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Nerve Disorders

Nerve Disorders

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The nervous system allows various parts of the body to communicate with each other, significantly affecting your overall health. Motor nerves regulate bodily movement, sensory nerves transmit data from the muscles and skin to the brain, generating sensation, and autonomic nerves control the body's basic functioning, including its temperature, heart rate, digestion, breathing, and blood pressure. Unfortunately, in such a complex interlocking system, there are a number of things that can go wrong. Below, we detail some of the most common nerve disorders.

Bell's Palsy

Spontaneous inflammation and weakness in the facial nerve can cause heightened sensitivity, loss of sensation, discomfort, sagging skin, and changes in expression, drooling, tearing, and headache on one side of the face. This condition is called Bell's palsy. Doctors are unsure what causes this disorder, but they believe it is linked to viral infection. The same viruses that cause flu, measles, cold sores, chickenpox, mumps, hand-foot-and-mouth disease, and other conditions can lead to Bell's palsy.

In most cases, this condition is short-lived, but some patients may experience more prolonged or recurrent symptoms.

In most cases, this condition is short-lived, but some patients may experience more prolonged or recurrent symptoms. Even without treatment, most patients can successfully heal from Bell's palsy. However, doctors can help alleviate uncomfortable symptoms and improve patients' quality of life while they suffer from this condition with:

  • Antiviral medications, although these have not been proven effective.
  • Corticosteroids, which reduce inflammation in the facial nerve.
  • Physical therapy to massage and exercise the facial muscle.
  • Decompression surgery, which manually opens the bone cavity around the facial nerve. However, most doctors do not recommend this treatment, since it can be very risky and is not usually necessary.

Carpal Tunnel Syndrome

If the medial nerve, which extends from the forearm to the wrist, becomes pinched, this can lead to impaired motor function in the hand, as well as a prickling sensation, numbness, weakness, and other uncomfortable symptoms. This disorder is called carpal tunnel syndrome. Occupational risks, inflammatory disorders, chronic illnesses, wrist fracture, repetitive motions, arthritis, or strain can bring about this condition. Carpal tunnel syndrome can interfere with patients' ability to complete daily tasks that require fine motor skills. They may not be able to hold objects, maneuver a steering wheel, talk on the phone, read a newspaper, type, or write. Carpal tunnel syndrome can also awaken patients from sleep. Early intervention is key to successfully treating carpal tunnel. Doctors may recommend the following methods to alleviate symptoms and restore hand function:

  • Making lifestyle modifications, such as avoiding any motions that exacerbate symptoms.
  • Applying ice to the hands to diminish inflammation and numb the tissue to reduce aching.
  • Wearing a wrist splint to hold the hand in proper position, especially during sleep.
  • Injecting corticosteroids into the hands or arms to reduce swelling.
  • Undergoing manual or endoscopic ligament surgery. Incising the band of tissue that presses against the medial nerve may correct carpal tunnel syndrome.

Central Pontine Myelinolysis

Patients may experience central pontine myelinolysis as a complication of treatment for abnormal sodium levels. While less common, malnutrition, alcoholism, and liver disease may also precipitate this disorder. No matter the source, rapidly fluctuating sodium levels can damage the myelin sheath, the proteins and oils that enclose and protect the pons, the nerves at the center of the brainstem. Deterioration in this layer of tissue can prevent the nerves inside and outside of the brain from communicating with each other, seriously disrupting patients' quality of life and bodily function. Common symptoms of central pontine myelinolysis include:

  • Poor coordination and balance
  • Seizures
  • Impaired speech
  • Hallucinations
  • Delusions
  • Confusion
  • Exhaustion and lethargy
  • Poor reflexes
  • Reduced mental acuity
  • Weakened facial, arm, or leg muscles
  • Sleepiness or drowsiness
  • Changes in gait
  • Respiratory issues (or, in extreme cases, suffocation)

Central pontine myelinolysis requires emergency medical intervention, since this condition can be fatal. This disorder is incurable, so doctors focus on relieving uncomfortable symptoms and rehabilitating patients with painkilling medications, physical therapy, and treatment for the source of this issue.

