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The 3 types of neuropathies include peripheral neuropathy, focal neuropathy, and proximal mononeuropathy.

Any abnormality in the function of the nerve is known as neuropathy. Diabetes is the leading cause of the condition in the United States; however, neuropathies may be caused by other reasons.

The 3 types of neuropathies include:

1. Peripheral neuropathy: Refers to various disorders caused by an injury to the peripheral nervous system that conveys information to the central nervous system
2. Focal neuropathy: A condition in which you typically have damage to single nerves
3. Proximal mononeuropathy: Usually affects one side of the body and very rarely spreads to the other

Peripheral neuropathy

It is further classified as:

• Motor neuropathy: Damage to the nerves that control the muscles and movement in the body
• Sensory neuropathy: Affects groups of nerves that affect your touch, pressure, and pain sensations
• Autonomic nerve neuropathy: Affects nerves that control functions such as heart rate, digestion, breathing, and blood pressure
• Combination neuropathies

Symptoms of peripheral neuropathy include:

• Numbness or decreased capacity to sense pain or temperature changes, particularly in your feet and toes (glove and stocking neuropathy)
• Tingling or warm sensation
• Highly sensitive to touch (pressure perceived as pain)
• Deterioration of muscles (muscle wasting)
• Sharp, stabbing pain that may be exacerbated at night
• Loss of reflexes
• Various foot disorders such as:
  • Infections
  • Ulcers
  • Deformities
  • Bone and joint discomfort

Proximal neuropathy

Proximal neuropathy is an uncommon and severe nerve injury that affects the hip, buttock, or thigh.

Proximal neuropathy affects men more than women and is more frequent in adults older than 50 years. A vast majority of people with this illness have type II diabetes.

Diabetes and high-fat levels in the blood are the main causes of proximal neuropathy. 

Symptoms of proximal neuropathy include:

• Pain in your hip, buttock, or thigh, which is sudden and severe
• Weakness in the legs making it difficult to stand
• Loss of reflexes in the joints of the legs
• Loss of muscle tissue
• Unwanted weight loss

Focal neuropathy

Focal neuropathy is also known as mononeuropathy and affects a single nerve and generally arises suddenly. The brain, thorax, hand, shoulder, leg, or feet are the most common sites of focal neuropathy.

Symptoms of focal neuropathy include:

• Weakness
• Discomfort
• Numbness
• Paralysis

The condition is less common than peripheral neuropathy.

Diabetes and excess fats in the blood are the most common causes of focal neuropathy. Other types of neuropathies come under focal neuropathy, and cranial neuropathy is one among them.

What is neuropathy?

Neuropathy is the term that defines damage and abnormal functions of the nerves.

Diabetes is the leading cause of various types of neuropathies; however, they may be caused by the following:

• Trauma or entrapment of nerves under a fractured bone, fibrotic, or scarred structures
• Neurological events such as a stroke
• Vitamin deficiency, especially vitamin B12
• Aging
• Poisoning due to heavy metals such as lead
• Prolonged use of neurotoxic medications, especially chemotherapy
• Metabolic disorders such as diabetes
• Other organ damage or malfunctions such as kidney or liver failure
• Tumors
• Paraneoplastic syndrome
• Chronic infections such as human immunodeficiency virus, leprosy, tuberculosis, or herpes
• Hereditary disorders of metabolism

How to diagnose neuropathy

Clinically, neuropathy may be demonstrated with physical examination where the doctor checks for reflexes, senses, and sensitivity tests.

Specific nerve function tests can be performed to check the functionality and extent of damage to the nerve, which may include:

• Nerve conduction velocity (NCV): NCV is a measurement of the rate at which impulses are carried by the nerves.
  • This test is frequently performed in conjunction with electromyography (EMG).
    • The doctor places small patches with surface electrodes on the skin over the nerves at various sites during the NCV test.
    • Each patch emits a very low-level electrical impulse that activates the nerve.
    • The electrical activity of the nerves is monitored, and the speed of electrical impulses between electrodes (which reflects the speed of nerve transmissions) is determined.
• EMG: EMG is a test that evaluates nerve functions.
  • The doctor injects a very thin needle through the skin into the muscle for this examination. An electrode in the needle monitors the electrical activity of the muscle.
• Nerve biopsy: The doctor may recommend a nerve biopsy in some instances.
  • A biopsy is the surgical removal of a tiny sample of tissue for microscopic examination. A pathologist (a physician who specializes in tissue diagnostics) analyzes samples and can assist in determining the etiology of the neuropathy.
  • A local anesthetic is used to execute the surgery.
  • The sural nerve in the ankle or superficial radial nerve in the wrist is the most commonly used biopsy site.