Case Study: Neuropathy Kelsey Koch PHGY 220- Gerald McGraw April 8, 2016 Neuropathy is defined as the disease or dysfunction of one or more peripheral nerves. It is caused by damaged nerves. It generally, causes a weakness or numbness but can be as severe as paralysis There are many different types of neuropathy. In this case study I am going to go into detail about the epidemiology, discuss the signs and symptoms, diagnosis, treatment, prognosis, and touch on some statistics of this disorder. Neuropathy is classified by the locations of nerves that are affected. It can also be classified by the disease that is causing it. An example of this would be diabetic neuropathy, which is caused by the …show more content…
effects of diabetes. I will briefly touch on some more common types. Peripheral neuropathy affects the nerves outside of the brain and spinal cord. This type of neuropathy may affect the feet, toes, legs, fingers, hands, and arms. Proximal neuropathy refers to the nerve damage that causes pain in the legs hips, buttocks and shoulders. Cranial neuropathy is an example of autonomic neuropathy which causes damage to nerves of the involuntary system including the heart, circulation, bowel function, bladder function, sexual response, and perspiration or sweating. Focal neuropathy is self explanatory meaning it it is restricted to one single group of nerves or also one part of the body. Many different conditions can cause damage to the nerves therefore may cause neuropathy. Diabetes is the most common associated condition that can cause neuropathy. It is referred to as diabetic neuropathy. It tends to occur in diabetic’s that have had the condition for years also most often known as type one diabetic. It can also be common in diabetic’s that are overweight. My mother is a type one diabetic and suffers from this type of neuropathy. In her case she handles it well. There are days that she comes home and her feet feel numb.
Other times I have heard her say that she has a burning sensation or tingling like the feeling when your feet fall asleep. It can be very painful. Autoimmune can be seen in anyone with conditions such as Guillain-Barre syndrome, rheumatoid arthritis, and systemic lupus. Neuropathy can also been see individuals that have certain infections such as HIV, AIDs, Lyme disease, syphilis, and leprosy. Postherpetic neuralgia is one I see I working at a dermatology clinic. It occurs in patient’s that have a complication of the shingles virus. Alcoholic neuropathy is obviously seen with alcoholics. The exact reason for this type is unclear. It may be due to the alcohol’s affect on the body. Alcohol can also cause vitamin deficiencies in alcoholics. Certain genetic or inherited diseases such as Friedreich’s ataxia and Charcot Marie Tooth disease affect the nerves as well. Amyloidosis is the condition where abnormal protein fibers are found in the organs and tissues, causing damage which can lead to neuropathy. Uremia is seen with kidney failure that may cause neuropathy. Certain drugs or medications can have side effects that lead to neuropathy as well. Any trauma or injury depending on where and how severe can cause damage to the nerves. Benign or malignant tumors can also cause nerve damage to the surrounding organs. Idiopathic neuropathy is seen in people that the cause of the neuropathy is unknown. Motor neuropathy …show more content…
is damage to the nerves that controls speech along with muscles and movement in the body. Sensory nerves control our senses such as feeling, touch or pain. Autonomic neuropathy affects the nerves that control biological function that we are not conscious of, such as breathing, gastrointestinal functions, or our heart beat. Damage to these nerves can be serious. Combination neuropathy is when you have more than one of the above discussed neuropathies. Neuropathy is not environmental or communicable. It can not be spread from person to person. Some types of neuropathy can be inherited therefore can sometimes be genetic depending on what type or cause of the neuropathy. This condition is seen all over the world. It is not more common in one certain location. I was unable to find much research on neuropathy throughout history. I can imagine in some cases neuropathy was more of a rare condition due to the fact that people did not live as long as they do today and also did not have the best medical care. Neuropathy affects the body at the cellular, chemical and gross levels in the tissues and organs of the body. The signs and symptoms with neuropathy can also vary with each type. Some people may have no symptoms others can have such severe symptoms such as paralysis. Neuropathy is most commons felt in the hands and feet but can spread to other parts of the body as it progresses. Some symptoms include a numbness, tingling, or burning sensation. There can be a gradual onset or it may be a sudden loss sensation or paralysis. The symptoms can progress and move towards the center of the body with time. Loss of sensory nerves can be very harmful if not evaluated. In a diabetic person neuropathy can cause a loss of sensation in the feet which may cause an open sore or blister to go unknown which can lead to more serious problems and a greater risk for infection in some cases leading to amputation. There are also a wide variety of symptoms including nausea, vomiting, dizziness or fainting, urinary symptoms, blurred vision, heat intolerance or a decreased ability. The signs and symptoms like with many other conditions will usually worsen with progression of the condition. In the most severe phase neuropathy can cause paralysis and can further lead to amputation. If you are having any of the above symptoms on a regular basis you should seek medical attention. There are exams and tests that can be done to indicate if a person has neuropathy. Neurological examination is often done for the initial exam. With that includes testing of the reflexes and function of the motor and sensory nerves. There are no blood tests that can be done to determine if neuropathy is present. Imaging can also be done for example CT scan, and X ray, and MRI scan. There also some tests that can be done such as electromyography, a nerve conduction velocity test, and in some cases a nerve biopsy can establish if neuropathy is existent. The treatment for neuropathy depends on the type and severity.
