside of the upper arm. This damage mostly occurs when their is a fracture to the humerus bone (the long bone of the thighs) and fractures in the upper part of the arm.
The Peroneal nerve palsy is caused by compression to the nerves at the top of the calf on the outside of the knee. The resultant effect is associated with foot drop” a condition called " foot drop ," in which it becomes difficult to lift the foot by the individual.
What is Polyneuropathy
Another type of neuropathy is called the Polyneuropathy and it is linked with the greatest number of peripheral neuropathy diseases complaints. Polyneuropathy is as a result of multiply damage to peripheral nerves. The causes of polyneuropathy is associated with complications with diseases such as cancer, kidney failure, alcohol abuse, poor nutrition.
A chronic form of polyneuropathy is diabetic neuropathy, a condition that occurs in people with diabetes mellitus. It is more severe in people with poorly controlled blood sugar levels.
Another associated disease with polyneuropathies is Guillain-Barre syndrome, a very rare disease that affects the immune system by attacking the nerves in the body just as they leave the spinal cord, this disease is quickly noticeable with obvious signs and worsen quickly, sometimes leading to paralysis.
Signs and symptoms of Peripheral Neuropathy
Signs and symptoms of peripheral neuropathy includes the following:
Extreme sensitivity to touch
Lack of coordination that may sometimes result in falling
Muscle weakness or paralysis in instances of motor nerves damage
Heat intolerance and sweating
Tingling sensation in hands or feet
Experiencing sharp and stabbing pains
Sensation of numbness in the hands or feet
Thinning of the skin
A drop in blood pressure when autonomic nervous system is affected causing dizziness or lightheadedness.
sexual dysfunction, especially in men
Digestive problems, constipation and diarrhoea
excessive sweating
Causes of peripheral Neuropathy
Peripheral neuropathy is caused by a number of reasons and situations. This does not narrow down to a specific disease or Ill health state. The causes of peripheral neuropathies include:
Diabetes . People who suffers from diabetes mellitus as some point develop some type of peripheral neuropathy and this affects more than half the people with diabetes disease.
Alcoholism . alcoholism can lead to various deficiencies and can trigger the unset of peripheral neuropathy.
Poor diet. Poor diet can also cause the development of peripheral neuropathy due to absent of essential vitamins nessesary for the body
Trauma, damage, injuries and pressure on the nerve.
Tumors
Vitamin deficiencies . B vitamins — including B-1, B-6 and B-12 — vitamin E and niacin are crucial to nerve health.
Autoimmune diseases. Disorders such as Lupus, Sjogren's syndrome, rheumatoid arthritis, Guillain-Barre syndrome, chronic inflammatory demyelinating and necrotizing vasculitis.
Exposure to toxins, heavy metals and chemicals.
Medications . Certain medications, especially those used to treat cancer (chemotherapy), can cause peripheral neuropathy.
Infections. Such as leprosy, diphtheria, HIV, Lyme disease and shingles can trigger the onset of peripheral neuropathy.
Risk factors associated with Peripheral neuropathy
Uncontrolled Diabetes mellitus
Alcohol abuse
Vitamin deficiencies especially B vitamins
Infections such as Epstein-Barr virus and hepatitis C
Autoimmune diseases
Kidney, liver or thyroid disorders
Exposure to chemical and toxins
Some certain jobs that requires extreme physical stress
Family history of neuropathy
Diagnosis of Peripheral Neuropathy
Diagnosis of peripheral neuropathy is in diverse forms and its caused by different situations. Physical examination is performed and medical history is requested and accessed. Certain physical exam done includes vibration and monofilament testing.
Nerve conduction studies (NCS)
CT Scan
Electromyelography ( EMG).
Skin biopsies
Nerve biopsy
Quantitative sudomotor axon reflex testing (QSART)
Treatment of Peripheral Neuropathy
Treatment
Treatment are based on underlying condition causing neuropathy and to relieve symptoms.
Medications used to relieve peripheral neuropathy signs and symptoms include:
Pain relievers such as nonsteroidal anti-inflammatory drugs.
Opioids, such as tramadol (Conzip, Ultram) or oxycodone (Oxycontin, Roxicodone, others).
Anti-seizure drugs such as gabapentin (Gralise, Neurontin) and pregabalin (Lyrica) are useful and may relieve nerve pain.
Lidocaine patches are another treatment you apply to your skin that might offer pain relief.
Antidepressants. Such as amitriptyline and doxepin have been found to help relieve pain.
Therapies to help improve peripheral neuropathy
Transcutaneous electrical nerve stimulation (TENS).
Plasma exchange and intravenous immune globulin.
Surgery. If the neuropathy is caused by pressure on nerves, by tumour or growth.
Prevention of Peripheral Neuropathy
Practise healthy diet and good eating habits
Exercise regularly
Avoid exposure to chemicals and toxins
Quit smoking.
Avoid excessive alcohol intake and use
Monitor and manage diabetes well
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