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{{Peripheral neuropathy}}
{{Peripheral neuropathy}}


{{CMG}} {{AE}} {{SME}}
{{CMG}}; {{AE}}{{MMJ}}
== Signs and symptoms ==
==Overview==
Symptoms are related to the type of affected nerve and may be seen over a period of days, weeks, or years. Muscle weakness is the most common symptom of motor nerve damage. Other symptoms may include painful cramps and fasciculations (uncontrolled muscle twitching visible under the skin), muscle loss, bone degeneration, and changes in the skin, hair, and nails. These more general degenerative changes also can result from sensory or autonomic nerve fiber loss.
Patients with peripheral neuropathy may have a positive history of: Metabolic disorder, long-standing [[illness|illness,]] childhood [[clumsiness|clumsiness,]] unsteady [[gait]] and falls, [[Neurological diseases]], [[Neurological diseases|neurological diseases,]] occupational inorganic lead exposure and [[Malignancy]]. The most common symptoms of peripheral neuropathy include: Gradual progressive [[numbness]], [[Prickling]] or [[tingling]] in [[feet]] and hands, [[Burning pain]] in [[extremities|extremities,]] extreme [[sensitivity to touch]], [[Ataxia]], frequent falls, muscle weakness or paralysis, [[Constipation]], [[Diarrhea|diarrhea,]] early satiety, [[Nausea|nausea,]] problems controlling [[bowel]] movements, [[Swallowing]] problems, [[Abdomen]] [[distention]],[[Vomiting]], impaired [[heart rate]], resting [[tachycardia]], [[Exercise intolerance|exercise intolerance,]] abnormal [[blood pressure]] regulation, [[orthostatic hypotension]], [[Heat intolerance]] and altered [[sweating]], [[Urinary incontinence|urine incontinence,]] pain (usually from optic neuritis), [[Vision loss]], [[Visual field]] los, loss of color vision and flashing lights.


Sensory nerve damage causes a more complex range of symptoms because sensory nerves have a wider, more highly specialized range of functions. Larger sensory fibers enclosed in myelin (a fatty protein that coats and insulates many nerves) register vibration, light touch, and position sense. Damage to large sensory fibers lessens the ability to feel vibrations and touch, resulting in a general sense of numbness, especially in the hands and feet. People may feel as if they are wearing gloves and stockings even when they are not. Many patients cannot recognize by touch alone the shapes of small objects or distinguish between different shapes. This damage to sensory fibers may contribute to the loss of reflexes (as can motor nerve damage). Loss of position sense often makes people unable to coordinate complex movements like walking or fastening buttons, or to maintain their balance when their eyes are shut.  
==History and Symptoms==
===History===
Patients with peripheral neuropathy may have a positive history of: Metabolic disorder, long-standing [[illness|illness,]] childhood [[clumsiness|clumsiness,]] unsteady [[gait]] and falls, [[Neurological diseases]], [[Neurological diseases|neurological diseases,]] occupational inorganic lead exposure and [[Malignancy]].


