Neuropathies

Neuropathies are characterized by diseases related to damage to the cranial and peripheral nerves. If the disease affects only one nerve, then it is called mononeuropathy (personal nerve palsy, carpal tunnel syndrome, etc.). If it concerns more nerves, then it is characterized as polyneuropathy.

Depending on the type of nerve affected, they can be characterized as motor (where disturbances in walking or speech are observed), sensory (where disturbances in sensation are observed, eg in the perception of pain or temperature), autonomic (e.g. eating or breathing disorders) and mixed disorders, in which more than one type of nerve is affected.

The symptoms usually appear at the point of nerve attack and are: Pain, burning or tingling sensation, numbness, stinging. They can also manifest with motor symptoms, that is, with weakness in movements.

The causes of neuropathy are many, with different development and prognosis.

There are Peripheral Neuropathies of autoimmune etiology, such as:
Guillain-Barre Syndrome or Acute Inflammatory Demyelinating Polyneuropathy. It is characterized by muscle weakness and then muscle paralysis, which starts from the lower extremities and then affects the trunk and upper extremities, oftentimes within a period of hours or a few days.

The hands and muscles of the face are affected and sometimes even swallowing and breathing (due to involvement of the corresponding nerves). There are also sensory disorders, as well as pain in the affected muscles.

Chronic Inflammatory Demyelinating Polyneuropathy. Rare disease of peripheral nerves, characterized by gradually increasing weakness of the legs and to a lesser extent, the hands, due to inflammation and damage to the insulating substance that covers and protects the nerves, myelin. 

The disease can manifest itself at any age in both sexes. Muscle weakness, usually, occurs within a period of a few months. The disease, usually, is manifested by difficulty in walking which gradually worsens. In this disease, exacerbations and remissions are observed, as in Multiple Sclerosis. Early diagnosis and rapid start of treatment increases the chances of no permanent injuries remaining.

Compressive neuropathies or peripheral nerve entrapment syndromes are a large class of diseases belonging to peripheral neuropathies. They are due to pressure exerted on the peripheral nerves by various anatomical structures adjacent to them, which are hypertrophic or are edematous due to overuse, or by pathological processes, such as ganglia, lipomas and various other tumors, or by rare anatomical variants, such as adjuvant muscles, vascular stems, etc. 

The external pressure exerted on the nerves reduces blood flow to the vessels that supply them. This causes local ischemia that disrupts the function of the nerve. Over time, if the condition is not treated, demyelination occurs, permanent damage to the axons and eventually the nerve becomes scarred. The most common compressive neuropathies are carpal tunnel syndrome and ulnar neuritis, while rarer conditions are the syndromes of the radial canal, Guyon’s canal (ulnar nerve), suprascapular nerve entrapment, thoracic outlet syndrome, etc.

The Neurologist clinically checks the patient, evaluates the symptoms, performs or recommends tests such as electroneuromyography, neurosonography, laboratory tests, if deemed necessary, electroencephalogram, etc., from which the exact cause will be derived.

Christos Sidiropoulos, MD, PhD, FAAN

Christos Sidiropoulos, MD, PhD, FAAN

Associate Professor of Neurology, Michigan State University, USA
Specialist in Parkinson’s Disease, Movement Disorders & Dementias.
16 years of training and specialization in the USA, Germany & Canada.
Specialist in the use of Botulinum Toxin for neurological disorders.
Tremendous experience in the assessment for patient candidacy for Deep Brain Stimulation (DBS) for Movement Disorders and patient follow up.

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