Peripheral neuropathy is a disorder affecting motor, sensory or autonomic nerves outside of the central nervous system. There are two main types: mononeuropathy, which damages a single nerve, and polyneuropathy, which affects multiple nerves. Causes include diabetes, alcoholism, toxins, medications and genetic factors. Symptoms depend on the affected nerves and may include numbness, tingling, pain, muscle weakness and autonomic issues. Diagnosis involves examinations, tests and imaging. Treatment focuses on managing the underlying cause, pain relief medications, nerve stimulation, splinting and self-care techniques. Nursing care includes education, medication management, safety measures and physical therapy.

1. Peripheral
Neuropathy
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2. CONTENTS
• Introduction
• Types
• Causes
• Sign and symptoms
• Diagnosis
• Treatment/management
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3. Introduction
• The peripheral nervous system
refers to the parts of the nervous
system that are outside the
central nervous system i.e. those
outside the brain and spinal cord.
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4. Thus, the peripheral nervous system includes:
• The nerves that connect the head, face, eyes, nose, muscles, and ears
to the brain – 12 pairs of Cranial Nerves
• The nerves that connect the spinal cord to the rest of the body,
including the 31 pairs of Spinal Nerves
• More than 100 billion nerve cells that run throughout the body
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5. • Peripheral nerves, by connecting the spinal cord and brain to all other
body organs, transmit motor impulses outward and rely back sensory
impulses to encode sensation in the brain.
• Damage to these nerves interrupts communication between the brain and
other parts of the body and can impair muscle movement, prevent normal
sensation in the arms and legs, and cause pain.
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6. Peripheral neuropathy is a disorder affecting motor, sensory or
autonomic nerves.
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7. Types
Neuropathies are classified according to the problems they cause. They
are:
a)Mono neuropathy
b)Poly neuropathies
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8. a. Mononeuropathy
• Damage to a single peripheral nerve is known to as mononeuropathy.
• Mononeuropathy occurs when myelin sheath or part of the nerve cell is
damaged. The damage prevents nerves from spreading signals.
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9. • The most common cause is physical injury or trauma from an
accident.
• Common complains are:
-loss of feeling in the affected area
-weakness in the affected area
-pain or burning
-feeling of “pins and needles” etc
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10. Types of mononeuropathies
1. Carpel tunnel syndrome
2. Ulnar nerve palsy
3. Radial nerve palsy
4. Tarsal tunnel syndrome
5. Peroneal nerve palsy
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11. 1. Carpel tunnel syndrome
• AKA overuse strain injury
• Common type of
mononeuropathy
• Occurs due to compression of
median nerve at wrist .
• Risk: people whose work
requires repeated motions with
the wrist
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12. 2. Ulnar nerve palsy
• Occurs when ulnar
nerve is damaged.
• Numbness is noted
in the 4th and 5th
digit of the hand.
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13. 3. Radial nerve palsy
• Caused by injury to the radial
nerve
• Occcurs when humerus bone is
fractured.
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14. 4. Tarsal tunnel syndrome
• Caused when the posterior tibial
nerve is trapped
• Posterior nerve travels along tarsal
tunnel.
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15. 5. Peroneal nerve palsy
• Occurs when
peroneal nerve is
compressed.
• This leads to a
condition called
“ foot drop”.
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16. b. Polyneuropathy
• Accounts for the greatest number of peripheral neuropathy cases.
• It occurs when multiple peripheral nerves throughout the body
malfunctioned at the same time causing weakness ,numbness and burning
pain in roughly the same side of the body.
• One of the most common forms of chronic polyneuropathy is diabetic
neuropathy.
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17. Causes
• Idiopathic causes
• Age: over 40
• Acquired causes: environmental factors such as illness,trauma,toxins etc.
• Other causes are diabetes,alcoholism, under nutrition(especially vitamin
B), cancer and chemotherapy, different medications, etc
• Hereditary : are not so common. most common of these is Charcot-Marie
tooth disease type 1.
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18. Sign And Symptoms
Depends upon the type of nerve is affected.
• When sensory nerve is affected:
-Gradual onset of numbness
-Prickling or tingling in feet or hands, which can spread upward into
legs and arms .
-Sharp, throbbing or burning pain
-Extreme sensitivity to touch
-Pain during activities that shouldn't cause pain.
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19. S/S Cont’d…
• When motor nerve is affected: lack of coordination, falling, muscle
atrophy, diminished reflex ,etc.
• When autonomic nerve is affected: heat intolerance, excessive
sweating or no sweating, changes in blood pressure causing dizziness,
etc
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20. Diagnosis
• History taking
• Physical examination
• Blood test
• CT/MRI
• Nerve biopsy
• Electromyography
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21. Treatment
1.Medical Management
2. Nursing management
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22. 1.Medical Management
a. Pharmacological treatment
• Treatment of peripheral neuropathy depends upon the cause. Eg if
diabetes is the cause, then it is important to control blood sugar level.
• Analgesics: acetaminophen and other NSAIDS like ibuprofen,aspirin
• Other medications: cyclo oxygenase 2 inhibitor, serotonin nor
epinephrine reuptake inhibitor-cymbalta, etc
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23. b. Plasmapheresis can be done in
case of polyneuritis.
• AKA plasma exchange.
• Works by ridding plasma off
certain antibodies that
contributes immune system to
attack on peripheral nerves
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24. c.Transcutaneous nerve stimulation:
The goal of is to disrupt nerves from
transmitting pain signals to the brain.
• It uses low voltage electrical current to
provide pain relief
• A battery-powered device delivers
electrical impulses through electrodes
placed on the surface of skin at or near
nerves where the pain is located or at
trigger points.
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25. d. Use of splints:
• casts provide support for the part of
body that is uncomfortable.
• This can relieve pain.
• For example, a cast or splint that holds
wrists in a proper position while sleeping
can relieve the discomfort of carpal
tunnel syndrome.
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26. e. Self care:
• Acupuncture
• Massage,
• Yoga, meditations, exercises etc
• Avoiding alcohol and smoking
• Controlling blood sugar level
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27. f.Precaution at home:
• Always wear shoes
• Keep floor clean
• Check temperature before bathing with elbow
• Don’t stay in one position for long period, etc
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28. 2.Nursing management:
• History taking
• Complete physical assessment.
• Assess level of patients understanding.
• Provide prescribed medications on time ,assess side effects and ,manage them
efficiently.
• Instruct about good foot care including proper use of good shoes.
• If overweight, advise to reduce weight.
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29. • Assist in choosing walking aids for those with severe leg weakness
• Maintain safe environment, assist with ambulation.
• Explain the effectiveness of using braces/splints in case of foot drops.
• Physiotherapy is very effective, so provide and teach the patient and family
members.
• Counseling is must and focus on the underlying causes, self care and
precautions to be taken at home. Also focus for immediate follow up when the
symptoms got worsen.
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