The third and least common pattern affects the cell bodies of neurons directly. In demyelinating polyneuropathies, the myelin sheath around axons is damaged, which affects the ability of the axons to conduct electrical impulses. Diabetic neuropathy is the most common cause of this pattern. In distal axonopathy, one common pattern is that the cell bodies of neurons remain intact, but the axons are affected in proportion to their length the longest axons are the most affected. In cases of polyneuropathy, many nerve cells in various parts of the body are affected, without regard to the nerve through which they pass not all nerve cells are affected in any particular case. The term "peripheral neuropathy" sometimes is used loosely to refer to polyneuropathy. " Polyneuropathy" is a pattern of nerve damage that is quite different from mononeuropathy, often more serious and affecting more areas of the body. The affected nerves are found in an EMG (electromyography) / NCS (nerve conduction study) test and the classification is applied upon completion of the exam. Peripheral neuropathy may be classified according to the number and distribution of nerves affected (mononeuropathy, mononeuritis multiplex, or polyneuropathy), the type of nerve fiber predominantly affected (motor, sensory, autonomic), or the process affecting the nerves e.g., inflammation ( neuritis), compression ( compression neuropathy), chemotherapy ( chemotherapy-induced peripheral neuropathy). Additionally, motor neuropathy may cause impaired balance and coordination or, most commonly, muscle weakness sensory neuropathy may cause numbness to touch and vibration, reduced position sense causing poorer coordination and balance, reduced sensitivity to temperature change and pain, spontaneous tingling or burning pain, or allodynia (pain from normally nonpainful stimuli, such as light touch) and autonomic neuropathy may produce diverse symptoms, depending on the affected glands and organs, but common symptoms are poor bladder control, abnormal blood pressure or heart rate, and reduced ability to sweat normally. Neuropathy may cause painful cramps, fasciculations (fine muscle twitching), muscle loss, bone degeneration, and changes in the skin, hair, and nails. When two or more (typically just a few, but sometimes many) separate nerves in disparate areas of the body are affected it is called " mononeuritis multiplex", "multifocal mononeuropathy", or "multiple mononeuropathy". Neuropathy affecting just one nerve is called "mononeuropathy" and neuropathy involving nerves in roughly the same areas on both sides of the body is called "symmetrical polyneuropathy" or simply " polyneuropathy". In conventional medical usage, the word neuropathy ( neuro-, "nervous system" and -pathy, "disease of") without modifier usually means peripheral neuropathy. It can also be genetic (present from birth) or idiopathic (no known cause). Peripheral neuropathy may be acute (with sudden onset, rapid progress) or chronic (symptoms begin subtly and progress slowly), and may be reversible or permanent.Ĭommon causes include systemic diseases (such as diabetes or leprosy), hyperglycemia-induced glycation, vitamin deficiency, medication (e.g., chemotherapy, or commonly prescribed antibiotics including metronidazole and the fluoroquinolone class of antibiotics (such as ciprofloxacin, levofloxacin, moxifloxacin)), traumatic injury, ischemia, radiation therapy, excessive alcohol consumption, immune system disease, celiac disease, non-celiac gluten sensitivity, or viral infection. More than one type of nerve may be affected simultaneously. Damage to peripheral nerves may impair sensation, movement, gland, or organ function depending on which nerves are affected in other words, neuropathy affecting motor, sensory, or autonomic nerves result in different symptoms. Peripheral neuropathy, often shortened to neuropathy, is a general term describing disease affecting the peripheral nerves, meaning nerves beyond the brain and spinal cord. Micrograph showing a vasculitic peripheral neuropathy plastic embedded Toluidine blue stain
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