Neuropathic pain is difficult to control and can seriously affect emotional well-being and overall quality of life. Neuropathic pain is often worse at night, seriously disrupting sleep and adding to the emotional burden of sensory nerve damage. Neuropathic pain is usually perceived as a steady burning and/or "pins and needles" and/or "electric shock" sensations and/or tickling. The difference is due to the fact that "ordinary" pain stimulates only pain nerves, while a neuropathy often results in the firing of both pain and non-pain (touch, warm, cool) sensory nerves in the same area, producing signals that the spinal cord and brain do not normally expect to receive.
Patients with peripheral neuropathy may have a positive history of:<ref name="pmid16400316">{{cite journal| author=Kelly JJ| title=Peripheral neuropathy: the importance of history and examination for correct diagnosis. | journal=Rev Neurol Dis | year= 2005 | volume= 2 | issue= 3 | pages= 150-3 | pmid=16400316 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16400316  }} </ref><ref name="pmid11459892">{{cite journal| author=Rubens O, Logina I, Kravale I, Eglîte M, Donaghy M| title=Peripheral neuropathy in chronic occupational inorganic lead exposure: a clinical and electrophysiological study. | journal=J Neurol Neurosurg Psychiatry | year= 2001 | volume= 71 | issue= 2 | pages= 200-4 | pmid=11459892 | doi= | pmc=1737511 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11459892  }} </ref><ref name="pmid10716658">{{cite journal| author=Keller MP, Chance PF| title=Inherited peripheral neuropathy. | journal=Semin Neurol | year= 1999 | volume= 19 | issue= 4 | pages= 353-62 | pmid=10716658 | doi=10.1055/s-2008-1040850 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10716658  }} </ref><ref name="pmid2405988">{{cite journal| author=Sharma CM, Sears M| title=Metabolic neuropathy. | journal=Clin Podiatr Med Surg | year= 1990 | volume= 7 | issue= 1 | pages= 97-105 | pmid=2405988 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2405988  }} </ref><ref name="pmid11374098">{{cite journal| author=Storstein A, Vedeler C| title=Neuropathy and malignancy: a retrospective survey. | journal=J Neurol | year= 2001 | volume= 248 | issue= 4 | pages= 322-7 | pmid=11374098 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11374098  }} </ref>
*Metabolic disorders
*Long-standing [[illness]]
*Childhood [[clumsiness]]
*Unsteady [[gait]] and falls
*[[Neurological diseases]]
*[[Neurological diseases]]
*[[Occupational inorganic lead exposure]]
*[[Malignancy]]
===Common Symptoms===
The most common symptoms of peripheral neuropathy include: Gradual progressive [[numbness]], [[Prickling]] or [[tingling]] in [[feet]] and hands, [[Burning pain]] in [[extremities|extremities,]] extreme [[sensitivity to touch]], [[Ataxia]], frequent falls, muscle weakness or paralysis, [[Constipation]], [[Diarrhea|diarrhea,]] early satiety, [[Nausea|nausea,]] problems controlling [[bowel]] movements, [[Swallowing]] problems, [[Abdomen]] [[distention]],[[Vomiting]], impaired [[heart rate]], resting [[tachycardia]], [[Exercise intolerance|exercise intolerance,]] abnormal [[blood pressure]] regulation, [[orthostatic hypotension]], [[Heat intolerance]] and altered [[sweating]], [[Urinary incontinence|urine incontinence,]] pain (usually from optic neuritis), [[Vision loss]], [[Visual field]] los, loss of color vision and flashing lights.


Smaller sensory fibers without myelin sheaths transmit pain and temperature sensations. Damage to these fibers can interfere with the ability to feel pain or changes in temperature. People may fail to sense that they have been injured from a cut or that a wound is becoming infected. Others may not detect pains that warn of impending heart attack or other acute conditions. (Loss of pain sensation is a particularly serious problem for people with diabetes, contributing to the high rate of lower limb amputations among this population.) Pain receptors in the skin can also become oversensitized, so that people may feel severe pain (allodynia) from stimuli that are normally painless (for example, some may experience pain from bed sheets draped lightly over the body).
The most common symptoms of peripheral neuropathy include:
 
