Damage to peripheral nerves, which are nerves throughout the body leading from the brain and spinal cord, is called peripheral neuropathy.

The damage sometimes occurs as a complication of a generalized illness such as diabetes mellitus, alcoholism, certain vitamin deficiencies, or tumors in distant parts of the body. There are many other possible causes of peripheral damage, including some hereditary conditions, toxic effects of some drugs, and exposure to toxic chemicals (especially arsenic, mercury, lead, and the organic phosphates found in insecticides. Avoiding toxic chemicals, injuries, and excessive intake of alcohol, along with observing good nutritional and exercise habits, can help you prevent neuropathy.

What are the symptoms?

In most forms of peripheral neuropathy, symptoms begin gradually, over many months. The typical pattern is a tingling sensation that begins in the feet and later in the hands, spreading slowly along the arms and the legs to the trunk. In the same way, numbness may develop. Often the skin becomes very sensitive, and you may have pain. In some cases there is a gradual weakening of the muscle power throughout the body, usually in the muscles of the feet, legs, and hands.

What are the risks?

Peripheral neuropathy is relatively common among alcoholics and people with diabetes. Cases caused by a build-up of toxic chemicals are rare in the general population, but occur often among farm workers and others who work where there is considerable exposure to chemicals.

One of the risks associated with peripheral neuropathy is that if a numbed part of your body is injured, you may be unaware of the injury until infection or ulceration occurs. Numbness in the fingers can make you more susceptible to accidents and injuries. A gradually wasting away of the muscles can eventually progress to the point where it impairs its function severely.

What should be done?

If your hands and feet are tingling, and especially if any of the factors that cause this condition are applicable to you, see your physician, who will probably refer you to a neurologist. The neurologist will take your medical and personal history and will examine you for signs of numbness, muscle weakness, and changes in your reflexes. The neurologist will test you for any correctable vitamin or metabolic deficiencies that can affect nerve function. He or she may send you for electromyography (EMG), a procedure that tests nerve and muscle function, a nerve conduction velocity measurement.

If any of your family members have had similar symptoms, the neurologist may want to review their medical records or examine them to look for possible hereditary conditions that might be involved.

What is the treatment?

If the cause of the nerve damage is a vitamin deficiency or another treatable disorder, control of the underlying problem can halt or reverse the progress of the neuropathy. If toxic chemicals or drugs are the cause, you will be advised to stop your exposure to those substances. This may require a change of occupation or a change in medications.

In severe cases where muscles have been badly weakened, aids to mobility and independence, such as physical therapy, walking with a cane or other support, and bath rails may be prescribed. You will also be warned to be alert to any wounds on your numb arms and legs and to consult your physician immediately whenever you have a severe bruise or an open sore. Be sure to take good care of your feet and toe nails and wear shoes that fits well to prevent pressure sores and infections. Vitamin B Complex (Nervital). Take 1-2 capsule every day after meal.

Dr. Gary S.Sy, MD, is the medical director of Life Extension Medical Center located at The Garden Plaza Hotel (formerly Swiss Inn Hotel) 1370 Gen. Luna St., Paco, Manila. He is a diplomate in gerontology and geriatrics, advocate diet-nutritional therapy.