Neuropathy
Neuropathy is used to describe a range of disorders that affect the body's nerves and can cause pain, weakness, and discomfort. There are innumerable causes of neuropathy, including:
- Diabetes and prediabetes
- Nerve compression
- Certain hereditary conditions
- Rheumatologic and immune diseases, including autoimmunity
- Trauma
- HIV/AIDS, Lyme disease, and other infections
- Kidney disease
- Medications (such as cancer chemotherapy)
- Toxins
- Nutritional deficiencies
- Bone marrow disorders
- Critical illnesses
NewYork-Presbyterian neurologists and neurosurgeons work with other specialists to determine the cause of each patient's neuropathy, assemble a comprehensive plan of care, manage symptoms, and improve quality of life. Because we are a large academic medical center, we also have the specialists in place to address any of a patient's other healthcare concerns.
Symptoms
Neuropathy most often develops in the limbs ("peripheral neuropathy") and can cause hypersensitivity, numbness, tingling, burning, and prickling, stinging, or stabbing sensations. Patients may also experience weakness and unsteadiness. The skin over an affected area may change: it is often colder and has a different color, less hair, and is thinner than normal skin.
Unlike peripheral neuropathy, "autonomic" neuropathy affects the nerves that supply the internal organs regulating body functions such as blood pressure, heart rate, sweating, and bowel, bladder, and sexual function. Symptoms of autonomic neuropathy include urinary or sexual problems, dizziness, fainting spells, dry eyes and mouth, sweating problems, and digestive disorders.
Diagnosis
It's important to diagnose and treat neuropathy as soon as possible, because left untreated, the pain and weakness may become permanent. Neurologists at NewYork-Presbyterian Hospital perform a comprehensive evaluation of each patient to assess the cause of neuropathy symptoms. These tests include:
- Physical and neurologic examination
- Electrodiagnostic studies, including electromyography (which measures the electrical activity in muscles), nerve conduction studies (which measure how well signals travel through nerves), and Q-SWEAT (which measures the ability of autonomic nerves to induce sweating)
- A skin biopsy to measure the number of pain- and temperature-sensitive or autonomic nerve fibers, with expert interpretation of the test results by a skilled neuropathologist
Treatment
To treat neuropathy, doctors at NewYork-Presbyterian first address any underlying conditions that may be causing symptoms. Treatment of the underlying condition may resolve a patient's symptoms and allow damaged nerves to heal. Other medical treatment may include drugs to alleviate pain and muscle weakness (some of which also have antidepressant or anticonvulsant properties). Topical pain relievers may also help some patients.
If neuropathy is caused by pressure on a nerve, surgeons can sometimes perform a procedure to alleviate the pressure. NewYork-Presbyterian neurosurgeons are highly skilled at performing such procedures.
Rehabilitation
Physical and occupational therapy can help patients with neuropathy regain or maintain their ability to perform daily activities. Rehabilitation experts at NewYork-Presbyterian Hospital work with patients to:
- Develop an individualized program to maintain or improve function
- Recommend devices (such as neck supports, canes, walkers, and wheelchairs) and equipment for the home to ensure patient safety and mobility
- Discuss ways to modify activities, conserve energy, and simplify work
Research
NewYork-Presbyterian researchers are conducting studies to better understand the causes of neuropathy and to develop more effective therapies. The Columbia Neuropathy Research Center is committed to basic science and clinical research focusing on peripheral and autonomic neuropathies of all types. At NewYork-Presbyterian/Weill Cornell Medical Center, the Diabetic Neuropathy Research Center focuses on developing new treatments for diabetic neuropathy.