*Gradual progressive [[numbness]]<ref name="pmid18615140">{{cite journal| author=Marchettini P, Lacerenza M, Mauri E, Marangoni C| title=Painful peripheral neuropathies. | journal=Curr Neuropharmacol | year= 2006 | volume= 4 | issue= 3 | pages= 175-81 | pmid=18615140 | doi= | pmc=2430688 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18615140  }} </ref><ref name="pmid21479990">{{cite journal| author=Wolf SL, Barton DL, Qin R, Wos EJ, Sloan JA, Liu H et al.| title=The relationship between numbness, tingling, and shooting/burning pain in patients with chemotherapy-induced peripheral neuropathy (CIPN) as measured by the EORTC QLQ-CIPN20 instrument, N06CA. | journal=Support Care Cancer | year= 2012 | volume= 20 | issue= 3 | pages= 625-32 | pmid=21479990 | doi=10.1007/s00520-011-1141-9 | pmc=3329939 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21479990  }} </ref>
Symptoms of autonomic nerve damage are diverse and depend upon which organs or glands are affected. Autonomic nerve dysfunction can become life threatening and may require emergency medical care in cases when breathing becomes impaired or when the heart begins beating irregularly. Common symptoms of autonomic nerve damage include an inability to sweat normally, which may lead to heat intolerance; a loss of bladder control, which may cause infection or incontinence; and an inability to control muscles that expand or contract blood vessels to maintain safe blood pressure levels. A loss of control over blood pressure can cause dizziness, lightheadedness, or even fainting when a person moves suddenly from a seated to a standing position (a condition known as postural or orthostatic hypotension).
*[[Prickling]] or [[tingling]] in [[feet]] and [[[hands]]<ref name="pmid18615140">{{cite journal| author=Marchettini P, Lacerenza M, Mauri E, Marangoni C| title=Painful peripheral neuropathies. | journal=Curr Neuropharmacol | year= 2006 | volume= 4 | issue= 3 | pages= 175-81 | pmid=18615140 | doi= | pmc=2430688 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18615140  }} </ref><ref name="pmid21479990">{{cite journal| author=Wolf SL, Barton DL, Qin R, Wos EJ, Sloan JA, Liu H et al.| title=The relationship between numbness, tingling, and shooting/burning pain in patients with chemotherapy-induced peripheral neuropathy (CIPN) as measured by the EORTC QLQ-CIPN20 instrument, N06CA. | journal=Support Care Cancer | year= 2012 | volume= 20 | issue= 3 | pages= 625-32 | pmid=21479990 | doi=10.1007/s00520-011-1141-9 | pmc=3329939 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21479990  }} </ref>
 
*[[Burning pain]] in [[extremities]]<ref name="pmid18615140">{{cite journal| author=Marchettini P, Lacerenza M, Mauri E, Marangoni C| title=Painful peripheral neuropathies. | journal=Curr Neuropharmacol | year= 2006 | volume= 4 | issue= 3 | pages= 175-81 | pmid=18615140 | doi= | pmc=2430688 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18615140  }} </ref>
Gastrointestinal symptoms frequently accompany autonomic neuropathy. Nerves controlling intestinal muscle contractions often malfunction, leading to diarrhea, constipation, or incontinence. Many people also have problems eating or swallowing if certain autonomic nerves are affected.
*Extreme [[sensitivity to touch]]<ref name="pmid18615140">{{cite journal| author=Marchettini P, Lacerenza M, Mauri E, Marangoni C| title=Painful peripheral neuropathies. | journal=Curr Neuropharmacol | year= 2006 | volume= 4 | issue= 3 | pages= 175-81 | pmid=18615140 | doi= | pmc=2430688 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18615140  }} </ref><ref name="pmid21479990">{{cite journal| author=Wolf SL, Barton DL, Qin R, Wos EJ, Sloan JA, Liu H et al.| title=The relationship between numbness, tingling, and shooting/burning pain in patients with chemotherapy-induced peripheral neuropathy (CIPN) as measured by the EORTC QLQ-CIPN20 instrument, N06CA. | journal=Support Care Cancer | year= 2012 | volume= 20 | issue= 3 | pages= 625-32 | pmid=21479990 | doi=10.1007/s00520-011-1141-9 | pmc=3329939 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21479990  }} </ref>
 
