Severe Neuropathy

Severe Neuropathy (Dutch: Zware Neuropathie) is a chronic and often progressive condition that affects the peripheral nerves, which are the nerves outside of the brain and spinal cord. These nerves play a vital role in transmitting information from the brain and spinal cord to the rest of the body. When these nerves become damaged, it can cause various symptoms, such as pain, numbness, weakness, and organ dysfunction.

Causes

Severe neuropathy can be caused by a variety of factors, including:

• Diabetes: High blood sugar levels can damage the nerves over time, leading to neuropathy. This is known as diabetic neuropathy.
• Infection: Certain infections, such as Lyme disease or shingles, can cause inflammation and damage to the nerves, resulting in neuropathy. Postherpetic neuropathy is a type of neuropathy that occurs after an attack of shingles.
• Toxins: Exposure to certain toxins, such as heavy metals or industrial chemicals, can damage the nerves and cause neuropathy.
• Autoimmune diseases: Certain autoimmune diseases, such as lupus or rheumatoid arthritis, can cause the immune system to attack the nerves, leading to neuropathy.
• Vitamin deficiencies: Deficiencies in vitamins B1, B6, B12, and E can contribute to the development of neuropathy.
• Alcohol abuse: Chronic alcoholism can lead to thiamine (vitamin B1) deficiency, which can cause neuropathy.
• Medications: Some medications, such as chemotherapy drugs or HIV medicines, can cause nerve damage and lead to neuropathy.

Symptoms

The symptoms of severe neuropathy depend on the affected nerves and the location of the damage. Common symptoms include:

• Pain: Sharp, burning, or dull pain in the affected areas. The pain may be constant or come and go.
• Numbness: Loss of feeling in the affected areas, such as hands and feet.
• Weakness: Muscle weakness in the affected areas, which may make it difficult to walk or perform daily activities.
• Sensitivity: Increased sensitivity to touch or temperature changes in the affected areas.
• Organ dysfunction: Damage to the autonomic nerves can cause problems with digestion, bladder function, and sexual function.

Diagnosis

Diagnosing severe neuropathy typically involves a combination of physical examination, medical history, and laboratory tests. The following tests may be used to help diagnose neuropathy:

• Nerve conduction studies (NCS): This test measures how well electrical signals travel through the nerves. It can help identify areas of nerve damage.
• Electromyography (EMG): This test measures muscle response to electrical stimulation. It can help determine whether the problem is due to nerve damage or muscle dysfunction.
• Blood tests: Blood tests can help identify any underlying conditions that may be contributing to the development of neuropathy, such as diabetes or vitamin deficiencies.

Treatment

Treatment for severe neuropathy depends on the underlying cause and severity of the condition. In some cases, treating the underlying condition may help improve neuropathy symptoms. For example, controlling blood sugar levels in people with diabetes can help prevent further nerve damage. Other treatments may include:

• Pain medication: Over-the-counter pain relievers or prescription pain medication may be used to manage pain associated with neuropathy.
• Antidepressants: Certain antidepressants, such as tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs), can help manage neuropathy pain.
• Anti-seizure medications: Certain anti-seizure medications, such as gabapentin and pregabalin, may be used to help manage neuropathy pain.
• Topical treatments: Creams or patches containing lidocaine or capsaicin may be used to help relieve pain in the affected area.
• Physical therapy: Physical therapy may be recommended to help improve mobility and strength in affected areas.

Complications

Untreated severe neuropathy can lead to a number of complications, including falls and injuries due to loss of balance or sensation in the feet, organ dysfunction due to damage to autonomic nerves, and worsening pain and disability over time. People with severe neuropathy may also be at increased risk for depression and anxiety due to the impact of the condition on their quality of life.