Mononeuropathy

Mononeuropathy is damage to a single nerve or nerve group, which results in loss of movement or sensation. Mononeuropathy is most often caused by injury, although systemic (body wide) disorders may cause isolated nerve damage. For example, Mononeutitis multiplex. Prolonged pressure on the nerve due to swelling or injury can result in Mononeuropathy. The covering of the nerve ( Myelin Sheath) or part of the nerve cell (the axon) is destroyed. This damage slows or prevents signaling through the nerves.

Symptoms

Symptoms depend on the nerve that is damaged. Symptoms also depend on whether the damage affects one nerve, several nerves, or the whole body.

  • PAIN AND NUMBNESS – Tingling or burning in the arms and legs may be an early sign of nerve damage. These feelings often start in your toes and feet. You may have deep pain. This often happens in the feet and legs.
  • You may lose feeling in your legs and arms. Because of this, you may not notice when you step on something sharp. You may not notice when touch something that is too hot or cold, like the water in a bathtub. You may not know when you have a small blister or sore on your feet.
  • MUSCLE PROBLEMS – Damage to the nerves can make it harder to control muscles. It can also cause weakness. You may notice problems moving a part of your body. You may fall because your legs buckle. You may trip over your toes.
  • Doing tasks such as buttoning a shirt may be harder. You may also notice your muscles twitch or cramp. Your muscles may become smaller.
  • PROBLEMS WITH BODY ORGANS – People with nerve damage may have problems digesting food. You may feel full or bloated and have heartburn after eating only a little food. Sometimes you may vomit food that has not been digested well. You may have either loose stools or hard stools. Some people have problems swallowing.
  • Damage to the nerves to your heart may cause you to feel lightheaded, or faint, when you stand up.
  • Angina is the warning chest pain for heart disease and heart attack. Nerve damage may “hide” this warning sign. You should learn other warning signs of a heart attack. They are sudden fatigue, sweating, shortness of breath, nausea, and vomiting.
  • OTHER SYMPTOMS OF NERVE DAMAGE – Sexual problems. Men may have problems with erections. Women may have trouble with vaginal dryness or orgasm.
  • Bladder problems. You may leak urine. You may not be able to tell when your bladder is full. Some people are not able to empty their bladder.
  • You may sweat too much. This may happen when the temperature is cool, when you are at rest, or at other unusual times.

Resources

Resources

  • Katirji B, Koontz D. Disorders of peripheral nerves. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley’s Neurology in Clinical Practice. 6th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 76.
  • Shy ME. Peripheral neuropathies. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 428.

Treatments

  • Treating the cause of nerve damage, if known, may improve your symptoms.  If you use alcohol, stop.  Your medicines may need to be changed. Do not stop taking any medicine before talking to your health care provider. Replacing a vitamin or making other changes in your diet may help. If you have low levels of B12 or other vitamins, your doctor may recommend supplements or injections.  You may need surgery to remove pressure from a nerve. You may have therapy to learn exercises to get better muscle strength and control. Wheelchairs, braces, and splints may improve movement or the ability to use an arm or leg with nerve damage.
  • Wear shoes at all times to protect your feet from injury. Before you put them on, always check inside your shoes for stones, nails, or rough areas that may hurt your feet. Check your feet every day. Look at the top, sides, soles, heels, and between the toes. Wash your feet every day with lukewarm water and mild soap. Use lotion, petroleum jelly, lanolin, or oil on dry skin. Check bathwater temperature with your elbow before putting your feet in the water. Avoid putting pressure on areas with nerve damage for too long.
  • Medicines may help reduce pain in the feet, legs, and arms. They usually do not bring back loss of feeling. You may take pain pills. Medicines used to treat other medical problems, such as seizures or depression, can also help manage the pain. Use the lowest dose possible to avoid side effects.  Your doctor may refer you to a pain specialist. Talk therapy may help you better understand how your pain is affecting your life. It can also help you learn ways to better cope with pain.
  • Wearing elastic stockings may help treat low blood pressure and fainting. So can sleeping with your head raised. Some medicines may also help.

 

Your health care provider may give you medicines to help with problems going to the bathroom. Eating small frequent meals may help.

There are ways to help bladder problems. You can learn exercises to strengthen your pelvic floor muscles. You may need to use a thin tube that is inserted into your bladder (urinary catheter). You may take medicines. 

Medicines can often help with erection problems.

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