In most cases the condition that leads to the neuropathy would need to be treated and may help control if not complete alleviate neuropathy. For example, controlling the blood sugar can reduce the neuropathy in diabetics. There are steps a person should follow at home to prevent infections. Inspecting the hands and feet on a regular basis. Never go barefoot or wear to tight fitting footwear. Decreasing or quitting smoking can help to improve the neuropathy sensations as well. There are also medications that can be prescribe to treat this condition. Anticonvulsants, antidepressants, and opioids are some oral medications that can be prescribed. There are also topical medications such as lidocaine patches or capsaicin cream can be used to decrease the pain caused by neuropathy. Physical therapy along with acupuncture have also been used to treat neuropathy. The prognosis of this condition depends on the causing factor. Most often this condition is not life threatening. A healthier life style can help to decrease the symptoms of neuropathy. Seeing a podiatrist in the case of people with diabetic neuropathy to avoid a possible amputation. If amputation is needed additional support will be beneficial to the patient. The support of family and friends is critical in that case as the amputation is life changing for the
patient. Neuropathy can be a common condition that affect many people in some way. There are statistics for each type of neuropathy. According to Neuropathy Alliance of Texas “Neuropathy may be the most common medical problem that you don’t know about. The Neuropathy Association estimates that over 20 million people, or 1 in 15 in the U.S., have some form of neuropathy.” In conclusion, I would like to note that I have no idea that there were so many different types of neuropathy or just how common it really is. As stated before I have delt with it with my mother also with my grandfather. My grandpa is in his eighties and at one point suffered from neuropathy in his feet to the point that my grandparent’s had to get a new vehicle. They vehicle they had had low seats the seats in it. They were low enough that when my grandpa drove at times his feet would go completely numb. That was a scary thing to realize that he could have been in a accident because he couldn’t feel the gas or breaks! My uncle also has had neuropathy but swears by a certain kind of water call cogon water that he drinks that he is cured. That goes to show there can be different ways to cope with and treat neuropathy. I have enjoyed learning about the different types of neuropathy during this case study. References Hopkins, J. (n.d.). Peripheral neuropathy. Retrieved April 10, 2016, from http://www.hopkinsmedicine.org/healthlibrary/conditions/nervous_system_disorders/peripheral_neuropathy_134,51/ Neuropathy. (n.d.). Retrieved April 10, 2016, from webmd.com
warm) in the left upper and lower extremities; decreased strength and movement of the right upper and lower extremities and of the left abdominal muscles; lack of triceps and biceps reflexes in the right upper extremity; atypical response of patellar, Achilles (hyper) reflexes in the right lower extremity; abnormal cremasteric reflex in the right groin; fracture in cervical vertebrae #7; and significant swelling in the C7-T12 region of the spinal canal (Signs and symptoms, n.d.). The objective complaint of a severe headache could also be consistent with a spinal cord injury (Headache, nausea, and vomiting,
1. Outline the causes, incidence and risk factors of the identified disease and how it can impact on the patient and family (450 words)
What causes Bell’s palsy is not clear, but some experts believe it is linked to the herpes simplex virus, that causes cold sores or Influenza. Many health problems can cause weakness or paralysis of the face. This is a form of cranial mononeuropathy VII, which is the 7th cranial facial nerve and the nerve controls the movement of the face. Bell’s palsy could also be linked to inflammation of the nerve in the area where it travels through the bones of the skull. And other such conditions as diabetes, and Lyme disease the symptoms for Bell’ palsy is as follows.
Peripheral and central mechanisms involving nerve lesions and their input are substantial when perceiving phantom pain. Due to the impairment of peripheral nerves in the process of amputation, regenerative sprouting of damaged axons occurs and the activity rate of inflamed C-fibres and demyelinated A-fibres spontaneously increases (Flor, 2002). As a consequence of this nerve injury, a neuroma, which is a mass of pruned and tangled axons, may form in the residual limb producing abnormal (ectopic) activity (Katz, 1992). Flor, Nikolajsen and Jenson (2006) proposed that ectopic discharge from a neuroma in the stump illustrates abnormal afferent input to the spinal cord, which is a possible mechanism for unpro...
