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Is Neuropathy Always Caused By Diabetes?
Diabetes is the most usual cause of polyneuropathy , but it is not the only cause ofneuropathy . Peripheral neuropathies ( polyneuropathy ) are the most coarse type of upset of the peripheral nervous organisation in adults and are prevalent in about 5 - 8 % people . Alcohol - touch on polyneuropathy is seen in about 22 - 66 % of case of the great unwashed with inveterate potomania . Chemotherapy - induced neuropathy is also increasing in number due to the increase in the number of malignant disease , which is prevailing in about 30 - 40 % of the patients depending on the type of medication and treatment regimen . Polyneuropathy is also view in hereditary aberrations or due to vitamin deficiency or overdose , immunologic mental process and vulnerability to various toxic heart and soul and drug . Neuropathic pain is present in about half of all case of polyneuropathy . It is important to name the causal agent of polyneuropathy in decree to treat the patient.(1 )
Peripheral neuropathy affects the sensory , motor or autonomic uneasy scheme . Sensory neuropathy conduct to numbness , tingling , and electrocution , cold paraesthesia , burn pain in the ass , stinging , electric shock like pain , gait unbalance , and falls . Motor neuropathy leads to impuissance , muscle cramp , fasciculations ( muscle twitches ) and muscle release .
intoxicant - induced polyneuropathy is associate with the duration of alcohol abuse and quantity of alcohol use of goods and services in the lifetime . Delta soaker ( people who can not refrain from alcoholic drink ) are more normally affected than the mass who drink alcohol on occasion . what is more , women are more usually impress than man . Intake of alcoholic beverage > 100 g / Clarence Shepard Day Jr. over a inveterate point increases the chances of peripheral neuropathy . Sensational disfunction is seen that may be present with or without neuropathic pain . Mostly , sensorimotor neuropathy is maintain affecting the thin mettle fibers . It is managed by abstaining from inebriant and dietetic changes.(1 )
Chemotherapy - induced neuropathy is mostly see with Cancer the Crab therapy and drugs such as atomic number 78 derivatives , antibody - based therapies , genus Vinca alkaloids , taxanes and proteasome inhibitor that mostly feign sensorial nerves . The damage increases with the growth in the length of the intervention ; however , once therapy is discontinued , retrieval is see . In therapy with Pt and on rare occasions Oncovin derivatives can induce an initial worsening of symptoms after discontinuance of therapy.(1 )
Various drugs and environmental toxins can direct to peripheral neuropathy . These include anti - infective agents ( dapsone , isoniazid , chloroquine , metronidazole , quinolones , Macrodantin , and thalidomide ) , anti - rheumatic drugs and immunosuppressive drug ( chloroquine , colchicines , atomic number 79 , tacrolimus ) , cardiovascular drugs ( Cordarone , Apresoline , propafenone , dronedarone ) , psychiatrical medicament and sedatives ( atomic number 3 , disulfiram ) and other medicine ( pyridoxine , diphenylhydantoin ) . The environmental toxins have peripheral neuropathy include lead , Hg , arsenic , thallium , acrylamide , solvents , carbon disulfide , and triorthocresyl orthophosphate . Treatment includes obviate the photograph of these toxin and speedy removal of the toxins from the body.(1 )
Vitamin B12 deficiencycan steer to paresthesia and tingling of feet , centripetal ataxia , and hypesthesia ( subdue physical sensory faculty ) . Vitamin B6 inadequacy , as well as overdose , can go to subacute sensorimotor peripheral neuropathy.(1 )
Immune - mediate neuropathy is seen in conditions such asGuillain Barre syndrome , chronic inflammatory polyradiculoneuropathy , paraproteinemic neuropathies , paranodopathies , multifocal motor neuropathy , and vasculitic neuropathies.(1 )
Most of the neuropathic pain sensation is due to an abnormality in the peripheral nervous systems , such as painful peripheral neuropathy , radiculopathy , complex regional nuisance syndrome , and postherpetic neuralgia . However , occasionally , neuropathic nuisance can be due to cardinal neuropathy as observed in neurological complications of the central queasy system too . The fundamental neuropathic pain in the ass can arise from disease of the brain , brainstem , and spinal cord . The various insults of the central nervous system can be vascular ( ischemic or hemorrhagic ) , infectious ( abscess , myelitis , phrenitis ) , traumatic ( brain or spinal cord ) , demyelinating , or neoplastic disorder ) . The most common cause of central neuropathic painful sensation include stroke , multiple sclerosis , andspinal electric cord injury . There is dysfunction of spinal - thalamic - cortical pathways that can be manifest as abnormal painfulness and temperature sensations.(2 )
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