# peripheral neuropathy | Symptoms, Causes, Tests and Treatment | OSANG > Peripheral neuropathy is a nerve disease whose main symptoms include tingling in the hands and feet, burning pain, and numbness. Diabetes is the most common cause, occur… - Official page: https://osns.co.kr/en/encyclopedia/peripheral-neuropathy - Organization: OSANG Neurosurgery ## Page content Neurological Conditions ## peripheral neuropathy Peripheral Neuropathy · G62.9 Peripheral neuropathy is a general term for neurological diseases in which damage occurs to peripheral nerves excluding the brain and spinal cord, resulting in sensory abnormalities (numbness, tingling, pain), decreased motor function, and autonomic dysfunction. ## At a glance Peripheral neuropathy is a nerve disease whose main symptoms include tingling in the hands and feet, burning pain, and numbness. Diabetes is the most common cause, occurring in approximately 50% of diabetic patients. When autonomic nerve fibers are simultaneously damaged, orthostatic hypotension, digestive problems, and sweating abnormalities appear. Along with treating the cause, neuropathic pain control, fall prevention, and foot care are the core of treatment. - 01Definition and Overview - 02Classification - 03cause - 04symptoms - 05diagnosis - 06treatment - 07life guide ## Definition and Overview Peripheral neuropathy is a general term for diseases that cause damage to peripheral nerves excluding the brain and spinal cord (central nervous system). It shows various clinical manifestations depending on the type of damaged nerve (sensory nerve, motor nerve, autonomic nerve), distribution (single, multiple), and cause. According to European epidemiological studies, the overall prevalence of chronic polyneuropathy is approximately 1-2.5% in the general population, and approximately 8% in people over 70 years of age. Neuropathy occurs in approximately 50% of diabetic patients. ## Classification ### Classification by type of nerve involved - Sensory neuropathy: Numbness, burning pain, and paresthesia are the main symptoms. - Motor neuropathy: Muscle weakness and muscle atrophy occur. - Autonomic neuropathy: Abnormalities in blood pressure, heart rate, sweating, digestive tract, and bladder function occur. - Mixed type: A combination of the three above occurs. ### Classification according to distribution pattern - Mononeuropathy: Damage to one nerve. Representative examples include carpal tunnel syndrome and peroneal neuropathy. - Polyneuropathy: Multiple peripheral nerves are affected simultaneously. It is characterized by a symmetrical distribution, with a typical 'stocking-glove pattern' starting from the toes and fingertips and progressing to the proximal area. - Mononeuritis multiplex: Multiple non-contiguous nerves are involved. Appears in vasculitis and diabetes. ## cause ### diabetic neuropathy It is the most common cause. Neuropathy occurs in approximately 50% of diabetic patients, and the risk of developing it is proportional to the duration of the disease and the degree of blood sugar control. The mechanisms are oxidative stress caused by high blood sugar, accumulation of advanced glycation end products (AGEs), and decreased neuronal blood flow. ### Other major causes - Nutritional deficiencies: Vitamin B1 (thiamine), B6, B12, and folic acid deficiencies. B12 deficiency is common in vegetarians and gastrointestinal malabsorption. - Alcoholism: A combination of neurotoxicity caused by chronic drinking and B1 deficiency. - Immune-mediated: Guillain-Barre syndrome (acute), chronic inflammatory demyelinating polyneuropathy (CIDP). - Drug triggers: chemotherapy (vincristine, paclitaxel, cisplatin), tuberculosis drugs (isoniazid), antivirals. - Hereditary: Charcot-Marie-Tooth disease, etc. - Renal failure: uremic neuropathy. - Hypothyroidism: Myxedema neuropathy. - Idiopathic: Cause unknown. It accounts for approximately 20-30% of the total. ## symptoms ### sensory symptoms - Typically, symmetrical numbness starts from the toes on both sides and moves up to the ankles, calves, and fingertips. - Neuropathic pain such as burning pain, electric shock sensation, and stabbing pain occurs. - Balance disorders occur due to decreased vibration and position sense. - Paradoxically, there are cases where hypoesthesia, a dulling of the senses, occurs and the trauma cannot be recognized. ### motor symptoms - Decreased muscle strength in the toes and ankles, foot drop. - Foot muscle atrophy can cause foot deformity. ### autonomic symptoms It is prominent in diabetic autonomic neuropathy. - Orthostatic hypotension: dizziness and fainting when standing up. - Heart rate fixation (cardiac denervation): Heart rate changes due to exercise or change in position decrease. - Gastroparesis: Early satiety, nausea, and vomiting. - Bladder dysfunction: feeling of residual urine, frequent urination, difficulty urinating. - Sweating abnormalities: anhidrosis of the extremities and compensatory hyperhidrosis of the trunk. ## diagnosis ### Nerve conduction study (NCS) and electromyography (EMG) Presence and type of neuropathy (axonal damage vs. It is a key test to evaluate demyelination, extent, and