Neuropathies

Neuropathies are diseases that occur as a result of nerve damage in our bodies. They are divided into two main groups as peripheral and central neuropathies.

Peripheral neuropathies are damages of the nerves outside of the brain and spinal cord regions of the body. These nerves are responsible for the force (motor), sensory and autonomic functions of the body. These functions can be affected altogether, or a single one can be selectively affected.

Neuropathy that occurs when a single peripheral nerve is affected is called “mononeuropathy”, neuropathies that occur when more than one peripheral nerve is affected are called “polyneuropathy”. The most common examples of mononeuropathy are median and ulnar nerve entrapment neuropathies, and the most common polyneuropathies are diabetic polyneuropathy due to diabetes.

In patients with peripheral neuropathies;

• Muscle weakness, muscle wasting, muscle twitches, paralysis
• Sensory complaints such as numbness, burning, tingling, stinging and freezing, instability while walking, increased pain sensation or not feeling anything painful, wounds, and infections in the limbs
• Conditions such as heart rhythm disorders, excessive sweating or decreased sweating, sexual dysfunctions, inability to urinate or incontinence, skin color changes, orthostatic hypotension, known as low blood pressure when standing up, can be observed.

Peripheral neuropathies have many causes:

• Diabetes (Diabetes Mellitus)
• Vitamin deficiencies (e.g., vitamin B12)
• Medicines (especially chemotherapy drugs)
• Poisoning (Agricultural pesticides, solvents such as thinner, environmental toxins such as mercury and lead)
• Chronic kidney failure
• Chronic liver failure
• Infections (Guillain Barre Syndrome, shingles, HIV…etc)
• Alcohol overuse
• Rheumatic diseases (Rheumatoid Arthritis, SLE…etc)
• Hereditary (Familial) neuropathies (e.g., Charcot Marie Tooth Disease)
• Cancer-related neuropathies (especially lung and blood cancers)

Detailed anamnesis and physical examination are important in the diagnosis of neuropathies. Imaging methods (MR, CT, Ultrasound, etc.), electrophysiological examinations (EMG, SEP, MEP, etc.), cerebrospinal fluid (CSF) examinations, detailed blood tests, and molecular genetic tests are the diagnostic tests.

First of all, the underlying cause should be defined and treatments should be arranged accordingly. In some cases, the cause of neuropathy may not be revealed. In such cases, drug treatments and physical therapy methods are used to help reduce the symptoms of the disease.

Once the progression of the disease stops, the function of the nerves may return depending on the underlying cause. The less damage, the better the healing. Therefore, early diagnosis and treatment are very important.