*[[Ataxia]]<ref name="pmid26054379">{{cite journal| author=Linnemann C, Tezenas du Montcel S, Rakowicz M, Schmitz-Hübsch T, Szymanski S, Berciano J et al.| title=Peripheral Neuropathy in Spinocerebellar Ataxia Type 1, 2, 3, and 6. | journal=Cerebellum | year= 2016 | volume= 15 | issue= 2 | pages= 165-73 | pmid=26054379 | doi=10.1007/s12311-015-0684-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26054379  }} </ref>
Numbness is an abnormal sensation called [[dysesthesia]]s and [[allodynia]]s that occur either spontaneously or in reaction to external stimuli, and a characteristic form of pain, called neuropathic pain or neuralgia, that is qualitatively different from the ordinary [[Pain and nociception|nociceptive]] pain one might experience from stubbing a toe or hitting a finger with a hammer.
*Frequent falls<ref name="pmid26054379">{{cite journal| author=Linnemann C, Tezenas du Montcel S, Rakowicz M, Schmitz-Hübsch T, Szymanski S, Berciano J et al.| title=Peripheral Neuropathy in Spinocerebellar Ataxia Type 1, 2, 3, and 6. | journal=Cerebellum | year= 2016 | volume= 15 | issue= 2 | pages= 165-73 | pmid=26054379 | doi=10.1007/s12311-015-0684-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26054379  }} </ref>
 
*Muscle weakness or paralysis<ref name="pmid18615140">{{cite journal| author=Marchettini P, Lacerenza M, Mauri E, Marangoni C| title=Painful peripheral neuropathies. | journal=Curr Neuropharmacol | year= 2006 | volume= 4 | issue= 3 | pages= 175-81 | pmid=18615140 | doi= | pmc=2430688 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18615140  }} </ref>
Those with diseases or dysfunctions of their [[peripheral nerve]]s can present with problems in any of the normal peripheral nerve functions.
*[[Gastrointestinal]] symptoms:
 
**[[Constipation]]<ref name="pmid29048762">{{cite journal| author=Yamada E, Namiki Y, Takano Y, Takamine H, Inazumi K, Sasaki H et al.| title=Clinical factors associated with the symptoms of constipation in patients with diabetes mellitus: A multicenter study. | journal=J Gastroenterol Hepatol | year= 2018 | volume= 33 | issue= 4 | pages= 863-868 | pmid=29048762 | doi=10.1111/jgh.14022 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29048762  }} </ref>
In terms of sensory function, there are commonly ''loss of function'' (''negative'') symptoms, which include [[numbness]], [[tremor]], and [[encopresis|gait imbalance]].
**[[Diarrhea]]<ref name="pmid23940440">{{cite journal| author=Pfluecke C, Ulbrich S, Ibrahim K, Geiger KD, Strasser RH, Wunderlich C| title=Chronic diarrhea as the initial clinical manifestation of light-chain amyloidosis with cardiac involvement despite negative duodenal and rectal biopsies. | journal=Exp Clin Cardiol | year= 2013 | volume= 18 | issue= 2 | pages= 148-50 | pmid=23940440 | doi= | pmc=3718595 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23940440  }} </ref>
 
**Early satiety<ref name="pmid23940440">{{cite journal| author=Pfluecke C, Ulbrich S, Ibrahim K, Geiger KD, Strasser RH, Wunderlich C| title=Chronic diarrhea as the initial clinical manifestation of light-chain amyloidosis with cardiac involvement despite negative duodenal and rectal biopsies. | journal=Exp Clin Cardiol | year= 2013 | volume= 18 | issue= 2 | pages= 148-50 | pmid=23940440 | doi= | pmc=3718595 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23940440  }} </ref>
''Gain of function'' (''positive'') symptoms include [[tingling]], [[Pain and nociception|pain]], [[itch]]ing, [[crawling]], and [[paresthesia|pins and needles]]. Pain can become intense enough to require use of opiate drugs (i.e., morphine, oxycontin).
**[[Nausea]]<ref name="pmid18524793">{{cite journal| author=Devigili G, Tugnoli V, Penza P, Camozzi F, Lombardi R, Melli G et al.| title=The diagnostic criteria for small fibre neuropathy: from symptoms to neuropathology. | journal=Brain | year= 2008 | volume= 131 | issue= Pt 7 | pages= 1912-25 | pmid=18524793 | doi=10.1093/brain/awn093 | pmc=2442424 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18524793  }} </ref>
 
