Do your limbs feel tingly? Do they feel like they're burning? Let's talk about Peripheral Neuropathy.

Have you ever felt a tingling sensation in your hands or feet? For some people, this is not just a tingling sensation, but it can also be unbearable pain and inflammation. The cause of such things may be a problem with your nervous system. Peripheral Neuropathy is a common name for a number of such nerve disorders. Although this name may sound strange, this condition is very common in our country. So let's talk about it in simple terms today.

Simply put, what is Peripheral Neuropathy?

Okay, to understand this, we first need to know a little about our nervous system. Our nervous system has two main parts.

1. Central Nervous System: This consists of our brain and spinal cord. Think of it as the main computer and main cable in our body.

2. Peripheral Nervous System: This refers to all the nerves that extend from the main cable, that is, the spinal cord and brain, all the way to the arms, legs, and fingertips. These are like little wires that run from the main cable to every part of the house.

Do you understand now? Peripheral Neuropathy is a condition that occurs when there is damage or disease to the peripheral nervous system , the small nerves that are spread throughout the body. When these nerves are damaged, they don't send messages to and from the brain properly. That's why we start to feel things like numbness and pain.

This condition can develop in anyone of any age, but the risk of developing it increases with age and in people with certain medical conditions.

How do these nerves get damaged?

To understand this, let's look at what a nerve is. Think of a nerve as an electrical wire, a current-carrying wire.

• Axon: This is the electrical conductor inside the wire. This is where nerve messages are carried.
• Myelin: This is the plastic sheath that surrounds the wire. It protects the axon and helps messages travel faster.

There are two main ways that peripheral neuropathy can occur:

1. Demyelinating Neuropathy: This is when the plastic sheath of the nerve fibers is damaged. This means that electrical signals, or nerve messages, do not travel properly, and messages may even "leak".

2. Axonal Neuropathy: This is the most common type. This is where the nerve fibers inside the nerve are damaged. Since the longest nerves in our body are in our legs, the first symptoms of this type of neuropathy are usually in the legs and feet.

How quickly this damage occurs depends on the cause. An accident can happen immediately. Some infections and injuries can happen within days or weeks. Diseases like diabetes can take months or years to cause this damage.

What are the symptoms of Peripheral Neuropathy?

The symptoms of this are very diverse. This is because it can affect different types of nerves in our body. The symptoms can be mainly divided into three types.

What is the main reason for this?

There are many causes of peripheral neuropathy. Some are very common, while others are a little rarer.

• Uncontrolled Diabetes (Type 2 Diabetes): This is the leading cause of Peripheral Neuropathy in the world and in our country. High blood sugar levels over a long period of time damage the nerves, especially the nerves in the legs.
• Excessive alcohol consumption: Excessive alcohol consumption over a long period of time directly damages the nerves.
• Vitamin deficiencies: Deficiencies in vitamins, especially vitamin B12, B1, and B6, can affect nerve function. Also, taking too much vitamin B6 is harmful to the nerves.
• Autoimmune conditions: In diseases like Guillain-Barré syndrome, Lupus, and Rheumatoid arthritis, our own body's immune system attacks the nerves.
• Medications and toxins: Some chemotherapy drugs and other medications used to treat cancer can damage nerves. Heavy metals such as lead and mercury can also cause nerve damage.
• Infections: Viral infections such as HIV, shingles, and bacterial infections such as Lyme disease can damage nerves.
• Accidents or surgeries: An accident or surgery can cause damage to a nerve by cutting, crushing, or pulling it.
• Genetic causes: Some neurological diseases are hereditary, for example, Charcot-Marie-Tooth disease.
• Idiopathic Neuropathy: In some cases, despite all tests, no specific cause can be found.

How does a doctor find this?

If you have these symptoms, it is very important to see a doctor. The doctor will follow several steps to diagnose this condition.

1. Asking you details: They will ask you a lot of questions, such as what your symptoms are, how long you have had them, whether you have other illnesses like diabetes, what medications you take, and whether you drink alcohol.

2. Physical examination: The doctor will examine your arms and legs, especially muscle strength, reflexes (such as tapping your knee with a small hammer), and sensation (touching your limb with a cotton swab or a small pin to see if you can feel it).

3. Special tests: If necessary, the doctor may refer you for several other tests.

• Blood tests: Find causes such as diabetes, vitamin deficiencies, and kidney problems.
• Nerve Conduction Study (Electromyogram - EMG): This is a slightly more specialized test. It measures the speed and strength of electrical signals traveling through your nerves. This can help determine if the nerve is damaged and, if so, where.
• Nerve Biopsy: Very rarely, a small piece of nerve may be taken and examined under a microscope.

What are the treatments? Can this be cured?

Treatment for peripheral neuropathy depends on the cause.

• Treating the cause: For example, if you have neuropathy due to diabetes, the most important treatment is to control your blood sugar levels . If it's a vitamin deficiency, you'll be given vitamins.
• Medications to control pain and inflammation: Nerve pain is not relieved by regular painkillers. There are specific medications for it. Your doctor will prescribe the right medication for you.
• Physical Therapy: If muscles are weak, physical therapy can be very helpful in strengthening them, improving walking difficulties, and improving balance.
• Special care for feet: Diabetics, in particular, have reduced sensation in their feet, so they may not feel any injuries. Therefore, it is important to check your feet daily, wear appropriate footwear, and see a podiatrist.

In some cases, especially if the cause is identified and treated early, some of the nerve damage can be reversed. However, neuropathy caused by chronic conditions such as diabetes is often permanent. However, with proper treatment, it is possible to control the symptoms and lead a normal life .

When do you need to see a doctor or go to the ETU in an emergency?

Peripheral Neuropathy is not usually a life-threatening emergency. However, if you experience any of the following symptoms, it is essential to see a doctor immediately or go to the Emergency Department (ETU) of the nearest hospital .

• Sudden weakness on one side of the body, mouth drooping to one side, difficulty speaking: These can be signs of a stroke .
• Weakness or numbness that starts in the feet and quickly spreads up the body, difficulty breathing or swallowing: These can be signs of a dangerous condition like Guillain-Barré syndrome .
• If you frequently feel dizzy and lose consciousness when standing or getting up (especially if the fall resulted in an injury to the head, neck, or back).
• Irregular heartbeat (suddenly fast or very slow).

In an emergency like this, don't stay at home and seek medical advice immediately.