What is neuropathy?

Tingling, numbness, burning, electic-like pain, even weakness can all be symptoms of neuropathy. Strictly speaking, “neuropathy” literally means “problem with the nerves.” It is actually a very broad, general statement. In its purest form, it can mean so many things. But typically, when people and doctors say “neuropathy,” they are actually referencing something called “polyneuropathy.” Poly- means “many.” So, “polyneuropathy” means that MANY nerves have a problem. This implies a that a larger, holistic problem is at play. Something is creating a problem with many nerves in the body.

When we describe polyneuropathies, we use lots of different descriptions to help us understand what TYPE of neuropathy is at work. For example, the most important differentiation that dramatically affects the next step in treatment, is to determine whether a neuropathy is “demyelinating” or “axonal.”

The best way to understand the difference between demyelinating neuropathy and axonal neuropathy is to think of nerves like electrical cables. In essence, this really is how they function. Take a typical electrical wire, for example. The wire has a layer of rubber or plastic coating around it to act as insulation. Underneath all the insulation, is a copper wire. Regarding the nerves, the rubber coating is called the “myelin” and the copper wire is called the “axon.” Demyelinating neuropathies have a problem with the rubber coating while axonal neuropathies have a problem with the copper wire.

In order to discover whether a neuropathy is axonal or demyelinating, a nerve conduction study (NCS) with needle electromyogram (EMG) will need to be performed. Once a NCS/EMG is performed, we can add further descriptive terms to the neuropathy to help understand the cause and treatment. For example, “length-dependent” would mean that the neuropathy is mainly affecting the longer nerves in the body such as the ones for the feet. “Large-fiber” would imply that the larger neurons are noticeably affected. “Autonomic” would mean that the nerves that control vital systems such as blood pressure, heart, and lung function are affected. “Symmetric” or “asymmetric” implies whether the neuropathy is affecting both sides equally. “Sensory,” “motor,” or “sensorimotor” explains whether the sensory and/or motor nerves are affected.

Most neuropathies can be easily treated to at least prevent progression, if not reverse altogether, if the type of neuropathy and causative agent can be identified.

Please see your doctor if you are suffering from neuropathy or call Dr. McCoy’s office to schedule an appointment. He is extensively trained in the diagnosis and treatment of neuropathy.