Patients come from across the country to be diagnosed and treated for an array of peripheral nerve disorders at the Mischer Neuroscience Institute. More than 100 types of inherited and acquired peripheral nerve disorders have been identified, each with its own characteristic set of symptoms, pattern of development and prognosis.
Causes of acquired peripheral neuropathy include trauma to a nerve, nerve sheath tumors, toxins, autoimmune responses, nutritional deficiencies, alcoholism, kidney disorders, hormonal imbalances, connective tissue disorders, repetitive stress and vascular and metabolic disorders.
Trauma is the most common cause of injury to a nerve, and can cause nerves to be partially or completely severed, crushed, compressed or stretched. Diabetes mellitus is a leading cause of peripheral neuropathy in the United States.
About 60 to 70% of people with mild diabetes have mild to severe forms of nervous system damage.
A peripheral nerve disorder specialist can use the following tests to identify a nerve disorder:
Electromyography (EMG) involves inserting a fine needle into a muscle to compare the level of electrical activity present when muscles are at rest and when they contract. EMG can help differentiate between muscle and nerve disorders.
Nerve conduction velocity (NCV) testing can precisely measure the degree of damage in larger nerve fibers, revealing whether symptoms are being caused by degeneration of the myelin sheath or the axon.
Nerve biopsy involves removing and examining a sample of nerve tissue, most often in the lower leg.
Skin biopsy offers unique advantages over NCV tests and nerve biopsy. Unlike NCV, it can reveal damage present in smaller fibers; in contrast to conventional nerve biopsy, skin biopsy is less invasive, has fewer side effects and is easier to perform.
Lumbar puncture may be used when immune-mediated polyneuropathies, cryptogenic axonal degeneration polyneuropathies or infections or inflammatory disorders are suspected.
In general, adopting healthy habits – maintaining optimal weight, avoiding exposure to toxins, cessation of smoking, following a physician-supervised exercise program, eating a balanced diet, correcting vitamin deficiencies and limiting or avoiding alcohol consumption – can reduce the physical and emotional effects of peripheral neuropathy.
For patients with diabetes and others with impaired ability to feel pain, meticulous foot care and careful wound treatment can improve quality of life. Lifestyle changes may create conditions that encourage nerve regeneration.
Affiliated physicians with Memorial Hermann perform innovative surgical treatments for nerve compression, acute nerve injury, entrapment neuropathies and nerve sheath tumors. They are experts in nerve transfer and nerve graft. The aim of treatment, which is frequently performed on an outpatient basis, is to correct underlying conditions, reduce pain and control symptoms.
Referring physicians are kept informed about patient progress throughout the evaluation and treatment process. After a patient’s office visit, referring physicians receive a summary that includes the initial diagnosis, pending tests and treatment options.
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