Neuropathy can be a general term used to describe many problems related to the experience of nerve-related symptoms in the body. The term usually describes symptoms related to or caused by the nervous system. When working towards a more specific diagnosis, the first differentiation to be made is whether or not the symptoms are caused by the central nervous system (brain and spinal cord) or the peripheral nervous system (nerve roots of the spine, extremity nerves, etc).

There are many different terms that one could be diagnosed with or hear related to their symptoms. A few of these include:

Mononeuropathy Multiplex

• Vasculitic Neuropathy
  Vasculitic Restricted to PNS
  Connective tissue disease-related
  Diabetes
  Paraneoplastic
  Thyroid Induced
  Drug induced
  

• Inflammatory Neuropathy
  Vascular
  Lyme
  Hepatitis
  HIV
  Leprosy
  Chronic Inflammatory Demyelinating Polyneuropathy
  Acute Inflammatory Demyelinating Polyneuropathy
  
  
• Entrapment Neuropathy
  Spinal Stenosis
  Herniated Disc
  Spinal Arthritis
  Carpal Tunnel Syndrome
  Cubital Tunnel Syndrome
  Piriformis Syndrome
  Cervical Radiculopathy
  Lumbar Radiculopathy
  Ligament of Struthers
  Anatomical Variants
  Compartment Syndrome
  Ulnar Neuropathy
  Radial Neuropathy
  Axillary Neuropathy
  Lateral Femoral Cutaneous Neuropathy
  Femoral Neuropathy
  Obturator Neuropathy (And its 20+ causes)
  

• Malignancy Neuropathy
• Diabetic Neuropathy
• Peripheral Neuropathy
• Small Fiber Neuropathy
• Motor Neuropathy
• Autonomic Neuropathy
• Vasculitic Neuropathy

These are just a small amount of the most common neuropathies related to the peripheral nervous system. However, they do encompass between 75-90% of the known causes.

Peripheral neuropathy can be subdivided into three types, mononeuropathy, mononeuropathy multiplex or mononeurotis multiplex, and Polyneuropathy. This is based on the involvement of a single nerve, multiple single nerves, or many nerves, respectively, in a symmetric length-dependent fashion.

The prevalence of Polyneuropathy is approximately 2.4% of the population in midlife but rises to 8% in individuals older than 55 years.

Careful consideration of relevant clinical medical history and presenting symptoms dictates the path moving forward. Many times, unfortunately, individuals are deemed to have idiopathic or diabetic neuropathy when that is not fully the case. Many patients have superimposed or overlapping conditions which are not fully understood by their medical specialists. It is our goal to fully diagnose and treat these conditions.

Early features and symptoms of these conditions are:

• Numbness
• Tingling
• Pain
• Gait Imbalance
• Toe Weakness
• Sensory loss to cold, heat

Proper evaluation involves a thorough medical history with all related – and seemingly unrelated –symptoms and a complete neurological evaluation. At our Carmel, Indiana Neuropathy Clinic, this includes the following:

• Complete medical history
• Review of previous testing
• Blood Work
• Nerve Testing of EMG and NCS Review
• MRI and X-ray if indicated
• 16-point Sensory Testing and Toronto Clinical Scoring Method for Polyneuropathy
• Extremity Thermal Imaging Test for microcirculation to the nerves

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