Introduction
The nervous system acts as a messenger between different body parts and the brain and vice versa. This system consists of the brain, spinal cord, and a network of nerves. The nervous system consists of special cells called neurons that send signals to various body parts. The nervous system is split into the peripheral and central nervous systems. The central nervous system is that part of the nervous system that includes the brain and spinal cord. The peripheral nervous system is composed of nerves that run through the whole body and lies outside the brain and spinal cord.
What Is Vasculitic Neuropathy?
Vasculitis is a disorder that is caused due to the swelling of blood vessels. The swelling may cause blockage in the blood vessel, which reduces the blood flow and oxygen supply to the body's various organs. When the swelling occurs in the blood vessels supplying the peripheral nerves, it is known as vasculitic neuropathy. The peripheral nervous system plays an important role in transmitting information from various parts of the body to the brain and carrying out the commands from the brain to different parts. The damage to peripheral nerves may disrupt the ability of the brain to communicate with the body's organs.
What Are the Causes of Vasculitic Neuropathy?
The various causes of vasculitic neuropathy are as follows:
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Autoimmune Diseases: In autoimmune disease, a person’s natural defense system present in the body loses its ability to differentiate between foreign and its own cells, leading to an attack of its healthy cells. Few examples of autoimmune diseases that can cause vasculitic neuropathy are rheumatoid arthritis (a condition that causes swelling and stiffness of the joints), Guillain-Barre syndrome (a disorder which causes weakening of muscles leading to numbness and tingling of body parts, especially feet, and hands), and Sjogren’s syndrome (a disorder which causes the damage of the salivary and tears glands leading to dry eyes and mouth).
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Trauma: Severe injuries and fractures can cause damage to the nerves. Swelling, which occurs as a result of injuries, may exert pressure on the peripheral nerves.
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Diabetes: Uncontrolled diabetes (high blood sugar levels) in patients can lead to vasculitic neuropathy.
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Tumors: Abnormal growth or tumor (both cancerous and non-cancerous) present in the body can pressure peripheral nerves, which may lead to vasculitic neuropathy.
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Toxins: People working in industries that use poisonous metals like mercury and lead in high amounts are prone to peripheral nerve damage that may lead to vasculitic neuropathy.
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Infections: Certain infections like acquired immunodeficiency syndrome (AIDS) and shingles (a virus-related infection that can lead to painful rashes) may damage peripheral nerves.
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Medications: Certain medications that are used for the treatment of cancer may damage the peripheral nerves.
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Vitamin Deficiencies: Patients with a deficiency of vitamin B1, B12, B6, B9, folic acid, and copper have increased chances of developing vasculitic neuropathy.
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Alcohol: People who consume excessive amounts of alcohol are prone to vasculitic neuropathy.
What Are the Symptoms of Vasculitic Neuropathy?
The symptoms experienced by patients with vasculitic neuropathy may differ according to the location and type of nerve affected. The common symptoms are as follows:
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Weakness and loss of muscles in the arms and legs may lead to hand and leg deformities.
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Tingling sensation in feet and hands that may spread to legs and arms.
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Numbness of hands and legs. Examples include the lack of ability of the patient to feel the coldness while picking a cold bottle or the inability to identify the texture of a carpet while walking on it.
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Increased sensitivity to touch.
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Lack of coordination and increased tendency to fall, which is more common in the dark.
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Difficulty in the movement of toes.
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The patient may experience uncontrolled muscle movements that may lead to cramps.
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Vasculitic neuropathy may cause malfunctioning in the duration and intensity of pain sent by the nerves. Hence patients may experience increased pain for a longer duration. The nerves may also generate pain signals spontaneously. This is known as neuropathic pain, the most common feature of vasculitic neuropathy.
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In patients with vasculitic neuropathy, the body automatically manages the temperature that may cause increased or decreased sweating. Decreased sweating may cause dryness and skin peeling of feet.
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Due to nerve damage, the body takes control of blood pressure which may result in increased or decreased blood pressure. The patient may have an increased heart rate and decreased blood pressure, especially while standing up.
