1. Presented by Myra Davis-Alston, RN, MSN, Ed Oncology Certified Nurse 1

2. OBJECTIVES  Describe symptoms of peripheral neuropathy  Examine known causes for peripheral neuropathy  List associated signs and symptoms of peripheral neuropathy  Explore techniques used to diagnose peripheral neuropathy  Discuss treatment options for peripheral neuropathy 2

3. Peripheral Neuropathy “describes damage to the peripheral nervous system” http://www.ninds.nih.gov/disorders/peripheralneuropathy 3

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5. http://www.webmd.com/brain/understan ding-peripheral-neurapathy-basics 5

6. Acquired neuropathies Caused by environmental factors such as toxins, trauma, illness, or infection. Known causes of acquired neuropathies include:  Diabetes – responsible for many cases of peripheral neuropathy  Several rare inherited diseases  Alcoholism  Poor nutrition or vitamin deficiency  Herniated discs in the back  Certain kinds of cancer  Conditions where nerves are mistakenly attacked by the body’s own immune system or damaged by an overaggressive response to injury  Certain medications  Kidney or thyroid disease  Infections such as Lyme disease, shingles, or AIDS 6

7. Polyneuropathy symptoms  Tingling  Numbness  Pricking sensation  Sensitivity to touch  Muscle weakness  Burning pain(especially at night)  Loss of sensation in the arms and legs 7

8. Diagnostic techniques  Neurological examination  extensive history (symptoms, work environment, social habits, exposure to toxins, history of alcoholisms, risk of HIV, or other infectious disease, family history of neurologic disease)  Blood test  Computed tomography scan (CT)  Magnetic resonance imaging(MRI)  Electomyography (EMG)  Nerve Conduction velocity  Nerve biospy  Skin biospy 8

9. TREATMENTS Treat underlying conditions Symptomatic treatment Optimal weight Correcting vitamin deficiencies Limiting or avoiding alcohol Active and passive forms of exercise can reduce cramps and improve muscle strength Meticulous foot care Control of blood glucose levels Neuropathic pain Mexiletine antiepileptic drugs-gabapetin, phenytoin,carbamazepine antidepressants-amitriptyline, Anesthetics such as lidocaine or topical patches Severe cases-surgical destruction of nerves Peripheral Neuropathy Fact Sheet 9