Flaccid dysarthria results from damage to the lower motor neurons (LMN) or the peripheral nervous system (Hageman, 1997). The characteristics of flaccid dysarthria generally reflect damage to cranial nerves with motor speech functions (e.g., cranial nerves IX, X, XI and XII) (Seikel, King & Drumright, 2010). Lower motor neurons connect the central nervous system to the muscle fibers; from the brainstem to the cranial nerves with motor function, or from the anterior horns of grey matter to the spinal nerves (Murdoch, 1998). If there are lesions to spinal nerves and the cranial nerves with motor speech functions, it is indicative of a lower motor neuron lesion and flaccid dysarthria. Damage to lower motor neurons that supply the speech muscles is also known as bulbar palsy (Pena-Brooks & Hedge, 2007). Potential etiologies of flaccid dysarthria include spinal cord injury, cerebrovascular accidents, tumors or traumatic brain injury (Pena-Brooks & Hedge, 2007). Possible congenital etiologies of flaccid dysarthria include Moebius syndrome and cerebral palsy. Flaccid dysarthria can also arise from infections such as polio, herpes zoster, and secondary infections to AIDS (Pena-Brooks & Hedge, 2007). Additionally, demyelinating diseases such as Guilian-Barre syndrome and myotonic muscular dystrophy can also lead to flaccid dysarthria (Pena-Brookes & Hedge, 2007). The lower motor neuron lesion results in loss of voluntary muscle control, and an inability to maintain muscle tone. Fasciculations, or twitching movements, may occur if the cell body is involved in the lesion (Seikel et. al., 2010). The primary speech characteristics of flaccid dysarthria include imprecise consonant production, hypernasal resonance, breathiness, and harsh voice (...
The effects include paralysis of a limb or one side of the body and disturbances of speech and vision. The nature and extent of damage depends on the size and location of the affected blood vessels. The main causes are cerebral infarction (approx. 85%) and spontaneous intracranial haemorrhage (15%) (Waugh & Grant, 2010).
Peripheral nerves are categorized as both sensory and motor which means they help provide sensations and move ligaments. These nerves attach to the spinal cord and run throughout the human body. Damaging these nerves may result in peripheral neuropathy. This condition is the degenerative state of the peripheral nerves. During this state, nerves may lose the ability to function therefore, causing multiple problems with one’s body. There are multiple causes to this condition and many can be avoided.
Rocha, J. A., Reis, C., Simoes, F., Fonseca, J., & Mendes Ribeiro, J. (2005). Diagnostic investigation and multidisciplinary management in motor neuron disease. Journal of Neurology, 252(12), 1435–1447.
the muscles lose their ability to respond to the brain and results in the inability to feel
... damaged neurons. (Mayo clinic, 2014). This is called neuroplasticity, the ability for the nerves to compensate for damage caused by some outside force. Because of neuroplasticity physical training works to cure some of the paralysis left by the virus and allows us to walk again after the legs or another appendage is deformed or damaged.
With motor neurone disease it attacks the nerves, in the brain and spinal cord. This means messages gradually stop reaching muscles, which leads to weakness and wasting. In the case study the
When a person begins to suffer from Guillain- Barre Syndrome their myelin sheath of their nervous system is being attacked and destroyed by the immune system (NINDS, 2011). The myelin sheath begins to lose its ability to transmit signals rapidly and affectively. Since signals are not getting transmitted to the brain fast enough, a person begins to notice fewer sensory responses from the rest of the body (NINDS, 2011). A person wouldn’t be able to tell right away or at all if an item they are touching is hot, cold, or causing pain. There also wouldn’t be good signal transmission from the brain to the rest of the body (NINDS, 2011). There would be signs of the muscles being unable to respond to the weakened or distraught signals they were receiving. Since the myelin sheath is responsible for transmitting the signals from a long distance, the upper and lower extremities would be the first to show signs of muscle dysfunction.
Diabetic Neuropathy is a group of neurological disorders caused by nerve damage resulting from the effects of type one and type two Diabetes. There are several types of neurological diseases, each affecting the individual differently. Each disorder presents with it's own symptoms, prognosis, and risks. It is important for the diabetic patient to receive adequate education from their physician on the basic signs and symptoms of neuropathy. Early identification and frequent check ups can impact the effects of neuropathy greatly.
The most common cause of sciatica is a herniated spinal disc (aka slipped disc). When this happens, the natural cushion between the vertebra of your spine ruptures, causing the disc to push out into areas usually occupied by these nerves. The nerves are compressed, and people then experience the symptoms of pain, weakness, and numbness. Other conditions, such as spinal stenosis, spondylolisthesis, or piriformis syndrome can also cause sciatica symptoms by irritating the nerve.
Functional motor deficits from a SCI occur when there is an interruption to the tracts in the ascending and descending pathways. In this case, the pyramidal tracts in the motor pathways, which originate in the brain and descend to the spinal cord, are affected. The corticospinal tracts (CST), which are located in the descending motor pathways, are a bundle of nerve fibers that are involved with voluntary motor movement and skilled limb movements. The effects of damage to the corticospinal tracts depend on the location in which the damage occurs. Most of the axons of upper motor neurons from the primary motor cortex project to the neurons in the spinal cord are contained in the lateral corticospinal tract (Vogelaar and Estrada 2016). As a result, damage to this area can lead to motor impairment in the form of paresis or paralysis (Maraka et al. 2014). When axons from