Peripheral neuropathy is the term for damage to nerves of the peripheral nervous system, which may be caused either by diseases of the nerve or from the side-effects of systemic illness. Peripheral neuropathies vary in their presentation and origin, and may affect the nerve or the neuromuscular junction. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // G00-G99 - Diseases of the nervous system (G00-G09) Inflammatory diseases of the central nervous system (G00) Bacterial meningitis, not elsewhere classified (G01) Meningitis in bacterial diseases classified elsewhere (G02) Meningitis in other infectious and parasitic diseases classified elsewhere (G03) Meningitis due to other and unspecified causes (G04) Encephalitis, myelitis... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... Nerves (yellow) Nerves redirects here. ... The peripheral nervous system or PNS, is part of the nervous system, and consists of the nerves and neurons that reside or extend outside the central nervous system (the brain and spinal cord) to serve the limbs and organs, for example. ... Nerves (yellow) Nerves redirects here. ... Adverse effect, in medicine, is an abnormal, harmful, undesired and/or unintended side-effect, although not necessarily unexpected, which is obtained as the result of a therapy or other medical intervention, such as drug/chemotherapy, physical therapy, surgery, medical procedure, use of a medical device, etc. ... Nerves (yellow) Nerves redirects here. ... A neuromuscular junction is the junction of the axon terminal of a motoneuron with the motor end plate, the highly-excitable region of muscle fiber plasma membrane responsible for initiation of action potentials across the muscles surface. ...

Major causes of peripheral neuropathy include diabetes mellitus, nutritional deficiencies, alcoholism, Sjögren's syndrome and HIV. For the disease characterized by excretion of large amounts of very dilute urine, see diabetes insipidus. ... The updated USDA food pyramid, published in 2005, is a general nutrition guide for recommended food consumption. ... Alcoholism is the consumption of, or preoccupation with, alcoholic beverages to the extent that this behavior interferes with the drinkers normal personal, family, social, or work life, and may lead to physical or mental harm. ... Sjögrens syndrome is an autoimmune disorder in which immune cells attack and destroy the glands that produce tears and saliva. ... Species Human immunodeficiency virus 1 Human immunodeficiency virus 2 Human immunodeficiency virus (HIV) is a retrovirus that causes acquired immunodeficiency syndrome (AIDS, a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections). ...

Mechanical pressure from staying in one position for too long, a tumor, intraneural hemorrhage, exposing the body to extreme conditions such as radiation, cold temperatures, or toxic substances (including some chemotherapy drugs such as vincristine) can also cause peripheral neuropathy. Tumor or tumour literally means swelling, and is sometimes still used with that meaning. ... Radiation as used in physics, is energy in the form of waves or moving subatomic particles. ... Chemotherapy is the use of chemical substances to treat disease. ... Vincristine (Oncovin®) is a vinca alkaloid from the Madagascar periwinkle (Catharanthus roseus, formerly Vinca rosea and hence its name). ...

Many of the diseases of the peripheral nervous system may present similarly to muscle problems (myopathies), and so it is important to develop approaches for assessing sensory and motor disturbances in patients so that a physician may make an accurate diagnosis. In medicine, a myopathy is a neuromuscular disease in which the muscle fibers dysfunction for any one of many reasons, resulting in muscular weakness. ... Pediatric polysomnography patient Childrens Hospital (Saint Louis), 2006 A patient or invalid is any person who receives medical attention, care, or treatment. ... The Doctor by Luke Fildes This article is about the term physician, one type of doctor; for other uses of the word doctor see Doctor. ...

Types

Peripheral neuropathies may either be symmetrical and generalized or focal and multifocal, which is usually a good indicator of the cause of the peripheral nerve disease.

Generalized peripheral neuropathy

Generalized peripheral neuropathies are symmetrical, and usually due to various systematic illnesses and disease processes that affect the peripheral nervous system in its entirety. They are further subdivided into several categories: The peripheral nervous system or PNS, is part of the nervous system, and consists of the nerves and neurons that reside or extend outside the central nervous system (the brain and spinal cord) to serve the limbs and organs, for example. ...

