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Understanding Neuropathy: A Comprehensive Guide

Neuropathy, a condition impacting the daily lives of those in Carmel, IN, surrounding areas, and the world, can be a general term used to describe many problems related to the experience of nerve-related symptoms in the body. The term usually describes symptoms related to or caused by the nervous system. When working towards a more specific diagnoses with our patients at our Carmel, IN neuropathy clinic, the first differentiation to be made is whether or not the symptoms are caused by the central nervous system (brain and spinal cord) or the peripheral nervous system (nerve roots of the spine, extremity nerves, etc). 

There are many different terms that one could be diagnosed with or hear related to their symptoms. A few of these include:

  • Mononeuropathy Multiplex

  • Vasculitic Neuropathy
     Vasculitic Restricted to PNS
     Connective tissue disease related 
     Diabetes
     Paraneoplastic
     Thyroid Induced
     Drug induced

  • Inflammatory Neuropathy
         
    Vascular
         Lyme 
         Hapatitis
         HIV
         Leprosy
         Chronic Inflammatory Demyelinating Polyneuropathy
         Acute Inflammatory Demyelinating Polyneuropathy

  • Entrapment Neuropathy
         
    Spinal Stenosis
         Herniated Disc
         Spinal Arthritis
         Carpal Tunnel Syndrome
         Cubital Tunnel Syndrome
         Piriformis Syndrome 
         Cervical Radiculopathy
         Lumbar Radiculopathy
         Ligament of Struthers
         Anatomical Variants
         Compartment Syndrome
         Ulnar Neuropathy
         Radial Neuropathy
         Axillary Neuropathy
         Lateral Femoral Cutaneous Neurpathy
         Femoral Neuropathy 
         Obturator Neuropathy (And its 20+ causes)


  • Malignancy Neuropathy
  • Diabetic Neuropathy
  • Peripheral Neuropathy
  • Small Fiber Neuropathy
  • Motor Neuropathy
  • Autonomic Neuropathy
  • Vasculitic Neuropathy


These are just a small amount of the most common neuropathies related to the peripheral nervous system. However, they do encompass between 75-90% of the known causes. 


Peripheral neuropathy can be subdivided into three types, mononeuropathy, mononeuropathy multiplex or mononeurotis multiplex, and Polyneuropathy. This is based on the involvement of a single nerve, multiple single nerves, or many nerves, respectively, in a symmetric length-dependent fashion. 


The prevelance of Polyneuropathy is approximately 2.4% of the population in midlife but rises to 8% in individuals older than 55 years. 


Careful consideration of relevant clinical medical history and presenting symptoms  dictates the path moving forward. Many times, unfortunately, individuals are deemed to have idiopathic or diabetic neuropathy when that is not fully the case. Many patients have superimposed or overlapping conditions which are not fully understood by their medical specialists. At our Carmel, IN neuropathy clinic, it is our goal to fully diagnose and treat these conditions for all of our patients who come from Indianapolis and the surrounding areas.


Early features and symptoms of these conditions are:

  • Numbness
  • Tingling
  • Pain
  • Gait Imbalance
  • Toe Weakness
  • Sensory loss to cold, heat


Proper evaluation involves a thorough medical history with all related – and seemingly unrelated  symptoms and complete neurological evaluation. At our Carmel, IN Neuropathy Clinic, this includes the following:

  • Complete medical history
  • Review of previous testing
  • Blood Work
  • Nerve Testing of EMG and NCS review
  • MRI and X-Ray if indicated
  • 16 point Sensory testing and Toronto Clinical Scoring Method for Polyneuropathy 
  • Extremity Thermal Imaging Test for micro circulation to the nerves


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