Neuropathy presenting features
So what are the signs and symptoms of someone with a neuropathic condition:
Sensory neuropathies present with the following signs and symptoms:
1) Numbness in the arms or legs ( a clue to neuropathy is that the signs and symptoms are usually symmetrical and start distally. For example the patient may complain of numbness in both legs or hands initially in the toes and the fingertips. As the disease progresses this numbness also moves more proximally reaching to the ankles, shin and the arms).
The patient may not complain of numbess rather may use words like ” my legs feel dead” or “my hands burn” to describe his symtoms.
2) Pins and needles sensation in the arms and legs: people with neuropathy have what doctors call paresthesias or abnormal sensations. They may complain of feeling pins and needles , electric shocks or at times as if their skin is been touched with a feather.
They have allodynia (a non-noxious stimuli feels noxious meaning that if I touch you with a feather you may feel as if I am boring a sharp pin into your skin) and hyperalgesia (meaning that they have an increased sensitivity to pain).
3) Patients with neuropathy may present with skin changes. This is most commonly noted on the skin overlying the shin and feet. The skin is shiny and atrophic, the overlying hair are sparse or completely lost. At times people may develop non-healing ulcers of the feet which may get infected and even gangrenous. This condition is commonly seen in diabetic patients with severe neuropathy (diabetic foot).
4) If a patient has a large fiber neuropathy, he may complain of difficulty with balance especially at night or when his eyes are closed. They feel as if they are walking on cotton wool.
5) Patients may present with ulcers or burns in their hands: this is because as they are not able to detect the sensations of heat etc they may touch something hot like a gas stove and get burnt.
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