Today we will be continuing our series on the different causes of neuropathy and what specific neuropathies they cause. We have talked about Diabetic Peripheral Neuropathy (DPN) and Diabetic Autonomic Neuropathy (DAN) which comprise the two major types of neuropathy that sufferers will deal with. The final types are a less common and therefore I will touch on them all here.
Charcot's Joint
Charcot's Joint, also called neuropathic arthropathy, occurs when a joint breaks down because of a problem with the nerves. This type of neuropathy most often occurs in the foot.
In a typical case of Charcot's Joint, the foot has lost most sensation. The person no longer can feel pain in the foot and loses the ability to sense the position of the joint. Also, the muscles lose their ability to support the joint properly. The foot then becomes unstable, and walking just makes it worse.
An injury, such as a twisted ankle, may make things even worse. Joints grind on bone. The result is inflammation, which leads to further instability and then dislocation. Finally, the bone structure of the foot collapses. Eventually, the foot heals on its own, but because of the breakdown of the bone, it heals into a deformed foot.
People at risk for Charcot's Joint are those who already have neuropathy. They should be aware of symptoms such as:
swelling
redness
heat
strong pulse
insensitivity of the foot.
Early treatment can stop bone destruction and aid healing.
Cranial Neuropathy
Cranial neuropathy affects the 12 pairs of nerves that are connected with the brain and control sight, eye movement, hearing, and taste. Within cranial neuropathy is also focal neuropathy which can vary widely, depending on the nerve affected. It can cause visual disturbances such as double vision.
Most often, cranial neuropathy affects the nerves that control the eye muscles. The neuropathy begins with pain on one side of the face near the affected eye. Later, the eye muscle becomes paralyzed. Double vision results. Symptoms of this type of neuropathy usually get better or go away within 2 or 3 months.
Compression Mononeuropathy
Compression mononeuropathy occurs when a single nerve is damaged. It is a fairly common type of neuropathy. There seem to be two kinds of damage. In the first, nerves are squashed at places where they must pass through a tight tunnel or over a lump of bone. Nerves of people with diabetes are more prone to compression injury. The second kind of damage arises when blood vessel disease caused by diabetes restricts blood flow to a part of the nerve.
Carpal tunnel syndrome is probably the most common compression mononeuropathy. It occurs when the median nerve of the forearm is compressed at the wrist. Symptoms of this type of neuropathy include numbness, swelling, or prickling in the fingers with or without pain when driving a car, knitting, or resting at night. Simply hanging your arm by your side usually stops the pain within a few minutes. If the symptoms are severe, an operation can give complete relief from pain.
Focal neuropathy
Focal Neuropathy affects a nerve or group of nerves causing sudden weakness or pain. It can lead to double vision, a paralysis on one side of the face called Bell's palsy, or a pain in the front of the thigh or other parts of the body.
Femoral Neuropathy
Femoral neuropathy occurs most often in people with type 2 diabetes. A pain may develop in the front of one thigh. Muscle weakness follows, and the affected muscles waste away.
Proximal Neuropathy
Proximal neuropathy can lead to pain in the lower body, often on one side, and weakness in the legs.
Radiculoplexus Neuropathy (Diabetic Amyotrophy)
Radiculoplexus neuropathy affects nerves in the thighs, hips, buttocks or legs. It's more common in people with type 2 diabetes and older adults. Diabetic amyotrophy woudl also include the areas of femoral neuropathy or proximal neuropathy.
Symptoms are usually on one side of the body, but sometimes may spread to the other side. You may have:
Severe pain in a hip and thigh or buttock that occurs in a day or more
Eventual weak and shrinking thigh muscles
Difficulty rising from a sitting position
Abdominal swelling, if the abdomen is affected
Weight loss
Most people improve at least partially over time, though symptoms may worsen before they get better.
Thoracic/lumbar Radiculopathy
Thoracic or lumbar radiculopath is another common mononeuropathy. It is like femoral neuropathy, except that it occurs in the torso. It affects a band of the chest or abdominal wall on one or both sides. It seems to occur more often in people with type 2 diabetes. Again, people with this neuropathy get better with time.
Unilateral Foot Drop
Unilateral foot drop is when the foot can't be picked up. It occurs from damage to the peroneal nerve of the leg by compression or vessel disease. Foot drop can improve.
How To Prevent
Again, how to prevent or delay all diabetic neuropathies or less or delay further damage is to keep your blood sugars the target range through meal planning, physical activity, and medications. It is so important to make better day to day decisions through accurate blood glucose readings through a glucose meter. Also get your A1C at least twice a year to find out your average blood sugar for 2 to 3 months.
Summary
Again, many times people will experience one or more types of neuropathy with diabetes. Extra present huh? The key here is knowledge, realize what is going on with your body and then you can decide how to best deal with it and continue to live a rewarding life!
Call your doctor for an appointment if you have:
A cut or sore on your foot that is infected or won't heal
Burning, tingling, weakness or pain in your hands or feet that interferes with daily activities or sleep
Changes in digestion, urination or sexual function
Dizziness
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