**Problems controlling [[bowel]] movements
Skin can become so hypersensitive that patients are prohibited from having anything touch certain parts of their body, especially the feet. People with this degree of sensitivity cannot have a bed sheet touch their feet or wear socks or shoes, and eventually become housebound.
**[[Swallowing]] problems<ref name="pmid18524793">{{cite journal| author=Devigili G, Tugnoli V, Penza P, Camozzi F, Lombardi R, Melli G et al.| title=The diagnostic criteria for small fibre neuropathy: from symptoms to neuropathology. | journal=Brain | year= 2008 | volume= 131 | issue= Pt 7 | pages= 1912-25 | pmid=18524793 | doi=10.1093/brain/awn093 | pmc=2442424 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18524793  }} </ref>
 
**[[Abdomen]] [[distention]]<ref name="pmid23772273">{{cite journal| author=Krishnan B, Babu S, Walker J, Walker AB, Pappachan JM| title=Gastrointestinal complications of diabetes mellitus. | journal=World J Diabetes | year= 2013 | volume= 4 | issue= 3 | pages= 51-63 | pmid=23772273 | doi=10.4239/wjd.v4.i3.51 | pmc=3680624 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23772273  }} </ref>
Motor symptoms include ''loss of function'' (''negative'') symptoms of weakness, [[fatigue (physical)|tiredness]], heaviness, and [[gait abnormality|gait abnormalities]]; and ''gain of function'' (''positive'') symptoms of [[cramps]], tremor, and [[fasciculation]]s.
**[[Vomiting]]<ref name="pmid18524793">{{cite journal| author=Devigili G, Tugnoli V, Penza P, Camozzi F, Lombardi R, Melli G et al.| title=The diagnostic criteria for small fibre neuropathy: from symptoms to neuropathology. | journal=Brain | year= 2008 | volume= 131 | issue= Pt 7 | pages= 1912-25 | pmid=18524793 | doi=10.1093/brain/awn093 | pmc=2442424 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18524793  }} </ref>
 
*[[Cardiovascular]] symptoms:<ref name="pmid20103559">{{cite journal| author=Pop-Busui R| title=Cardiac autonomic neuropathy in diabetes: a clinical perspective. | journal=Diabetes Care | year= 2010 | volume= 33 | issue= 2 | pages= 434-41 | pmid=20103559 | doi=10.2337/dc09-1294 | pmc=2809298 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20103559  }} </ref><ref name="pmid27034552">{{cite journal| author=McCarty N, Silverman B| title=Cardiovascular autonomic neuropathy. | journal=Proc (Bayl Univ Med Cent) | year= 2016 | volume= 29 | issue= 2 | pages= 157-9 | pmid=27034552 | doi= | pmc=4790554 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27034552  }} </ref><ref name="pmid29214181">{{cite journal| author=Bissinger A| title=Cardiac Autonomic Neuropathy: Why Should Cardiologists Care about That? | journal=J Diabetes Res | year= 2017 | volume= 2017 | issue=  | pages= 5374176 | pmid=29214181 | doi=10.1155/2017/5374176 | pmc=5682059 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29214181  }} </ref>
There is also [[Pain and nociception|pain]] in the muscles (''[[myalgia]]''), cramps, ''etc''., and there may also be [[autonomic nervous system|autonomic]] dysfunction.
**Impaired [[heart rate]]
 
**Resting [[tachycardia]]
During [[physical examination]], those with generalized peripheral neuropathies most commonly have distal sensory or motor and sensory loss, though those with a[[pathology]] (problem) of the peripheral nerves may be perfectly normal; may show proximal weakness, as in some [[inflammatory]] [[neuropathy|neuropathies]] like[[Guillain-Barré syndrome]]); or may show focal sensory disturbance or weakness, such as in [[mononeuropathy|mononeuropathies]], [[radiculopathy|radiculopathies]] and plexopathies.
**[[Exercise intolerance]]
 
