How to identify a neuropathy

Key points:

• The main symptoms are changes in the sensitivity of the limbs, as well as tingling or weakness.

• Neuropathies of days or weeks will need a short treatment, while in those of months or years, the treatment should be longer.

• Up to 2.4% of the Mexican population has some type of neuropathy.

Neuropathy is considered to be those diseases related to peripheral nerves, made up of nerves and nerve ganglia, which come out of the spinal cord and travel throughout the body, mainly in the limbs, giving us sensitivity and strength.

Dr. Paul Uribe Jaimes, clinical neurologist at ABC Medical Center, says that when the peripheral nerves become diseased, patients will have a combination of symptoms and alterations in sensitivity and muscle strength, due to this, it could be difficult for doctors who are not familiar with this situation to have an adequate approach or treatment.

Currently, it is estimated that up to 2.4% of the population in Mexico suffers from some type of neuropathy; one in 10 people over 55 years will suffer from it.

On the other hand, the type of neuropathy varies depending on age as shown below:

• Children. Caused by genetics and heredity.
• Adults. Due to metabolic causes such as diabetes or insulin resistance syndrome. It can also originate from toxic causes.
• Being older than 65 years. Older patients easily suffer from neuropathy as a result of another disease and this increases with age, although age-related neuropathy does not exist.

“Peripheral neuropathy can be the result of traumatic injuries, infections, metabolic problems, hereditary causes, and exposure to toxins. One of the most common causes is diabetes.”¹

Process to identify a neuropathy

There are more than 1,000 causes of neuropathies, says Dr. Uribe, which is why it must be approached in an orderly fashion. But in general, the following symptoms can be commonly perceived:

• Changes in feet sensation.
• Tingling, burning, pain, or electric shock sensation in the limbs.
• Distal weakness in hands and feet.

Once the doctor suspects the presence of neuropathy, they must follow an algorithm for its diagnosis:

1. Clinical profile. Includes symptoms and signs.
2. Investigating possible causes. The patient will talk about the timing, its evolution, etc.
3. Evaluation of the need for an NVC (Nerve Conduction Velocity), which will make it possible to identify whether the neuropathy is axonal, demyelinating, or topographic.
4. First-line tests. Includes glucose tests, PFH, B12, viral hepatitis profile, HIV, etc.
5. Complementary tests. Through CT, MRI, genetic tests, nerve or skin biopsy, and lumbar puncture, among others.

Depending on the diagnostic algorithm performed, the doctor will be able to classify the neuropathy:

• Topography
  • Mononeuropathy.
  • Radiculopathy.
  • Plexopathy.
  • Multiple mononeuropathy.
  • Cranial neuropathy.
  • Polyneuropathy.
• Evolution
  • Acute.
  • Subacute.
  • Chronic.
  • Recurrent
• Neurophysiology
  • Axonal.
  • Demyelinating.
• Clínica
  • Motor.
  • Sensitive.
  • Autonomous.

Thanks to this, the patient will be able to receive a more specific diagnosis, allowing them to continue with the necessary treatment for each case.

Each patient suffering from neuropathy must receive personalized attention. The recovery time varies depending on the time of evolution of the disease and can be a process that can take months to carry out.

Although most neuropathies can cause pain, some only affect movement or muscle strength, primarily in the feet, says Dr. Uribe. In case of having any of the main symptoms, it is advisable to see a specialized neurologist for their identification and, if necessary, the treatment to be followed. This recommendation is especially important in people living with diabetes or who have received cancer treatment.

At ABC Medical Center’s Neurology Center, we can provide you with specialized care. Contact us!

Fuente:
Dr. Paul David Uribe Jaimes – Clinical neurologist and head of neuroscience at ABC Medical Center
https://youtu.be/9eNpaw2cbsc
¹ https://www.mayoclinic.org/es/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061