Peripheral Nerve Problems

Overview

The peripheral nervous system is made up of all the nerves that exit the brain and spinal cord. Medical problems involving the peripheral nervous system include carpal tunnel syndrome and ulnar neuropathy, acute closed and open traumatic peripheral nerve injuries, tumors and a variety of other diseases.

Patients with peripheral nerve problems often need physical therapy with a physiatrist. After one or more visits, patients may continue therapy on their own to preserve and improve function. Physical therapy is often required after medical or surgical treatment.
Patients with peripheral nerve questions may request an appointment with Dr. Michel Kliot by calling 206.598.5637.

Symptoms

Peripheral injuries and diseases may cause abnormalities in sensation, including pain, tingling, hypersensitivity or numbness. These injuries may also affect strength, causing either weakness or paralysis in the distribution of the involved peripheral nerves.

Causes

The most common causes of peripheral nerve problems are entrapment and repetitive strain neuropathies and neuropathies due to medical conditions, such as diabetes. The two most common types of entrapment neuropathy are carpal tunnel syndrome and ulnar nerve entrapment at the elbow.

Trauma, either direct or indirect, may also lead to either closed or open peripheral nerve injuries.

Injuries or tumors involving the brachial plexus may result in weakness or paralysis, loss of sensation, pain and deformities of the affected arm or hand. The brachial plexus is the major network of nerves in the neck connecting the cervical spine with the upper extremity that controls movement and sensation in the arms and hands.

Other causes of peripheral neuropapthy include Lyme’s disease, HIV, alcoholism, fractures or dislocated bones, pressure from prolonged use of crutches or staying in one position for too long, tumors and other masses, bleeding in or around nerves or exposure to cold or radiation.

Vascular or collagen disorders, such as atherosclerosis, systemic lupus erythematosus, scleroderma, sarcoidosis, rheumatoid arthritis and polyarteritis nodosa, may also cause peripheral nerve problems.

Risk Factors

Risk factors for developing entrapment neuropathies include repetitive motion, trauma, pregnancy, endocrine abnormalities, such as diabetes, and certain genetic conditions, such as tomoculus or hereditary nerve pressure palsy.

Diagnosis

Peripheral nerve problems are best diagnosed by:
  • A thorough clinical history with a description of symptoms
  • A thorough physical peripheral nerve examination to elicit any signs
  • Electrodiagnostic testing, which includes electromyography (EMG) and nerve conduction studies and may include somatosensory and motor-evoked potential studies
  • Radiological imaging studies, which may include magnetic resonance imaging (MRI), computed tomography (CT) and myelography, and X-rays

Complications

Undiagnosed and untreated peripheral nerve problems may lead to further loss of function.

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