Charcot-Marie-Tooth Disease

This is actually a collection of congenital conditions that deteriorate the peripheral nerves, which are located in and transmit information to the arms, hands, legs, and feet. Depending on the type, Charcot-Marie-Tooth disease may harm the nerve itself, or the myelin sheath, the layer of tissue that covers it. This condition makes it difficult for nerves in patients' extremities to communicate back and forth with the brain. This could prevent patients from realizing they have a serious injury or interfere with their coordination and gait. Common symptoms of Charcot-Marie-Tooth Disease include:

  • Muscular deterioration and weakness in the feet, ankles, and legs
  • Frequent falling, stumbling, or tripping, which may make walking difficult and running impossible
  • Numbness in the feet and legs
  • Limited range of motion in the ankles and feet
  • Abnormally high foot arches
  • Hammer toes (involuntarily flexed toe joints)
  • An irregular, high stride

Charcot-Marie-Tooth disease typically begins in the lower extremities and spreads to the arms and hands. This condition is incurable, but it fortunately does not affect patients' lifespans. Doctors may recommend pain medications, physical therapy, orthopedic aids, and, in severe cases, foot surgery, to keep patients comfortable and maintain their mobility.

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CRPS/RSD

CRPS, or Complex Regional Pain Syndrome (also known as RSD, or Reflex Sympathetic Dystrophy) is a rare condition that creates persistent discomfort in patients' arms and legs. Type 1 CRPS is triggered by an injury, disease, or disorder that did not directly impact the nerves in the affected region. For example, many patients suffer from CRPS after heart attacks, infections, or periods of great psychological stress. Type 2 results from a particular nerve injury in the affected limb, such as a fracture, compression, or blunt force blow in the arm or leg. Patients who suffer from CRPS may experience:

  • Heightened heat or cold sensitivity
  • Tightened and inflamed joints
  • Muscle atrophy, weakness, and spasms
  • Restricted mobility in the arm or leg
  • Fluctuations in skin temperature, color or texture
  • A burning, pulsing discomfort in the extremities
  • Changes in nail or hair growth

CRPS is a variable disorder. It may remain localized to a particular area or spread throughout the body. In some patients, symptoms diminish seemingly at random, but in others, they can continue for years. If caught and treated early on, CRPS can be resolved or, at the very least, effectively managed. Doctors usually created individualized treatment plans that can include:

  • Painkillers
  • Anticonvulsants
  • Antidepressants
  • Medications to prevent bone loss
  • Nerve anesthetics
  • Physical therapy
  • Topical anesthesia
  • Intravenous ketamine (a potent anesthesia)
  • Hot and cold therapy
  • TENS (transcutaneous electrical nerve stimulation)
  • Electrical spinal cord stimulation
  • Biofeedback

Dystonia

Congenital defects, medical conditions like Parkinson's disease, brain tumors, traumatic brain injury, congenital, or abnormal function of basal ganglia nerve cells can lead to dystonia. Patients with this condition experience involuntary violent, repetitive muscle contractions in one area of the body (focal dystonia), several neighboring regions (segmental dystonia), or throughout many muscles (general dystonia). Most often, dystonia impacts the eyelids, face, head, neck, vocal cords, forearms, and hands.

Dystonia can cause abnormal posture, make daily tasks like typing difficult, and cause tremors.

Depending on the type, location, and severity of this disorder, it can have a minimal or severely disruptive impact on patients' lives. Dystonia can cause abnormal posture, make daily tasks like typing difficult, and cause tremors. It often begins in a particular regions and spreads. Exhaustion, anxiety, and stress may exacerbate dystonia. Unfortunately, like many nerve-related conditions, dystonia is incurable. Doctors often help patients control their symptoms and improve their wellbeing with:

  • Botulinum toxin (Botox) injections, which paralyze the muscles to prevent contraction.
  • Oral medications that modify neurotransmitters related to muscle motion.
  • Deep brain stimulation, during which a surgeon inserts electrodes into the brain to help patients better control their muscles.
  • Physical therapy to help patients prevent contractions.
  • Surgery to modify or remove the nerves from a particular region (this is usually a last resort).

Guillain-Barre Syndrome

For unknown reasons, the body's immune system sometimes mistakenly damages its own nerves. This condition is called Guillain-Barre syndrome. The most common form of this disorder among American patients is AIDP, or Acute Inflammatory Demyelinating Polyradiculoneuropathy, in which the body targets and harms the myelin sheath, a protective coating around the nerves. Guillain-Barre syndrome disrupts communications in the central nervous system. Common symptoms of this disorder include:

  • A tingling, stinging sensation in the toes, fingers, wrists, or ankles
  • Respiratory issues
  • High or low blood pressure
  • Bladder or bowel incontinence
  • Impaired facial and eye movements, which may prevent patients from chewing, swallowing, and talking
  • Weakness and unsteadiness in the legs, which can then spread throughout the body
  • Difficulty walking, particularly when going up stairs
  • Severe soreness, which often worsens at night
  • Increased heart rate

Guillain-Barre syndrome qualifies as a medical emergency, so patients who experience symptoms of this condition should seek treatment immediately. This disorder is incurable, but doctors may recommend the following treatments to help manage it:

  • Immunoglobulin therapy, which introduces healthy antibodies into the body to replace those attacking nerves.
  • Plasma exchange to filter damaging antibodies from the blood.
  • Painkillers.
  • Anticoagulants.
  • Physical therapy.
  • Orthopedic devices.

