What Happens To Untreated Peripheral Neuropathy & When To Go To Doctor?

The peripheral nervous system is the nervous system that is present outside the brain and spinal cord. The peripheral nervous system plays a very vital role in connecting the central nervous system comprising of the brain and spinal cord to other parts of the body like extremities and varied organs. The peripheral nervous system is composed of three types of nerves: motor nerves, sensory nerves, and autonomic nerves. Peripheral neuropathy is a disorder that arises due to damage or the dysfunctional role of peripheral nerves. Peripheral neuropathy can arise due to inherited condition, damage or destruction of peripheral nerves, disease conditions like Diabetes Mellitus type 1 and type 2 or systemic illness due to bacterial and viral infections. The prominent symptoms observed in case of peripheral neuropathy include sharp pain; extremities display tingling sensations, a sensation of profound heaviness of extremities, digestive problems including constipation or diarrhea, cuts or ulcers that take longer than normal to heal, sexual functional issues, a drastic decline in blood pressure and profuse sweating.

What Happens To Untreated Peripheral Neuropathy?

If peripheral neuropathy is diagnosed, the cause of it should be ascertained as soon as possible. If the cause of peripheral neuropathy can be treated, it prevents chronic margin of implications. In case the cause cannot be permanently treated, palliative medication is suggested. But if the case cannot be treated, it results in complications. A normal clinical sign can turn grave if it’s left untreated. In cases of foot ulcers, patients with peripheral neuropathy take longer than normal time to heal; which can lead to cell death around the affected area, causing development of ‘gangrenous mass’ at the site of infection and to relieve the patient, surgical intervention is required and if the case is severe, amputation of foot would have to be done. It is commonly observed if the underlying cause is Diabetes; so it is also called ‘Diabetic foot ulcer.’ In the case of Diabetes, regular checkups to a foot specialist called podiatrist are mandatory. Another important consequence of untreated peripheral neuropathy is cardiovascular abnormalities. Drop-in blood pressure is a relevant clinical sign of peripheral neuropathy. It leads to exercise intolerance and causes a decrease in blood flow to peripheral organs, which can lead to decreased oxygen tissue supply and cause cell death and necrosis. This condition is termed ‘Cardiovascular autonomic neuropathy.’ The approach for its treatment is the administration of fludrocortisone and midodrine to the patient so as to elevate blood volume and tighten blood vessels respectively. Other steps include administering beta-blockers, keeping the patient well hydrated and elevation of bed when the person is at rest. The postural changes should be gradual and regular timely medication intake. (1)

When To Go To A Doctor For Peripheral Neuropathy?

As soon as you start experiencing any of the clinical signs, you should book your appointment. Even if you visit a physician, he will carry out a full medical examination which will include physical examination, blood tests, history taking, etc. Then, you will be referred to a neurologist who will undertake an in-depth examination of posture, coordination, receptivity of stimuli and alteration in responses and refer for imaging tests, biopsy tests, nerve function tests, etc. Depending on the severity of the case and the underlying cause, treatment would be started which will include pain relievers, antidepressants, anti-seizure medication, physical therapy, acupressure, and proper lifestyle modification. As soon as any clinical sign is manifested, a doctor must be contacted, so that treatment can be started as soon as possible.

The treatment options in a patient suffering from peripheral neuropathy are usually symptomatic. Laxatives are administered to relieve constipation. Blood pressure drop is treated with medications. Antidepressants and corticosteroid injections are administered in patients suffering from chronic peripheral neuropathy. Acupuncture, massage, postural changes, lifestyle modifications, therapist and support groups also aid in treating peripheral neuropathy.

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