Damage to peripheral nerves caused by nutritional deficiency
- Poor diet and excessive alcohol consumption are risk factors
- Age, gender, and genetics are not significant factors
In nutritional neuropathies, the peripheral nerves, which branch from the brain and spinal cord, are damaged by deficiencies of essential nutrients, particularly those of the vitamin B complex (see Nutritional deficiencies).
Worldwide, nutritional neuropathies are generally caused by malnutrition. In developed countries, such neuropathies are more commonly associated with excessive alcohol consumption. People who drink heavily often also have a poor diet, which can cause a vitamin B1 deficiency. In addition, alcohol may directly damage the peripheral nerves. A person who has been drinking heavily for 10 years or more has a greatly increased risk of developing a nutritional neuropathy.
Nutritional deficiencies may occur in people with eating disorders, such as anorexia nervosa. People with long-term conditions that affect absorption of nutrients from the intestines (see Malabsorption) may also develop nutritional deficiencies.
What are the symptoms?
Nutritional neuropathies usually first affect the tips of the fingers and the toes. The symptoms appear gradually over several months or years and slowly progress up the limbs to the trunk. Symptoms may include:
Loss of sensation.
Pins and needles.
Pain in the feet and/or the hands.
Walking may be clumsy as a result of the loss of sensation in the feet and legs. If the motor nerves (nerves that stimulate the muscles) are affected, muscle weakness and wasting may develop and further affect the ability to walk.
What might be done?
Your doctor will examine you by checking your reflexes and your ability to feel sensation such as a pin prick. He or she may arrange for blood tests to look for a vitamin deficiency or for evidence of liver damage caused by excessive alcohol consumption. Your doctor may also arrange for tests that measure the extent of the nerve damage (see Nerve and muscle electrical tests).
Nutritional neuropathies are treated by replacing the missing nutrients. This is done either by giving a course of oral supplements or, in some cases, by injections (see Vitamins). Your doctor may also prescribe anticonvulsant drugs or antidepressants to help to control the symptoms. You may also be prescribed painkillers to relieve any discomfort.
Nerve damage is usually irreversible, but with treatment the progression of the disease can usually be halted.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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