Causes

• One of the most widespread causes of peripheral neuropathy is diabetes. The Mayo Clinic says approximately 50 percent of people with peripheral neuropathy have diabetes.
  
  It can also be due to exposure to toxins (heavy metals), traumatic injuries, pressure on the nerves (spending an extended period typing on a keyboard) and kidney, thyroid or liver malfunctions.
  
  Peripheral neuropathy may also be the result of vitamin deficiencies, especially B vitamins. Alcohol abuse may also contribute to the condition.
  
  

Examination

• Your doctor will most likely take a complete medical history and conduct a physical and neurological exam.
  
  Your tendon reflexes, muscle strength, tone, posture and coordination will all be checked. You may also undergo a blood test to determine your level of vitamin B-12.
  
  Your doctor may order other specialized tests to help detect the presence of peripheral neuropathy.
  
  

Electromyography (EMG) and Nerve Conduction Velocity (NCV)

• Electromyography (inserting a thin needle into a muscle) measures the electrical discharges produced in your muscles. This test can help identify carpal tunnel syndrome and other peripheral nerve disorders.
  
  Nerve conductor velocity tests measure the exact amount of damage in larger nerve fibers. During this test a probe electrically arouses a nerve fiber, which reacts by producing its own electrical impulses.
  
  

Nerve and Skin Biopsies

• During a nerve biopsy a sample of nerve tissue (commonly from the lower leg) is removed and studied to determine the extent of nerve damage.
  
  A skin biopsy involves taking a thin skin sample and examining its nerve fiber endings. This test can reveal damage in smaller fibers that a nerve biopsy may miss.
  
  

CT Scan and MRI

• Computerized tomography (CT scan ) produces rapid, clear two-dimensional images of organs, bones, and tissues. This test can identify bone and vascular irregularities and other conditions.
  
  Magnetic resonance imaging (MRI) uses a strong magnetic field around the body to study muscle quality and size. An MRI can establish whether a nerve fiber has suffered compression damage.
  
  

Treatment

• The foremost goal of treatment is to remedy the condition that is causing peripheral neuropathy. In the meantime there are medications to help alleviate its painful symptoms.
  
  In some cases doctors prescribe antiseizure medications gabapentin (Neurontin), topiramate (Topamax) and pregabalin (Lyrica) that are used primarily to treat epilepsy. These medications can also reduce nerve pain.
  
  Tricyclic antidepressant medications, such as amitriptyline and nortriptyline (Pamelor), have been found to help lessen pain by obstructing the chemical processes in your brain and spinal cord that cause you to experience discomfort.