neuropathiesare

Neuropathies are disorders of the peripheral nervous system, the network of nerves outside the brain and spinal cord. They can affect sensory fibers, motor fibers, autonomic fibers, or a combination of these. Neuropathies may be focal, affecting a single nerve or region (mononeuropathy), or generalized (polyneuropathy), which often presents as symmetric involvement of distal limbs.

The most common generalized form is diabetic peripheral neuropathy, but neuropathies arise from many causes, including alcohol use, nutritional deficiencies (notably B12), infections, autoimmune and inflammatory conditions (such as Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy), toxins and medications (including certain chemotherapies), metabolic disorders, and inherited genetic conditions (such as Charcot-Marie-Tooth disease). Onset can be acute, subacute, or chronic, and progression ranges from slowly progressive to fluctuating or relapsing.

Symptoms depend on which nerves are affected. Sensory neuropathies may cause numbness, tingling, or pain, often starting in the feet or hands. Motor involvement can lead to weakness and coordination problems. Autonomic neuropathies may cause blood pressure changes, heart rate variability, digestive or bladder symptoms, and abnormal sweating. Diagnosis relies on a combination of clinical examination, nerve conduction studies and electromyography, blood and urine tests to identify underlying causes, imaging when indicated, and sometimes nerve biopsy.

Management focuses on treating the underlying cause when possible, alleviating symptoms, and preventing complications. Pain is commonly addressed with medications such as anticonvulsants or antidepressants, while physical and occupational therapy support function. Immunotherapy or plasmapheresis may be used for certain inflammatory neuropathies. Prognosis varies widely by cause and severity; some conditions stabilize or improve with treatment, while others are chronic and progressive.