At a glance
What it is
Damage to or dysfunction of the peripheral nerves — those outside the brain and spinal cord — producing sensory, motor, and/or autonomic symptoms. Peripheral neuropathy encompasses many distinct conditions grouped by distribution (single nerve vs. many), fibre type affected (large vs. small fibre), and underlying cause (metabolic, autoimmune, hereditary, toxic, infectious, or idiopathic). The pattern and progression of symptoms, nerve conduction studies, and laboratory tests together identify the type and guide treatment.
Symptoms
Sensory: numbness, tingling, burning, stabbing, or electric pain — typically in glove-and-stocking distribution in polyneuropathy; following a single nerve territory in mononeuropathy. Motor: weakness, wasting, poor coordination, foot drop. Autonomic (if autonomic fibres involved): postural hypotension, heart rate instability, anhidrosis or excessive sweating, bladder and bowel dysfunction, sexual dysfunction. Severity ranges from mild tingling to severe disability.
Approach
Identify and treat the underlying cause: tight glucose control in diabetic neuropathy, immunotherapy (IVIG, plasma exchange, corticosteroids) for autoimmune neuropathies (GBS, CIDP), B12 supplementation for deficiency, nerve decompression for compressive mononeuropathies. Symptomatic pain management: neuromodulation (SCS, rTMS, pulsed radiofrequency), pharmacological agents (gabapentin, pregabalin, duloxetine, tricyclics), physiotherapy, and Botox for focal neuropathic pain.
What peripheral nerve disorders are
The peripheral nervous system comprises all neural tissue outside the brain and spinal cord: the cranial and spinal nerve roots, the sensory, motor, and autonomic nerves that supply every part of the body. Each peripheral nerve contains axons (the long processes of nerve cells) wrapped in myelin sheaths and supported by Schwann cells. Damage to these components — whether from metabolic injury, immune attack, infection, trauma, or toxins — disrupts signal transmission and produces peripheral neuropathy.
**Classification by distribution**
- *Polyneuropathy:* diffuse involvement of multiple nerves, symmetrical, typically length-dependent (feet > hands). Most common pattern; found in diabetes, alcohol, B12 deficiency, Charcot-Marie-Tooth disease, chemotherapy - *Mononeuropathy:* single nerve; typically compressive or traumatic — carpal tunnel syndrome (median nerve), ulnar neuropathy at the elbow, peroneal neuropathy at the fibular head, meralgia paraesthetica - *Mononeuropathy multiplex:* multiple individual nerves affected in an asymmetric, stepwise pattern — suggests vasculitis, diabetes, or sarcoidosis - *Radiculopathy:* nerve root compression; most often from disc herniation or spinal stenosis — produces dermatomal pain and weakness
**Key conditions**
*Diabetic peripheral neuropathy:* the most common cause globally; length-dependent polyneuropathy affecting more than half of diabetic patients. Prevention through glucose control; once established, management focuses on pain and autonomic symptoms.
*Guillain-Barré syndrome (GBS):* acute ascending demyelinating polyneuropathy, typically post-infectious. Rapidly progressive weakness reaching maximum within 4 weeks; treated urgently with IVIG or plasma exchange; most patients recover.
*Chronic inflammatory demyelinating polyneuropathy (CIDP):* the chronic counterpart to GBS; treated with corticosteroids, IVIG, or plasma exchange.
*Hereditary neuropathies:* Charcot-Marie-Tooth disease — the most common inherited neuropathy; causes slowly progressive distal weakness and sensory loss, high arched feet, and hammer toes.
*Amyotrophic lateral sclerosis (ALS):* motor neuron disease causing progressive weakness of limb, facial, and respiratory muscles — the most severe neuromuscular disorder.
**Treatment principles**
*Cause-specific treatment:* the most important intervention where a treatable cause exists.
*Pain management:* - Pharmacological: gabapentinoids (gabapentin, pregabalin), serotonin-noradrenaline reuptake inhibitors (duloxetine), tricyclic antidepressants, topical lidocaine - Interventional: pulsed radiofrequency applied to spinal cord or peripheral nerves; spinal cord stimulation for severe refractory neuropathic pain; Botox injection for focal neuropathic pain - Neuromodulation: rTMS targeting primary motor or prefrontal cortex modulates central pain processing
*Rehabilitation:* physiotherapy for weakness, balance, and fall prevention; occupational therapy for adaptive equipment; orthotics for foot drop.
Treatment options at Alimran Medical Center
Injection therapies
- Botox® injections
- Prolotherapy
- Ozone injection
- Trigger point injections
- Epidural steroid injections
Advanced therapies
Physiotherapy & rehabilitation
- Electrical stimulation
- Short and long wave therapy
- Laser therapy
- Ultrasound therapy
- Nerve mobilisation and functional rehabilitation
- SpineMED® system
- Sigma
Book a consultation
The secretary schedules first appointments during clinic hours; please have prior imaging, operative notes and a current medication list available at the time of the call.
This page provides general information about peripheral nerve disorders and is not a substitute for individual medical assessment. If your symptoms are severe or worsening, contact a clinician promptly.