chemotherapy induced peripheral neuropathy is a medical condition whereby the peripheral nerves are not functioning correctly. Under normal circumstances, the nerves of the nervous system are responsible for transmitting electrical impulses and signals from the body to the brain or central nervous system and vice versa. Unfortunately, when there is neuropathy, there is an impairment in the transmission of impulses from the central nervous system, and this will cause a cascade of symptoms. The symptoms that occur in peripheral neuropathy vary for each individual and is dependent on the severity of the disease itself, the underlying cause and the group of nerves affected.
Some of the symptoms that have been linked to neuropathy include:
Disorders of sensation are the most common symptoms of neuropathy, and as a result, most people with this disease often complain of tingling or numbness in their hands, feet and other localized areas of the body. These disorders of sensation (paresthesia) occur due to the fact that the nerves that carry sensation of pain, touch, pressure, and temperature to the brain are malfunctioning. Numbness is mostly experienced in the lower limb and in extreme cases, there can be a complete loss of perception of sensation. On the other hand, tingling can occur in any region, and it is usually described as a feeling of being pricked by hundreds of needles.
Pain is another common manifestation of neuropathy. Many individuals who have neuropathy have reported experiencing episodes of sharp shooting pains mostly in the lower limb. Due to paresthesia, some people experience hypersensitivity and as a result, merely touching them illicit a painful sensation. The pain in neuropathy has been described as a feeling of electrocution only in the affected region. Some individuals also complain of burning sensations in their arms, hands, legs, and feet.
People who suffer from neuropathy often lose their balance because the various regions of their body are not working synergistically; there is lack of coordination in various parts of their body. Ideally, proprioceptors are receptors responsible for balance and coordination of the body. These proprioceptors are located subcutaneously all over the body hence when a group of nerves supplying a particular area or region of the body are affected, the proprioceptors located in the affected areas are also affected and are unable to achieve optimum balance and coordination. Loss of balance can further lead to bodily harms such as fractures, concussions, bruises, and lacerations.
The way each and everyone walks is controlled by several integrative mechanisms of the sensory and motor nervous system. In case of neuropathy, since the sensory nerves are affected, there is a dysfunction in the integration of the sensory and motor nervous system; hence the likelihood of developing an abnormal gait is high. Gait changes that might be observed in neuropathy include feet dragging, stooping walk or a lopsided gait.
In layman's term, myalgia means muscle pain or cramps. Please note that neuropathy doesn't affect only the sensory nerves; motor nerves that control motion can also be affected, and in such situations, muscle cramps are one of the presenting symptoms of neuropathy. The cramps might be so severe that individuals find it difficult to walk, stand or even perform basic daily living activities. Such severe cramps are NSAIDs resistant and stronger medications such as opioids might be required for relief.
When the motor nervous system is affected by neuropathy, there is muscle weakness and impairment in muscle control. Affected individuals find it challenging to perform voluntary tasks like buttoning a shirt, chopping some vegetables, grasping objects and gesticulating. These signs might be missed in elderly individuals because they might be misdiagnosed as a manifestation of natural ageing.
Few cases of indigestion, flatulence, bloating, diarrhea and constipation have been observed in patients who have neuropathy. The cause of these gastrointestinal disorders has been linked to neuropathy affecting the autonomic nervous system. In most cases, the gastric disorders are managed using over the counter medications which bring about relief, thus causing late diagnosis of the underlying neuropathy.
The autonomic nervous system controls the blood pressure. If the autonomic nerves are affected by neuropathy, it can cause a reduction in blood pressure. Some of the signs and symptoms of hypotension include syncope/fainting, fatigue, visual disturbances, dizziness, and palpitations. Just like gastrointestinal disorders associated with neuropathy, autonomic neuropathy is usually misdiagnosed as hypotension; the hypotension is treated, but the underlying cause is not because it goes undiagnosed.
Bell's palsy is a neurological condition characterized by paresis or paralysis on one side of the face, and it is caused by trauma to the seventh cranial nerve- the facial nerve. In some rare cases of neuropathy, the facial nerve may be affected, and signs of Bell's palsy might be seen. These signs include muscle weakness and drooping on one side of the face.
Other signs and symptoms that might raise suspicion of neuropathy include; sweating, carpal tunnel syndrome, disorders of micturition, altered consciousness and decreased libido or impotency.