Many different factors, from genetic inheritance to inflammatory diseases such as lupus, can cause nerve damage. These disorders are known as peripheral neuropathies and cause symptoms related to the sensory pathways, movement or the autonomic nervous system.

One of the most frequent types of peripheral neuropathy is sensory neuropathy , which is characterized by the appearance of symptoms and signs related to the perception of sensations and occurs as a consequence of lesions in the nerves.

In this article we will analyse the symptoms, causes and most common treatments of this disorder.

What is peripheral neuropathy?

Peripheral neuropathy is a category of diseases that affect nerve function. The specific consequences of these disorders vary depending on which nerves are injured; it is common for them to cause sensory and motor deficits , as well as dysfunctions in the organs and glands of the endocrine system.

Since the autonomic nervous system also contains nerve fibers, peripheral neuropathy is sometimes associated with disorders in functions such as breathing, blood circulation, and body temperature regulation.

Some of the most common causes of peripheral neuropathy include systemic diseases such as diabetes or lupus erythematosus, the use of certain antibiotic drugs, chemotherapy and radiotherapy, trauma, vitamin deficiency and viral infections. It is sometimes transmitted by hereditary genetic mechanisms.

Types of peripheral neuropathy

We speak of “mononeuropathy” when the involvement is limited to a single nerve, while the term “polyneuropathy” is used to refer to cases where multiple nerves in the same area are damaged. In contrast, multifocal mononeuropathy is diagnosed when there is more than one nerve damaged independently.

The label “sensory neuropathy” is reserved for nervous disorders that predominantly affect the sensory system , associated mainly with touch and proprioception. In any case, it is very common for different types of neuropathy to appear together in the same person.

Symptoms

The characteristic symptoms of sensory neuropathy consist of the development of functional deficits in the senses, as well as the appearance of sensations that should not be perceived or that have a greater intensity than expected. The symptoms of sensory neuropathy tend to occur symmetrically in the two hemispheres of the body.

Among the deficit symptoms we find the lack of sensitivity to tactile stimuli , such as sensations of texture, vibration or pressure, as well as pain. In addition, there are often problems with the perception of temperature changes and a reduced ability to detect intense heat or cold.

It is very characteristic of sensory neuropathy the loss of perception of body position, which is associated with deficits in balance, posture and coordination of movements , especially when standing and walking. Symptoms are often more pronounced in the feet, further altering these types of functions.

On the other hand, significant pain sensations may occur as a result of stimuli that are objectively not very painful (hyperalgesia) or that should not cause any harm at all (allodynia). Sometimes itching, tingling, burning or shooting pains are also perceived without identifiable cause, and muscle tremors may occur.

In a large number of cases sensory neuropathy occurs simultaneously with motor nerve dysfunctions. When this happens, the most common is that sensory symptoms first appear in the lower extremities and then signs of a motor type develop , such as muscle weakness and gait disturbances .

Causes of this disorder

The scientific community has identified a large number of possible causes of sensory neuropathy. Some of the more common ones are as follows:

  • Inflammatory diseases such as lupus systemic erythematosus, multiple sclerosis, sarcoidosis, Guillain-Barré syndrome or leprosy.
  • Endocrine and metabolic diseases such as diabetes mellitus, hypothyroidism, amyloidosis or chronic kidney disease.
  • Bone marrow diseases such as lymphomas.
  • Traumatic-type injuries to the nerves of the senses.
  • Strokes , particularly ischemia.
  • Genetic inheritance of diseases such as Charcot-Marie-Tooth and Friedreich’s Ataxia
  • Contact with toxic substances such as poisons and heavy metals
  • Deficiency of vitamins A, B1, B12 and E or excess of vitamin B6 (pyridoxine)
  • Chronic inflammatory responses in nerve fibers.
  • Alterations in the blood circulation to the affected nerves.
  • Consumption of medications such as fluoroquinolones.
  • Chemotherapy and radiotherapy.

Treatment and drugs

The treatment of the symptoms of sensory neuropathy is mainly focused on the identification of the underlying cause in order to correct the core of the disorders. When this is not possible, therapy is directed at the relief of specific symptoms.

Analgesic drugs (including therapeutic cannabis), as well as antidepressants and anticonvulsants, are often used in this regard . Among the antidepressant drugs, duloxetine and tricyclics such as nortriptyline and amitriptyline stand out, while gabapentin, pregabalin and sodium valproate are the most widely used antiepileptic drugs.

On the other hand, recent research suggests that transcutaneous electrical neurostimulation therapy can be very effective in reducing pain symptoms, although the results are only maintained as long as the treatment continues.

In cases where neuropathy occurs as a result of complications in a case of diabetes mellitus , management of blood glucose levels may be sufficient to correct the problems.