Classification, Differential Diagnosis – Peripheral Neuropathy
Peripheral neuropathy at the most basic level can be defined as damage to any nerve, or nerve cluster, of the peripheral system of the body.
The peripheral system, and the nerves that comprise it, are the messengers carrying information from the brain to the spinal cord, and from the spinal cord to the surrounding areas of the body. Peripheral neuropathy has a multitude of causes stemming from genetic heritage, disease; trauma suffered to the nerves, and can even result solely as a side effect of systemic illness.
Peripheral neuropathy has a number of classifications dependent upon the nerves affected, the type of nerve damage suffered, the root process causing the damage, and finally on the extent of the damage itself.
Peripheral Neuropathy: Mononeuropathy
The first classification is when only a single nerve has been affected, referred to as mononeuropathy. Often the root cause is a notable infection or a localized suffering of trauma, making this diagnostically distinguishable from polyneuropathy. This damage is most often caused by physical compression to the nerve, which notable examples being axillary nerve palsy and carpal tunnel syndrome.
Some individuals have experienced mononeuropathy without recognizing it when they have a limb “fall asleep” and they suffer the “pins and needles” sensation that accompanies it. This feeling is the result of physical compression cutting off blood supply to the nerve, causing a brief bout of mononeuropathy that can be remedied by re-positioning one’s own body.
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Peripheral Neuropathy: Polyneuropathy
The next classification, and logical successor, is when many nerve cells of the body are injured in various areas of the body. This polyneuropathy is most often the result of illness as opposed to injury, and refers mainly to processes that affect all parts of the body without being focused in one central attack.
There are three sub-patterns to this classification, depending on the exact nerves being affected. The three patterns refer to either damage to the axons based on their size, damage to the myelin sheath of the axon resulting in failure to transmit electrical pulses, and finally a pattern affecting the neuron cells themselves with damage to either the sensory neurons or the motor neurons.
Peripheral Neuropathy: Autonomic neuropathy
The third prime classification of peripheral neuropathy is autonomic neuropathy, which is damage to the autonomous systems of the body such as: the bladder, digestive tract, and cardiovascular system. It is a failure for the body to maintain control over these systems, which individuals to do not have conscious control. The autonomic nerve fibers have large bundles resting in the abdomen, thorax, and pelvis surrounding the spinal cord. Damage to these systems is most often the result of long cases of Type 1 and Type 2 diabetes mellitus, and is most often found in conjunction with other neuropathy symptoms, such as sensory neuropathy.
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