Human nervous system consist of two main parts viz central nervous system and Peripheral Nervous system. Central Nervous system consist of brain and spinal cord. Peripheral Nervous system consist of nerves outside brain and spinal cord. The main function of Peripheral nervous system is to connect central nervous system to limbs and other end organs of the body. Any impairment in function of these peripheral nerves leads to condition called as peripheral Neuropathy.

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Causes of Peripheral Neuropathy

Causes of Peripheral Neuropathy can be cathegorised into two main groups:

Genetic
Acquired
- Secondary
  - Traumatic
  - Metabolic
  - Infectious
  - Malginant
  - Vascular
  - Inflammatory Problems
  - Drug Induced
  - Latrogenic
  - Cause not known
- Idiopathic
  - Cause not known

Acquired Peripheral Neuropathy

Traumatic

Road Traffic accident, fall - Any injury causing compression and physical damage to nerves. For instance fracture humerus causing injury to radial nerve.

Metabolic

Diabetes Mellitus.
Thyroid disease
Renal disease.
Chronic liver disease
Nutritional disease like alcoholism, vitamin B12 deficiency, Thiamine deficiency, vitamin A deficiency.
Toxic neuropathy - By acrylamide, carbon disulphide, carbon monoxide, ethylene oxide, glue sniffing.

Infectious

Viral

Varicellazoster.
Westnilevirus.
Cytomegalovirus
Herpes simplex.

B. Bacterial

Campylobacter Jejuni.

C. COVID

COVID infections cause myriad problems in peripheral nerve functions with early or late onset symptoms.
Malignant

Tumors either bycompression or from tumors arising from nerve sheath
Paraneoplstic syndrome.

Vascular and Blood Problems.

Smoking - Example: Buerger’s disease
Artherosclerosis

Inflammatory

Sarcoidosis
Vasculitis
Amyloidosis
Radiation

Iatrogenic
Trauma due to surgical procedure like Inj over sciatic nerve.
Others

Drug Induced.

Isoniazid
Ethambutol
Phentyoin
Lithium
Anticancer drugs like Vincaalkaloids, Platinum commands, Taxane derivatives etc.
Antimicrobials like Chloroquinine, Colistin, Linozolid, Voriconazole etc.

B. Connective tissue disorders

Rheumatoid arthritis.
SLE

Genetic Peripheral Neuropathy

Genetic peripheral Neuropathy is rare. Genetic variants may lead to mild neuropathy with symptoms began in early childhood. More severe hereditary neuropathy often appear in infancy or childhood. Genetic causes of Peripheral Neuropathy are:

Charcot - Marie tooth disease.
Fabry’s disease
Acute intermittent porphria

SYMPTOMS OF PERIPHERAL NEUROPATHY

Symptoms depends on type of nerve damaged.

Motor Nerves- Control moment of all muscles we consciously control such as muscles used for walking, gasping things or talking.
Sensory Nerves- Transparent information such as feeling of light touch, Tempreture, pain from cut
Autonomic Nerves - Control muscles or organ function we don’t consciously control such as breathing, digesting food, heart rate, functions of our gland.

Symptoms associated with neuropathy in motor nerves.

Muscles weakness
Painful cramps
Fasciculations
Muscle atrophy

B. Symptoms associated with neuropathy in sensory nerves.

Pain & Tingling sensation
Inability to feel vibration & touch especially in hand & feet
Loss of position sense which can leave a person unable to coordinate movements like walking, buttoning or maintain balance when their eyes shut.
Inability to feel pain or change in Tempreture.

C. Symptoms associated with neuropathy in autonomic nerves.

Excess and lack of sweating
Heat intolerance
Inability to expand and contract blood vessels that regulate blood pressure
Digestive symptoms.

DIAGNOSIS AND MANAGEMENT OF PERIPHERAL NEUROPATHY

Diagnosis

History & examination
Body fluid tests
Imaging
Genetic tests
Electromyography & Nerve conduction study.

Treatment of Peripheral Neuropathy

The treatment of peripheral neuropathy primarily focuses on the underline cause as dealt by appropriate specialist like Neurosurgeon and Neurologist.

PREVENTION OF PERIPHERAL NEUROPATHY
Getting recommended vaccine like shingles.
Life style changes like quit smoking, avoid toxins exposure, maintain healthy diet, exercises.
Managing Diabetes Mellitus and other preventable condition.

Conclusion

Pheripheral Neuropathy is a complex condition that can significantly impact an individual’s quality of life. By understanding the causes, symptoms and available treatment options, an effective management plan tailored to their needs. Early recognition and intervention can help prevent further nerve damage and alleviate symptoms, improving overall well-being and daily functioning.