neuropathinen

Neuropathies, commonly referred to as peripheral neuropathies, are a group of disorders caused by damage to peripheral nerves. They can affect sensory, motor, and autonomic fibers and may present with pain, numbness, weakness, or autonomic dysfunction. Neuropathy is a clinical syndrome rather than a single disease, and its cause, pattern, and prognosis vary widely.

Classification of neuropathies is often based on etiology, nerve fiber types involved, and distribution. Etiologies include diabetes mellitus and metabolic disorders, autoimmune or inflammatory diseases, infectious diseases, hereditary or genetic conditions, traumatic or compressive injuries, toxins, nutritional deficiencies, and vascular or infiltrative processes. Neuropathies can be focal (affecting a single nerve) or diffuse, and can be distal symmetric polyneuropathy, which classically begins in the feet and hands, or multifocal.

Pathophysiology commonly involves axonal degeneration or demyelination, or both. Small fiber neuropathies predominantly affect pain and temperature sensation and autonomic function, while large fiber involvement leads to numbness, proprioceptive deficits, and weakness. The mechanisms of neuropathic pain often include peripheral sensitization and changes in central nervous system processing.

Clinical features vary by type. Sensory symptoms include tingling, burning, stabbing pain, numbness, and allodynia. Motor involvement may cause weakness, muscle cramps, and gait disturbances. Autonomic symptoms can include orthostatic hypotension, abnormal sweating, digestive issues, and bladder dysfunction.

Diagnosis relies on clinical evaluation and targeted investigations. Nerve conduction studies and electromyography distinguish axonal from demyelinating disease; skin biopsy can assess small-fiber pathology. Laboratory testing aims to identify underlying causes (glucose control in diabetes, B12 levels, thyroid function, renal/hepatic disease, infections, or autoimmune markers). Treatment focuses on addressing the underlying cause when possible and on symptom management, particularly pain, through medications, physical therapy, and lifestyle modification. Prognosis depends on the cause and response to treatment.