परिधीय तंत्रिकाविकृति

का कारण बनता है

Many diseases and conditions can cause peripheral neuropathy. The damage may occur due to:

• कुपोषण
• Compression from repetitive stress
• कैंसर
• सदमा
• Inflammation of nerves or blood vessels
• संक्रमण
• Toxins
• दवाएं
• Hereditary syndromes
• अज्ञात कारण

Diseases that can damage peripheral nerves include (but are not limited to):

• Diabetes — type 1 or type 2
• शराब
• एड्स
• लाइम की बीमारी
• रूमेटाइड गठिया
• Uremia from chronic kidney failure
• स्वप्रतिरक्षी विकार
• हाइपोथायरायडिज्म
• Viral infections like hepatitis

Compression commonly occurs when nerves are pinched or trapped somewhere along their course, such as:

• Carpal tunnel syndrome —nerve in the wrist
• Sciatica —nerve roots forming the sciatic nerve in the back of the legs as they exit the spine

Toxins that can damage the peripheral nerves include:

• Lead
• Mercury
• Thallium
• Organic solvents
• Pesticides
• Carbon disulfide
• हरताल
• Acrylamide
• Diphtheria toxin
• शराब

Many medicines can lead to peripheral neuropathy. A partial list includes:

• Chemotherapeutic agents to treat cancer, such as vincristine, paclitaxel, and cisplatin
• Anti-HIV medications, such as didanosine and zalcitabine
• Anti- tuberculosis medications, such as isoniazid and ethambutol
• Other antimicrobial drugs such as dapsone, metronidazole , chloroquine, and chloramphenicol
• Psychiatric medications, such as lithium
• Other medications, such as amiodarone, aurothioglucose, phenytoin, thalidomide, colchicine, cimetidine, disulfiram, hydralazine, and high levels of vitamin B6

Other causes of peripheral nerve damage include:

• Vitamin deficiencies, such as thiamin, B12, and vitamin E deficiency
• चोट
• A tumor pressing on a nerve
• Exposure to cold or radiation
• Leprosy
• Acute or chronic demyelinating polyneuropathy
• आनुवांशिक असामान्यता
• Paraneoplatic syndromes
• Genetic disorders, such as Charcot-Marie-Tooth disease or hereditary motor and sensory neuropathy
• Prolonged treatment in the intensive care unit

जोखिम कारक

Factors that may increase your risk of getting peripheral neuropathy include:

• मधुमेह
• शराब का दुरुपयोग
• Autoimmune diseases, such as rheumatoid arthritis or celiac sprue
• Family member with peripheral neuropathy
• Exposure to toxins or medications known to cause neuropathy
• Vitamin deficiency, such as thiamin and vitamin B12
• एचआईवी संक्रमण
• Pressure on a nerve—may occur with repetitive stress injuries
• Hospitalization treatment in the intensive care unit

लक्षण

Damage to the peripheral nerves often results in sensory and motor symptoms in the:

• Arms
• Legs
• Hands
• पैर

Other parts of the body can also be affected. Symptoms depend on which nerves are involved. They can range from mild to severe and may seem worse at night. Sensations and pain may occur in the upper or lower limbs and move toward the trunk, such as from the feet to the calves.

लक्षणों में शामिल हैं:

• Numbness or reduced sensation
• Tingling
• Pain, often a burning or sharp, cutting sensation
• Sensitivity to touch
• Muscle twitches
• मांसपेशियों में कमजोरी
• Muscle cramping
• Difficulty with walking
• Loss of coordination or balance
• पक्षाघात

If untreated, peripheral neuropathy can lead to:

• Loss of reflexes and muscle control
• Muscle atrophy—loss of muscle bulk
• पैर की विकृति
• पैर के छाले
• Injuries to the feet that go unnoticed and become infected
• Autonomic dysfunction—sweating, bowel and bladder dysfunction, cardiovascular effects
• सांस लेने में दिक्क्त

If you have motor or sensory neuropathy, you may also have autonomic neuropathy. This is associated with symptoms such as:

• Problems regulating blood pressure
• कब्ज़
• स्तंभन दोष

निदान

The doctor will ask about your symptoms and medical history. A physical exam will be done. It may include examining:

• Muscle strength
• Reflexes
• Balance
• समन्वय
• Ability to feel vibration, temperature, and light touch
• Semmes-Weinstein monofilaments test—measures sensation in the feet using a fine flexible wire

Additional tests may also include:

• You may need to have tests of your bodily fluids and tissues. This can be done with:
  • Blood tests, such as glucose, vitamin B12 level, and thyroid function tests
  • Serum/urine electrophoresis
  • Genetic testing
  • Spinal tap, also called a lumbar puncture
  • Nerve or muscle biopsy —rarely
  • Nerve fiber density skin biopsy
• You may need to have your nerves and muscles tested. This can be done with:
  • Electromyography (EMG)
  • Nerve conduction studies (NCS)
• You may need to have pictures taken of your bodily structures. This can be done with:
  • एमआरआई स्कैन
  • सीटी स्कैन
• Your doctor may need to evaluate other family members for this condition.

उपचार

उपचार में शामिल हो सकते हैं:

रोकथाम

• Manage chronic medical conditions with the help of your doctor. If you have diabetes, visit a podiatrist for yearly exams.
• ऐसा स्वास्थ्यवर्धक आहार लें जिसमें संतृप्त वसा कम हो और साबुत अनाज, फल और सब्जियाँ भरपूर हों।
• Be sure to get the right amounts of thiamin and vitamin B12.
• Limit your alcohol intake to a moderate level. This means two or fewer drinks per day for men and one or fewer for women.
• Avoid:
  • Toxic chemicals
  • दोहरावदार हरकतें
  • Prolonged pressure on joints, especially elbows and knees