• Distal axonopathies are the result of some metabolic or toxic derangement of neurons. They may be caused by metabolic diseases such as diabetes, renal failure, deficiency syndromes such as malnutrition and alcoholism, or the effects of toxins or drugs.

• Myelinopathies are due to a primary attack on myelin causing an acute failure of impulse conduction. The most common cause is acute inflammatory demyelinating polyneuropathy (AIDP; aka Guillain-Barré syndrome), though other causes include chronic inflammatory demyelinating polyneuropathy (CIDP), genetic metabolic disorders (e.g., leukodystrophy), or toxins.

• Neuronopathies are the result of destruction of peripheral nervous system (PNS) neurons. They may be caused by motor neurone diseases, sensory neuronopathies (e.g., Herpes zoster), toxins or autonomic dysfunction. Neurotoxins may cause neuronopathies, such as the chemotherapy agent vincristine.

Distal axonopathy (aka dying back neuropathy) is a type of peripheral neuropathy that results from some metabolic or toxic derangement of peripheral nervous system (PNS) neurons. ... Drawing by Santiago Ramón y Cajal of neurons in the pigeon cerebellum. ... This article is about the disease that features high blood sugar. ... Renal failure is the condition in which the kidneys fail to function properly. ... Percentage of population affected by malnutrition by country, according to United Nations statistics. ... Alcoholism is the consumption of, or preoccupation with, alcoholic beverages to the extent that this behavior interferes with the drinkers normal personal, family, social, or work life, and may lead to physical or mental harm. ... This article or section does not cite any references or sources. ... It has been suggested that Blockbuster drug be merged into this article or section. ... Myelinopathy is due to primary destruction of myelin or the myelinating Schwann cells, which leaves the axon intact, but causes an acute failure of impulse conduction. ... Myelin is an electrically insulating phospholipid layer that surrounds the axons of many neurons. ... Guillain-Barré syndrome (GBS), is an acquired immune_mediated inflammatory disorder of the peripheral nervous system (i. ... Guillain-Barré syndrome (GBS) or acute inflammatory demyelinating polyradiculoneuropathy is an acute, autoimmune disease that affects the peripheral nervous system and is usually triggered by an acute infectious process. ... Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired immune-mediated inflammatory disorder of the peripheral nervous system but often can have central nervous system involvement. ... DNA, the molecular basis for inheritance. ... Leukodystrophy refers to progressive degeneration of the white matter of the brain due to imperfect growth or development of the myelin sheath, the fatty covering that acts as an insulator around nerve fiber. ... Neuronopathy is dysfunction due to damage to neurons of the peripheral nervous system (PNS), resulting in a peripheral neuropathy. ... The peripheral nervous system or PNS, is part of the nervous system, and consists of the nerves and neurons that reside or extend outside the central nervous system (the brain and spinal cord) to serve the limbs and organs, for example. ... Drawing by Santiago Ramón y Cajal of neurons in the pigeon cerebellum. ... The motor neurone diseases (MND) are a group of progressive neurological disorders that destroy motor neurones, the cells that control voluntary muscle activity such as speaking, walking, breathing, and swallowing. ... Herpes zoster, colloquially known as shingles, is the reactivation (from the general area of the spinal cord) of varicella zoster virus (VZV, primary infection of which leads to chickenpox), one of the Herpesviridae group, leading to a crop of painful blisters over the area of a dermatome. ... This article or section is in need of attention from an expert on the subject. ... Neurotoxicity occurs when the exposure to natural or manmade toxic substances ,which are called neurotoxins, alters the normal activity of the nervous system. ... Chemotherapy is the use of chemical substances to treat disease. ... Vincristine (Oncovin®) is a vinca alkaloid from the Madagascar periwinkle (Catharanthus roseus, formerly Vinca rosea and hence its name). ...

Signs and symptoms

Those with diseases or dysfunctions of their peripheral nerves can present with problems in any of the normal peripheral nerve functions. The peripheral nervous system or PNS, is part of the nervous system, and consists of the nerves and neurons that reside or extend outside the central nervous system--to serve the limbs and organs, for example. ...

In terms of sensory function, there are commonly loss of function (negative) symptoms, which include numbness, tremor, and gait imbalance. Look up numb in Wiktionary, the free dictionary. ... For the film see Tremors (film). ... Gait imbalance refers generally to difficulty in keeping ones balance when walking or standing, due to numbness in the patients lower legs and feet. ...