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Disturbances in bowel movements may cause diarrhea or constipation. Some patients may experience loss of bladder control (not able to control the urination process).
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Some patients may experience blurry vision.
How to Diagnose Vasculitic Neuropathy?
The various methods to diagnose vasculitic neuropathy are as follows:
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Medical History: The doctor makes a detailed history of the patient’s symptoms, lifestyle, and history of any diseases like diabetes and other infections. The doctor also collects information about the patient’s family history of nerve disorders.
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Neurological Examination: The doctor thoroughly examines the patient’s posture and ability to feel the sensations. The doctor also checks if the patient has any trouble walking and lacks coordination.
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Blood Tests: Blood tests are conducted to find out if the patient has vitamin deficiencies, diabetes, autoimmune diseases, and the presence of toxic metals like mercury or lead.
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Nerve Biopsy: A small piece of the nerve is removed and observed under a microscope. This is done to determine if any swelling or damage is present in the nerve.
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Imaging Tests: Computed tomography (CT) and magnetic resonance imaging (MRI) scans are taken. This is done to detect any tumors, abnormalities, or compression of nerves.
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Electromyography: An electromyogram (EMG) is a test that is performed by inserting a thin needle (electrode) inside a muscle to calculate the electrical activity of the muscle in action. The evaluation of the activity of the muscle gives information about nerve damage. Along with obtaining a myogram, a nerve conduction study is also performed. This is done by placing small patches of electrodes on the patient’s skin and passing a low electric current to the nerves. The doctor will record the response of the nerves to the electric current.
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Other Tests: Tests like sweat tests and sensory tests may also be done. A sweat test measures the body’s ability to sweat. The sensory test detects how a person feels and reacts to touch, heat, and cold.
How to Treat Vasculitic Neuropathy?
The different treatment options to treat vasculitic neuropathy are as follows:
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Medications: For patients with mild symptoms, low-dose painkiller medications are given. Antidepressants (medicines used to treat anxiety disorders) and anti-seizure medications (medicines used to decrease the electrical activity in the brain that causes sudden uncontrolled disturbance in the brain) are often given to the patient to relieve severe nerve pain. Certain ointments and Lidocaine patches are applied externally on the skin of the patient to get pain relief.
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Physical Therapy: Physical therapy is found to be very beneficial in patients with muscle weakness. Physical therapy helps to improve the movements and balancing ability of the patient. It helps the patient to walk without the fear of falling.
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Transcutaneous Electrical Nerve Stimulation (TENS): This therapy involves delivering low-voltage electric current near the nerves using a small device placed on the skin. This helps to relieve pain and should be done for 30 minutes daily for nearly a month. It is usually done in patients who do not get pain relief from medications.
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Plasma Exchange and Intravenous Immune Globulins (IVIG): In the plasma exchange procedure, plasma (the liquid component of the blood) is separated from the blood cells. The blood cells which are separated from the plasma are combined with a liquid and replaced in the body. This is done to remove abnormal proteins, extra antibodies (a substance that creates an immune response in the body), and other harmful substances from the blood. Intravenous immune globulin therapy involves the administration of high levels of protein. These proteins play the role of antibodies and are beneficial for people whose immune system is weak. Both of these therapies are useful in controlling the immune system of the body in patients with vasculitic neuropathy.
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Surgery: In cases of neuropathy caused due to pressure exerted by the presence of tumors on the nerves, surgery is done to remove the tumor. Surgery is helpful in reconnecting the nerves which have been separated and relieving the trapped nerves. In some patients, surgery is done to remove the damaged nerves, thereby stopping them from transmitting signals to the brain.
Conclusion
Vasculitic neuropathy is a disorder that creates problems in the nerve signals traveling between the brain and different body parts. Therefore, if left untreated, it can lead to serious complications in different organs of the body. Some cases of neuropathies can be reversed if treatment begins at a very early stage. Hence it is essential to seek the help of a doctor at the earliest and begin the right treatment.
