Metabolic neuropathies

Definition

A metabolic neuropathy is a disease of the nerves caused by a problem regulating chemical processes in the body. In some cases, nerve damage is caused by the inability to properly use energy in the body. In other cases, various toxins accumulate and damage nerves. Some metabolic disorders are inherited, while others are acquired during life through various diseases.

Causes, incidence, and risk factors

Diabetes is one of the most common metabolic neuropathies. Those who have poorly controlled blood sugar are at the highest risk. People who have damage to the kidneys or eyes from diabetes are also more likely to have nerve damage from diabetes.

Other common metabolic causes of neuropathies include:

• Thyroid disease
  
• Hypoglycemia (low blood sugar)
  
• Nutritional deficiencies, including Vitamin B12, Vitamin B6, vitamin E, and vitamin B1 deficiency
  
• Alcoholism
  
• Sepsis (severe systemic infection)
  
• Kidney failure
  
• Porphyria
  

Symptoms

The symptoms are due to the inability of nerves to send proper signals to and from your brain:

• Numbness (inability to feel things properly)
  
• Pain - burning, pins and needles, or shooting pains
  
• Loss of coordination
  
• Clumsy gait
  
• Weakness
  

Usually, these symptoms start in the toes and feet and progress up the legs, eventually affecting the hands and arms.

Signs and tests

Your doctor will test your strength, coordination, and sensation. Abnormal reflexes, weakness, or sensation can indicate that you have a neuropathy.

Blood tests are often used to detect most metabolic neuropathies. In some cases, an elecrical test of the nerves called EMG can show how severely the nerves are affected and can indicate if a metabolic disorder is suspected.

Treatment

For most metabolic neuropathies, the best treatment is to correct the underlying metabolic problem. Vitamin deficiencies are treated with an appropriate diet. Abnormal blood sugar or thyroid function may require specific medications to correct the problem.