Neuropathy

Definition

Neuropathy is damage or dysfunction of peripheral nerves, causing sensory, motor, or autonomic symptoms. It may be focal, multifocal, or diffuse (polyneuropathy).

Common Causes

• Diabetes (most common)
• Alcohol use disorder
• Chemotherapy (vincristine, cisplatin, paclitaxel)
• B12 deficiency
• HIV
• Autoimmune (Guillain-Barré)
• Compression (carpal tunnel)

Signs and Symptoms

Numbness, tingling, burning, stabbing pain, 'stocking-glove' distribution in polyneuropathy. Loss of protective sensation leads to foot ulcers (especially in diabetes). Autonomic neuropathy: orthostatic hypotension, gastroparesis, erectile dysfunction.

Nursing Interventions

Glycemic control (best prevention for diabetic neuropathy), B12 supplementation if deficient, alcohol cessation, gabapentin or pregabalin for neuropathic pain, duloxetine, TCAs. Teach daily foot inspection, proper footwear, avoid walking barefoot, protect from injury.

NCLEX Relevance

Diabetic foot care is a high-yield teaching point.