Neuropathy is a very common disorder and results from dysfunction of and injury to the peripheral nerves.

Common causes of Neuropathy:

• Idiopathic: In many cases no specific cause of neuropathy is identified.This condition is termed idiopathic neuropathy. In this case the neuropathy is the disease. In many cases developing a neuropathy seems to be a part of the aging process and a very slowly progressive numbness affecting especially the feet and toes occurs in up to 10% of the population over age 60.
• Alcohol: Excessive alcohol consumption can cause a significant neuropathy. The treatment for this condition is complete avoidance of any more alcohol use.
• Diabetes: In the US, the most frequent identified cause of neuropathy is diabetes. Treatment consists of medications to treat the neuropathy symptoms, and scrupulous diabetes control. To learn more about Diabetes, click here: Diabetes Prevention and Control
• Hereditary: A relatively frequent cause of neuropathy is that the codnition is inherited. This is more often seen in younger patients. Anyone with neuropathy of unkown cause should specifically ask their relatives about neuropathy symptoms.

Less common cause of Neuropathy

• Kidney disease
• Hypothyroid (Low thyroid)
• Inflammation of the blood vessels to the nerves (vasculitis)
• Vitamin deficiencies (especially vitamin B12)
• Toxin exposure (lead, arsenic, organic solvents)
• Medications: certain medications can cause neuropathy as a side effect

Symptoms of Neuropathy

The most common symptoms of neuropathy numbness, pain (burning/cold/electric shocks usually worse at rest than with walking), weakness, and imbalance. These symptoms are usually seen distally in the hands and feet (numbness in a distribution of where stockings and gloves are worn) or weakness most prominant in the feet and hands rather than legs and arms.

Treatment of Neuropathy

Treating the underlying condition

While neuropathy symptoms can be slowed by treating the underlying condition (where one is identified), patients with idiopathic neuropathy often slowly progress over many years.

Treating the symptoms

Medications can help with the pain these neuropathies can cause, but these medications do not lessen the numbness or weakness. Pain symptoms may be treated with medications even if there is no specific treatment for the underlying neuropathy. Medications most useful for treating neuropathy pain inlcude:

• Tricyclic antidepressants (especially nortryptiline, amytriptiline, desipramine)
• Anticonvulsants (especially carbamazepine, gabapentin)
• Topical capsaicin

Narcotic type pain medications are usually ineffective for neuropathy pain

Evaluation of Neuropathy.

A series of tests looking for diabetes, vitamin deficiencies, and abnormal blood proteins need to be performed, but even with these detailed tests many remain without a specific cause. For more rapidly progressive neuropathies (especially those that involve the hands or that result in upper thigh weakness) nerve conductions and EMG testing may be considered in consultation with a neurologist.

More information at:

The Neuropathy Association
NINDS Peripheral Neuropathy Information Page