**Abnormal [[blood pressure]] regulation
Common disorders of the peripheral nerves include ''focal entrapment neuropathies'' (''e.g.'', [[carpal tunnel syndrome]]), ''generalized peripheral neuropathies''(''e.g.'', [[diabetic neuropathy]]), ''plexopathies'' (''e.g.'', [[brachial]] [[neuritis]]) and ''radiculopathies'' (''e.g.'', of [[cranial nerve]] VII; [[Facial nerve]]).
**Orthostatic hypotension
*[[Heat intolerance]] and altered [[sweating]]<ref name="pmid27227101">{{cite journal| author=Kenny GP, Sigal RJ, McGinn R| title=Body temperature regulation in diabetes. | journal=Temperature (Austin) | year= 2016 | volume= 3 | issue= 1 | pages= 119-45 | pmid=27227101 | doi=10.1080/23328940.2015.1131506 | pmc=4861190 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27227101  }} </ref>
* [[Urinary incontinence|Urine incontinence]]:<ref name="pmid22190298">{{cite journal| author=Burakgazi AZ, Alsowaity B, Burakgazi ZA, Unal D, Kelly JJ| title=Bladder dysfunction in peripheral neuropathies. | journal=Muscle Nerve | year= 2012 | volume= 45 | issue= 1 | pages= 2-8 | pmid=22190298 | doi=10.1002/mus.22178 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22190298  }} </ref><ref name="pmid27706007">{{cite journal| author=Tanik N, Tanik S, Albayrak S, Zengin K, Inan LE, Caglayan EK et al.| title=Association Between Overactive Bladder and Polyneuropathy in Diabetic Patients. | journal=Int Neurourol J | year= 2016 | volume= 20 | issue= 3 | pages= 232-239 | pmid=27706007 | doi=10.5213/inj.1632508.254 | pmc=5083825 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27706007  }} </ref>
*[[Ocular]] symptoms:<ref name="pmid26500330">{{cite journal| author=DeMill DL, Hussain M, Pop-Busui R, Shtein RM| title=Ocular surface disease in patients with diabetic peripheral neuropathy. | journal=Br J Ophthalmol | year= 2016 | volume= 100 | issue= 7 | pages= 924-928 | pmid=26500330 | doi=10.1136/bjophthalmol-2015-307369 | pmc=5037046 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26500330  }} </ref><ref name="pmid27423690">{{cite journal| author=Srinivasan S, Pritchard N, Sampson GP, Edwards K, Vagenas D, Russell AW et al.| title=Diagnostic capability of retinal thickness measures in diabetic peripheral neuropathy. | journal=J Optom | year= 2017 | volume= 10 | issue= 4 | pages= 215-225 | pmid=27423690 | doi=10.1016/j.optom.2016.05.003 | pmc=5595257 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27423690  }} </ref><ref name="pmid19830009">{{cite journal| author=Nightingale LM, Paviour DC| title=Nutritional optic and peripheral neuropathy: a case report. | journal=Cases J | year= 2009 | volume= 2 | issue=  | pages= 7762 | pmid=19830009 | doi=10.4076/1757-1626-2-7762 | pmc=2740016 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19830009  }} </ref>
**Pain (usually from optic neuritis)
**[[Vision loss]]
**[[Visual field]] loss
**Loss of color [[vision]]
**Flashing lights


==References==
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Latest revision as of 19:41, 24 August 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

Overview

Patients with peripheral neuropathy may have a positive history of: Metabolic disorder, long-standing illness, childhood clumsiness, unsteady gait and falls, Neurological diseases, neurological diseases, occupational inorganic lead exposure and Malignancy. The most common symptoms of peripheral neuropathy include: Gradual progressive numbness, Prickling or tingling in feet and hands, Burning pain in extremities, extreme sensitivity to touch, Ataxia, frequent falls, muscle weakness or paralysis, Constipation, diarrhea, early satiety, nausea, problems controlling bowel movements, Swallowing problems, Abdomen distention,Vomiting, impaired heart rate, resting tachycardia, exercise intolerance, abnormal blood pressure regulation, orthostatic hypotension, Heat intolerance and altered sweating, urine incontinence, pain (usually from optic neuritis), Vision loss, Visual field los, loss of color vision and flashing lights.

