Peripheral Neuropathy Symptoms & Diagnosis

Symptoms

Damage to the peripheral nerves often results in sensory (feeling) and motor (strength) symptoms in the:

• Arms
• Legs
• Hands
• Feet

Other parts of the body can also be affected. Symptoms depend on which nerves are involved. They can range from mild to severe and may seem worse at night. Sensations and pain may occur in the upper or lower limbs and move toward the trunk (eg, from the feet to the calves).

Symptoms include:

• Numbness or reduced sensation
• Tingling
• Pain, often a burning or sharp, cutting sensation
• Sensitivity to touch
• Muscle twitches
• Muscle weakness
• Muscle cramping
• Difficulty with walking
• Loss of coordination or balance
• Paralysis

If untreated, peripheral neuropathy can lead to:

• Loss of reflexes and muscle control
• Muscle atrophy (loss of muscle bulk)
• Foot deformities
• Foot ulcers
• Injuries to the feet that go unnoticed and become infected
• Autonomic dysfunction (sweating, bowel and bladder dysfunction, cardiovascular effects)
• Difficulty breathing

Diagnosis

The doctor will ask about your symptoms and medical history. She will also do a physical exam, which will include:

• Muscle strength
• Reflexes
• Balance
• Coordination
• Ability to feel vibration, temperature, and light touch

Additional tests may also include:

• Blood tests (including glucose, vitamin B12 level, and thyroid function tests)
• Electromyography (EMG) —measures and records electrical activity generated in muscle in response to a nervous stimulation
• Nerve conduction studies —measures the speed and degree of electrical activity in a nerve to determine if it is functioning normally
• Nerve or muscle biopsy (rarely)
• Evaluation of family members
• Genetic testing
• Serum/urine electrophoresis (protein evaluation)
• Spinal tap for demyelinating disorders