Hereditary Spastic Paraplegia

Hereditary spastic paraplegia, or HSP, is a group of rare genetic disorders involving spasms, paralysis, and weakness in the legs. This condition results from nerve dysfunction in these areas, often due to cellular defects that prevent proper transmission of important proteins. HSP symptoms can vary widely from patient to patient depending on the type and severity of the condition, but they generally include:

  • Muscle stiffness
  • Difficulty walking
  • Involuntary leg tremors
  • Poor coordination and balance
  • An awkward gait, characterized by dragging feet and frequent stumbling
  • Exhaustion
  • Bladder issues

Since it is an incurable hereditary condition, HSP cannot be stopped or reversed, but doctors can provide the following treatments to help patients remain as comfortable and capable as possible:

  • Physical or occupational therapy
  • Lower leg braces
  • Muscle relaxants
  • Surgery to modify affected muscles and tendons

Find a qualified neuro-spinal surgeon in your area

Multiple Sclerosis

An illustration of a nerve with multiple sclerosis

Similar to AIDP, multiple sclerosis, or MS, is an autoimmune disorder in which the body attacks the myelin sheath around its own nerves, interfering with the function of the central nervous system and, eventually, irreparably damaging the nerves themselves. Common symptoms of multiple sclerosis include:

  • Weakness or loss of sensation in one or more body parts, typically only on side at a time
  • Prickling, tingling, or shocking sensations
  • Blurred or double vision
  • Tremors
  • Fatigue
  • Poor coordination
  • Impaired speech
  • Bowel and bladder issues

MS may be consistently progressive, or symptoms may fluctuate over time in what doctors refer to as a "relapsing-remitting course," cyclically improving and worsening. MS cannot be cured, but doctors may help patients manage their symptoms with:

  • Steroid medications.
  • Plasma exchange therapy.
  • Physical therapy.
  • Muscle relaxants.
  • Drugs to minimize relapse symptoms.

Neurofibromatosis

Neurofibramatosis is an inherited genetic abnormality that causes irregular nerve tissue growth, causing tumors to develop in the spinal cord, nerves, or brain. In some cases, these tumors are cancerous, but even benign growths can create uncomfortable and unhealthy effects. There are three forms of neurofibramatosis:

  • Neurofibramatosis 1, or NFI, typically manifests in young patients, causing groin or armpit freckles, brown spots, small, soft lumps beneath the skin, ocular lesions, stunted growth, bone malformation, and learning disabilities.
  • Neurofibramatosis 2, or NF2, is a rarer type of this disorder in which non-cancerous tumors develop in both ears, leading to balance issues, hearing loss, and tinnitus. If this condition spreads, it can cause discomfort, loss of sensation and muscle weakness in the legs and arms, facial changes, and general discomfort.
  • Schwannomatosis. This extremely uncommon form of neurofibromatosis is characterized by the development of painful growths in peripheral, cranial, or spinal nerves, but not those that affect hearing or cognitive function.

Neurofibramatosis is incurable, but doctors can monitor patients who are at risk for this condition, as well as help symptomatic patients manage this condition using:

  • Chemotherapy and radiation for cancerous tumors.
  • Surgery to remove particularly problematic growths.

Parkinson's Disease

An illustration of a brain with Parkinson's Disease

In patients with Parkinson's disease, neurons (nerve cells) in the brain deteriorate and die, impairing brain function and reducing patients' dopamine levels. Common symptoms of this progressive disorder include:

  • Slower movements.
  • Muscle stiffness.
  • Abnormal posture and poor balance.
  • Tremors.
  • Difficulty speaking and writing clearly.
  • Reduced ability to execute typically unconscious motions such as smiling or blinking.

Parkinson's disease is incurable, but patients can be made more comfortable with:

  • Regular aerobic exercises.
  • Physical therapy.
  • Synthetic dopamine treatments to replace the concentrations of this neurotransmitter lost from Parkinson's disease.
  • Amantadine or Anticholinergics for tremors.
  • Deep brain stimulation surgery.

Peripheral Nerve Injuries

The peripheral nerves connect and transmit signals between the spinal cord and the rest of the body. Unfortunately, these important tissues are relatively fragile, so they may be harmed by traumatic injuries, such as falls, blows, compression, fractures, abnormal growths, or other conditions. Peripheral nerve injuries can create a numb, prickling sensation. Patients who experience peripheral nerve injuries should seek medical attention immediately to prevent the disorder from worsening and avoid permanent damage.

