What are the symptoms of peripheral neuropathy?

The most common symptom of peripheral neuropathy is loss of sensation. Or there may be problems such as abnormal sensory pain, and the main symptoms may be painful spasms or muscle fiber twitching. Severe patients may also have problems such as anorexia, impotence and rectal dysfunction.

1. Clinical manifestations

Peripheral nerve diseases have many specific symptoms and signs. Sensory disorders mainly manifest as sensory loss, paresthesia, pain, and sensory ataxia; movement disorders include motor nerve irritation and paralysis symptoms. The main symptoms of irritation are fasciculations, muscle fiber twitching, painful cramps, etc., while decreased or loss of muscle strength and muscle atrophy are symptoms of motor nerve paralysis. In addition, patients with peripheral nerve diseases often have reduced or absent tendon reflexes. Autonomic nerve damage is often manifested as anhidrosis, piloerection disorder and orthostatic hypotension. In severe cases, there may be no tears, no salivation, impotence and bladder and rectal dysfunction.

2. Classification

Due to the differences in disease causes, affected areas and disease courses, there is no unified classification standard for peripheral nerve diseases, and a single classification method is difficult to cover all types of diseases. First, it can be divided into hereditary and acquired. The latter can be divided into nutritional deficiency and metabolic, toxic, infectious, immune-related inflammatory, ischemic, mechanical trauma, etc. according to the cause; according to the pathological changes of its damage, it can be divided into primary neuropathy and interstitial neuropathy; according to the clinical course, it can be divided into acute, subacute, chronic, recurrent and progressive neuropathy, etc.; according to the distribution of the affected nerves, it can be divided into mononeuropathy, multiple mononeuropathy, polyneuropathy, etc.; according to the symptoms, it can be divided into sensory, motor, mixed, autonomic nervous system, etc.; according to the anatomical site of the lesion, it can be divided into radiculopathy, plexopathy and nerve trunk disease.

3. Rehabilitation

It is currently believed that patients with limb movement disorders (muscle atrophy, fasciculations, spasms, etc.) caused by peripheral neuropathy can significantly reduce or alleviate sequelae through formal rehabilitation training. Some people regard rehabilitation as particularly simple, or even equate it with "exercise", and are eager for quick results, which often results in half the effort and twice the results, and leads to joint and muscle injuries, fractures, shoulder and hip pain, increased spasms, abnormal spasm patterns and abnormal gait, as well as foot drop, inversion and other problems, namely "misuse syndrome".

Inappropriate muscle strength training can aggravate spasticity, while appropriate rehabilitation training can relieve such spasticity and make limb movements more coordinated. Once the wrong training method is used, such as repeatedly practicing forceful grasping with the affected hand, the flexor coordination of the affected upper limb will be strengthened, aggravating the spasm of the muscles responsible for joint flexion, causing elbow flexion, wrist pronation, and finger flexion deformities, making it more difficult to restore hand function. In fact, peripheral neuropathy is not just a problem of muscle weakness. Incoordination of muscle contraction is also an important cause of movement dysfunction. Therefore, we should not mistake rehabilitation training for strength training.