History and Symptoms

History

Patients with peripheral neuropathy may have a positive history of: Metabolic disorder, long-standing illness, childhood clumsiness, unsteady gait and falls, Neurological diseases, neurological diseases, occupational inorganic lead exposure and Malignancy.

Patients with peripheral neuropathy may have a positive history of:[1][2][3][4][5]

Common Symptoms

The most common symptoms of peripheral neuropathy include: Gradual progressive numbness, Prickling or tingling in feet and hands, Burning pain in extremities, extreme sensitivity to touch, Ataxia, frequent falls, muscle weakness or paralysis, Constipation, diarrhea, early satiety, nausea, problems controlling bowel movements, Swallowing problems, Abdomen distention,Vomiting, impaired heart rate, resting tachycardia, exercise intolerance, abnormal blood pressure regulation, orthostatic hypotension, Heat intolerance and altered sweating, urine incontinence, pain (usually from optic neuritis), Vision loss, Visual field los, loss of color vision and flashing lights.

The most common symptoms of peripheral neuropathy include:

References

  1. ↑ Kelly JJ (2005). "Peripheral neuropathy: the importance of history and examination for correct diagnosis". Rev Neurol Dis. 2 (3): 150–3. PMID 16400316.
  2. ↑ Rubens O, Logina I, Kravale I, Eglîte M, Donaghy M (2001). "Peripheral neuropathy in chronic occupational inorganic lead exposure: a clinical and electrophysiological study". J Neurol Neurosurg Psychiatry. 71 (2): 200–4. PMC 1737511. PMID 11459892.
  3. ↑ Keller MP, Chance PF (1999). "Inherited peripheral neuropathy". Semin Neurol. 19 (4): 353–62. doi:10.1055/s-2008-1040850. PMID 10716658.
  4. ↑ Sharma CM, Sears M (1990). "Metabolic neuropathy". Clin Podiatr Med Surg. 7 (1): 97–105. PMID 2405988.
  5. ↑ Storstein A, Vedeler C (2001). "Neuropathy and malignancy: a retrospective survey". J Neurol. 248 (4): 322–7. PMID 11374098.
  6. ↑ 6.0 6.1 6.2 6.3 6.4 Marchettini P, Lacerenza M, Mauri E, Marangoni C (2006). "Painful peripheral neuropathies". Curr Neuropharmacol. 4 (3): 175–81. PMC 2430688. PMID 18615140.
  7. ↑ 7.0 7.1 7.2 Wolf SL, Barton DL, Qin R, Wos EJ, Sloan JA, Liu H; et al. (2012). "The relationship between numbness, tingling, and shooting/burning pain in patients with chemotherapy-induced peripheral neuropathy (CIPN) as measured by the EORTC QLQ-CIPN20 instrument, N06CA". Support Care Cancer. 20 (3): 625–32. doi:10.1007/s00520-011-1141-9. PMC 3329939. PMID 21479990.
  8. ↑ 8.0 8.1 Linnemann C, Tezenas du Montcel S, Rakowicz M, Schmitz-Hübsch T, Szymanski S, Berciano J; et al. (2016). "Peripheral Neuropathy in Spinocerebellar Ataxia Type 1, 2, 3, and 6". Cerebellum. 15 (2): 165–73. doi:10.1007/s12311-015-0684-6. PMID 26054379.