Sciatica

The sciatic nerve runs from the lower back to the hips and buttocks, then extends down both legs. A bone spur or herniated disc in the region of the sciatic nerve can irritate and inflame it, causing sciatica, which is usually contained to just the left or right side of the body. Injuries and other central nervous system disorders can also bring about sciatica. This condition can cause severe symptoms, such as:

  • Diffuse pain from the lumbar region and down the leg. This discomfort may feel sharp, hot, sore, or like an electrical impulse. This pain may also be sudden or it may develop gradually and persist.
  • Muscle atrophy, weakness, or prickling in the disordered leg or foot.
  • Bowel or bladder dysfunction.

Fortunately, most of the time, sciatica symptoms diminish in just several weeks. However, patients who suffer from severe or prolonged sciatica may benefit from:

  • Anti-inflammatory, muscle relaxant, narcotic, antidepressant, or anti-seizure medications.
  • Physical therapy.
  • Steroid injections.
  • Surgery to correct the disc that pinches the sciatic nerve, if this is the cause.

Schwannoma

Healthy Schwann cells form the myelin sheath that covers and protects the nerves. However, as a result of Neurofibramatosis or other conditions, these cells may malfunction and form mostly benign (fewer than one percent are cancerous) tumors, called Schwannoma. These growths are often located in the ear region, so they may disrupt hearing. Schwannoma can also cause impaired eye movements, irregular tastes, trouble swallowing, or poor coordination. To treat this condition, a neurosurgeon can remove the Schwannoma growths, which usually do not grow back.

Shy-Drager Syndrome

Shy-Drager syndrome, which is also called Multiple System Atrophy (MSA), is a condition similar to Parkinson's disease. Neuroscientists aren't sure what triggers this process, but in patients with MSA, the basal ganglia, brainstem, and cerebellum begin to shrink, disrupting the body's involuntary processes. This appears to be related to heightened levels of the protein alpha-synuclein in nerve cells. Symptoms vary from patient to patient, but MSA can cause low blood pressure, impaired mobility, tremors, poor balance and coordination, sexual dysfunction, difficulty speaking, swallowing, or breathing, and changes in eyesight. Doctors can help patients manage this incurable disorder with oral medications, a pacemaker, lifestyle modifications (for example, eating softer foods to avoid the difficulties with swallowing), bladder treatments, impotence medications, and physical therapy.

Striatonigral Degeneration

At one time, this condition was considered separate from Shy-Drager syndrome, but more recent research indicates that both disorders fall under the heading of Multiple System Atrophy, explained in full above.

RELATED: Find a qualified neuro-spinal surgeon in your area

Thoracic Outlet Syndrome

Pregnancy, injury, poor posture, anatomical abnormalities, obesity, and other circumstances can constrict the nerves and blood vessels in the thoracic region of the chest, usually directly beneath the clavicle, or collarbone. Vascular TOS involves undue pressure on the veins and arteries in this region, causing inflammation and pain in the affected arm, pulse changes, discoloration in the hands, and growths near the collarbone. The neurological form of this disease (the most common type) is characterized by compression of the brachial plexus, the system of nerves that allow for motion and sensation in the hand, arm, and shoulder. Neurological TOS can cause a weakened grip, aching in the shoulder, neck, and hand, a loss of sensitivity or tingling in the fingers or arms, and Gilliatt-Sumner hand, in which the thumb tissue wastes away. To treat TOS, doctors often recommend physical therapy, anti-inflammatory drugs, anticoagulants (if blood clotting occurs), and thoracic surgery.

Trigeminal Neuralgia

Aging, nerve damage, or blood vessel contact can cause the trigeminal nerve (which transmits sensory information from the face to the brain) to malfunction and become overactive. Patients who suffer from trigeminal neuralgia typically experience episodes of severe discomfort, characterized by sharp, shocking pain in their facial tissue. These symptoms can be triggered by basic activities such as eating, talking, brushing their teeth, or even just touching their faces. To treat this condition, doctors typically prescribe muscle relaxants and anticonvulsants to alleviate discomfort and prevent episodes. More severe cases may require surgery to modify the trigeminal nerve.

Ulnar Nerve Compression

The ulnar nerve runs from the forearm to the ring and pinky fingers on each side. It is often referred to as the "funny bone" given its location in the elbow and the fact that even slight pinching of this nerve can lead to tingling, numbness, paralysis, and aching throughout the arm and hand. In many cases, ulnar nerve compression resolves itself within a few minutes. However, doctors recommend that patients with chronic cases improve their posture, wear elbow splints, take anti-inflammatory drugs, use vitamin B6 supplements, and, in extreme cases, surgery.

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