Gain of function (positive) symptoms include tingling, pain, itching, crawling, and pins and needles. Pain can become intense enough to require use of opiate drugs (i.e., morphine, oxycontin). Paresthesia (paraesthesia in British) is a sensation of tingling, pricking, or numbness of the skin with no apparent physical cause, more generally known as the feeling of pins and needles. ... “Hurting” redirects here. ... An itch (Latin: pruritus) is a sensation felt on an area of skin that causes a person or animal to desire to scratch that area. ... Crawling is a form of moving around by some animals, and, in some cases humans, generally involving slow movement on all limbs. ... Paresthesia or paraesthesia (in British English) is a sensation of tingling, pricking, or numbness of a persons skin with no apparent long-term physical effect, more generally known as the feeling of pins and needles or of a limb being asleep. // Transient paresthesia is the temporary sensation of tingling...

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 bedsheet touch their feet or wear socks or shoes, and eventually become housebound.

Motor symptoms include loss of function (negative) symptoms of weakness, tiredness, heaviness, and gait abnormalities; and gain of function (positive) symptoms of cramps, tremor, and fasciculations. The word fatigue is used in everyday living to describe a range of afflictions, varying from a general state of lethargy to a specific work induced burning sensation within muscle. ... Persons suffering from peripheral neuropathy experience numbness and tingling in their hands and feet. ... A cramp is an unpleasant sensation caused by contraction, usually of a muscle. ... A fasciculation (or muscle twitch) is a small, local, involuntary muscle contraction (twitching) visible under the skin arising from the spontaneous discharge of a bundle of skeletal muscle fibres. ...

There is also pain in the muscles (myalgia), cramps, etc., and there may also be autonomic dysfunction. “Hurting” redirects here. ... Myalgia means muscle pain and is a symptom of many diseases and disorders. ... ETC can refer to: Electronic toll collection Electronic throttle control Estimated Time of/to Completion Et cetera Electronic Theatre Controls Electron transport chain in mitochondria responsible for creating a proton gradient that allows the formation of ATP. ATM card service by HSBC and Hang Seng Bank only for withdrawal of... This article or section is in need of attention from an expert on the subject. ...

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 neuropathies like Guillain-Barré syndrome); or may show focal sensory disturbance or weakness, such as in mononeuropathies, radiculopathies and plexopathies. In medicine, the physical examination or clinical examination is the process by which the physician investigates the body of a patient for signs of disease. ... Pathology (from Greek pathos, feeling, pain, suffering; and logos, study of; see also -ology) is the study of the processes underlying disease and other forms of illness, harmful abnormality, or dysfunction. ... Guillain-Barré syndrome (GBS) or acute inflammatory demyelinating polyradiculoneuropathy is an acute, autoimmune disease that affects the peripheral nervous system and is usually triggered by an acute infectious process. ... Mononeuropathy (or mononeuritis) is a type of neuropathy that only affects a single peripheral or cranial nerve. ... Radiculopathy is not a specific condition, but rather a description of a problem in which one or more nerves are affected and do not work properly. ...

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). This article is about the medical condition. ... Diabetic neuropathies are neuropathic disorders that are associated with diabetes mellitus. ... Cranial nerves are nerves which start directly from the brainstem instead of the spinal cord. ... The facial nerve is seventh of twelve paired cranial nerves. ...

References

• Dr. Lee Dellon: Pioneering Pain Relief Dr. Lee Dellon's research in the pain caused by Peripheral Neuropathy and other nerve disorders is highlighted in this recent article.

• Diseases of the peripheral system^{[dead link – history]} - These lecture notes were presented to a second year medical school class at the University of Western Ontario on 2 December 2004 by Dr. Angelika F. Hahn.

• Approach to Muscle and nerve problems^{[dead link]} - Powerpoint slides from a lecture presented to a second year medical school class at the University of Western Ontario on 2 December 2004 by Dr. Michael W. Nicolle.

External links

• National Diabetes Information Clearinghouse

See also

• Neuropathy
• Myopathy
• Myelinopathy
• Guillain-Barré syndrome