  9. ↑ Yamada E, Namiki Y, Takano Y, Takamine H, Inazumi K, Sasaki H; et al. (2018). "Clinical factors associated with the symptoms of constipation in patients with diabetes mellitus: A multicenter study". J Gastroenterol Hepatol. 33 (4): 863–868. doi:10.1111/jgh.14022. PMID 29048762.
  10. ↑ 10.0 10.1 Pfluecke C, Ulbrich S, Ibrahim K, Geiger KD, Strasser RH, Wunderlich C (2013). "Chronic diarrhea as the initial clinical manifestation of light-chain amyloidosis with cardiac involvement despite negative duodenal and rectal biopsies". Exp Clin Cardiol. 18 (2): 148–50. PMC 3718595. PMID 23940440.
  11. ↑ 11.0 11.1 11.2 Devigili G, Tugnoli V, Penza P, Camozzi F, Lombardi R, Melli G; et al. (2008). "The diagnostic criteria for small fibre neuropathy: from symptoms to neuropathology". Brain. 131 (Pt 7): 1912–25. doi:10.1093/brain/awn093. PMC 2442424. PMID 18524793.
  12. ↑ Krishnan B, Babu S, Walker J, Walker AB, Pappachan JM (2013). "Gastrointestinal complications of diabetes mellitus". World J Diabetes. 4 (3): 51–63. doi:10.4239/wjd.v4.i3.51. PMC 3680624. PMID 23772273.
  13. ↑ Pop-Busui R (2010). "Cardiac autonomic neuropathy in diabetes: a clinical perspective". Diabetes Care. 33 (2): 434–41. doi:10.2337/dc09-1294. PMC 2809298. PMID 20103559.
  14. ↑ McCarty N, Silverman B (2016). "Cardiovascular autonomic neuropathy". Proc (Bayl Univ Med Cent). 29 (2): 157–9. PMC 4790554. PMID 27034552.
  15. ↑ Bissinger A (2017). "Cardiac Autonomic Neuropathy: Why Should Cardiologists Care about That?". J Diabetes Res. 2017: 5374176. doi:10.1155/2017/5374176. PMC 5682059. PMID 29214181.
  16. ↑ Kenny GP, Sigal RJ, McGinn R (2016). "Body temperature regulation in diabetes". Temperature (Austin). 3 (1): 119–45. doi:10.1080/23328940.2015.1131506. PMC 4861190. PMID 27227101.
  17. ↑ Burakgazi AZ, Alsowaity B, Burakgazi ZA, Unal D, Kelly JJ (2012). "Bladder dysfunction in peripheral neuropathies". Muscle Nerve. 45 (1): 2–8. doi:10.1002/mus.22178. PMID 22190298.
  18. ↑ Tanik N, Tanik S, Albayrak S, Zengin K, Inan LE, Caglayan EK; et al. (2016). "Association Between Overactive Bladder and Polyneuropathy in Diabetic Patients". Int Neurourol J. 20 (3): 232–239. doi:10.5213/inj.1632508.254. PMC 5083825. PMID 27706007.
  19. ↑ DeMill DL, Hussain M, Pop-Busui R, Shtein RM (2016). "Ocular surface disease in patients with diabetic peripheral neuropathy". Br J Ophthalmol. 100 (7): 924–928. doi:10.1136/bjophthalmol-2015-307369. PMC 5037046. PMID 26500330.
  20. ↑ Srinivasan S, Pritchard N, Sampson GP, Edwards K, Vagenas D, Russell AW; et al. (2017). "Diagnostic capability of retinal thickness measures in diabetic peripheral neuropathy". J Optom. 10 (4): 215–225. doi:10.1016/j.optom.2016.05.003. PMC 5595257. PMID 27423690.
  21. ↑ Nightingale LM, Paviour DC (2009). "Nutritional optic and peripheral neuropathy: a case report". Cases J. 2: 7762. doi:10.4076/1757-1626-2-7762. PMC 2740016. PMID 19830009.

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