severity. Patterns of slow nerve conduction speed (demyelinating type) or decreased action potential (axonal type) help determine the cause. ### blood test Check fasting blood sugar, glycated hemoglobin, vitamin B12, thyroid function, CBC, CRP, ESR, liver and kidney function, protein electrophoresis, and autoantibodies (ANA, ANCA, etc.). ### Autonomic function test Autonomic nerve fiber damage is assessed through heart rate variability (HRV) analysis, Valsalva maneuver test, deep breathing test, and sweating function test (QSART). ## treatment ### Cause Treatment Treatment of the causative disease is key to restoring neurological function and preventing progression. - Diabetic neuropathy: Tight blood sugar control. Studies have shown that intensive blood sugar control in type 1 diabetes can reduce the incidence of neuropathy by about 60%. - B12 deficiency: Intramuscular or high-dose oral B12 supplementation. - CIDP: Intravenous immunoglobulin, plasmapheresis, steroids. - Drug-induced: Adjust the causative medication. ### Neuropathy Pain Treatment According to a systematic meta-analysis, the following drugs have a significant effect on neuropathic pain: - Calcium channel ligands (gabapentin, pregabalin): drugs of first choice. - SNRIs (duloxetine, venlafaxine): Effective for both pain and mood improvement. - Tricyclic antidepressants (amitriptyline): Effective, but cautious about side effects in elderly people. - Topical capsaicin, topical lidocaine patches: For adjunctive use in localized pain. ## life guide - Foot care: Check your feet daily for cuts or blisters. Wear well-fitting, comfortable shoes and avoid walking barefoot. Do not soak your feet in hot water. - Balance training: Because the risk of falling is high, it is recommended to install anti-slip bathroom mats and handles along with balance exercises. - Abstaining from alcohol: Abstaining from alcohol is essential in alcoholic neuropathy. - Blood Sugar Management: In diabetic patients, blood sugar control is the most important way to slow the progression of neuropathy. - Regular low-impact aerobic exercise (swimming, cycling) helps improve nerve blood flow and reduce pain. ## Frequently asked questions ### Q01Why do my hands and feet feel numb? Numbness in hands and feet is a common symptom of peripheral nerve abnormalities. Diabetes, vitamin B12 deficiency, hypothyroidism, alcoholic neuropathy, and cervical/lumbar nerve compression are the main causes. If symptoms persist, it is important to evaluate the cause with nerve conduction studies and blood tests. ### Q02Can my hands and feet feel numb even if I don't have diabetes? Yes. There are various causes, including vitamin B12 deficiency, thyroid dysfunction, autoimmune diseases, certain drugs (anticancer drugs, tuberculosis drugs, etc.), chronic alcohol consumption, and kidney failure. Peripheral neuropathy of unknown etiology (idiopathic) also accounts for approximately 20-30% of all cases. ### Q03Why do autonomic abnormalities occur in peripheral neuropathy? Peripheral nerves include not only sensory and motor nerves but also autonomic nerve fibers. When these fibers are damaged, impaired blood pressure control when standing (orthostatic hypotension), abnormal heart rate control, abnormal sweating, and abnormal bladder and bowel function occur. Diabetic autonomic neuropathy is a representative example. ### Q04What tests are needed for numbness in hands and feet? Nerve conduction studies (NCS) and electromyography (EMG) are used to evaluate peripheral nerve function. Blood tests check blood sugar, glycated hemoglobin, vitamin B12, thyroid function, and autoantibodies. If autonomic abnormalities are suspected, heart rate variability analysis and sweating function tests may also be performed. ### Q05Can peripheral neuropathy be treated? When the causative disease is treated, nerve function may partially recover. For diabetes, blood sugar control is effective, and for vitamin B12 deficiency, supplementation treatment is effective. Neuropathic pain is managed with pregabalin, duloxetine, and tricyclic antidepressants. Although it may be difficult to fully recover from nerve damage, you can prevent its progression and reduce symptoms. ### Q06What should I pay attention to in my daily life when I have numbness in my hands and feet? If your senses are dulled, you may not be able to recognize burns or trauma, so caution is required. Foot care is especially important. You should check your feet every day to make sure there are no injuries and wear well-fitting shoes. If you have trouble with your balance, we will improve your environment to prevent falls, such as installing a non-slip mat in the bathroom. ## Related articles - delirium - Cervical radiculopathy - Cervical disc herniation - dystonia This article provides general medical information and does not replace an individual diagnosis or treatment plan. Please seek a medical assessment if symptoms persist. ## Important notice This Markdown alternative helps search and AI tools understand the public page accurately. It provides general health information and does not replace an individual diagnosis or treatment.