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Hypoesthesia or numbness is a common side effect of various medical conditions that manifests as a reduced sense of touch or sensation, or a partial loss of sensitivity to sensory stimuli. In everyday speech this is generally referred to as numbness.
Dysesthesia can include sensations in any bodily tissue, including most often the mouth, scalp, skin, or legs. [1] It is sometimes described as feeling like acid under the skin. Burning dysesthesia might accurately reflect an acidotic state in the synapses and perineural space.
Paresthesias are usually painless and can occur anywhere on the body, but most commonly occur in the arms and legs. [1] The most familiar kind of paresthesia is the sensation known as "pins and needles" after having a limb "fall asleep". A less well-known and uncommon paresthesia is formication, the sensation of insects crawling on the skin.
Peripheral neuropathy may be classified according to the number and distribution of nerves affected (mononeuropathy, mononeuritis multiplex, or polyneuropathy), the type of nerve fiber predominantly affected (motor, sensory, autonomic), or the process affecting the nerves; e.g., inflammation (), compression (compression neuropathy), chemotherapy (chemotherapy-induced peripheral neuropathy).
These paresthesias may be painful, such as shooting pain, burning, or a dull ache. They may also be pain-free, such as numbness or tingling. Motor nerve entrapment may present with muscle weakness or paralysis for voluntary movements of the innervated muscles. Entrapment of certain pelvic nerves can cause incontinence and/or sexual dysfunction. [2]
The following table describes the IENFD values in males and females of a 3 mm biopsy 10 cm above the lateral malleolus (above ankle outer side of leg). [21] Any value measured below the 0.05 Quantile IENFD values per age span, is considered a reliable positive diagnosis for small fiber peripheral neuropathy. [21]
Diabetic peripheral neuropathy can be diagnosed with a history and physical examination. The diagnosis is considered in people who develop pain or numbness in a leg or foot with a history of diabetes. Muscle weakness, pain, balance loss, and lower limb dysfunction are the most common clinical manifestations. [7]
[3] [5] Symptoms include rapid onset of arm or leg weakness and decreased reflexes. [3] Difficulty moving the eyes, speaking, or swallowing may also occur. [3] Occasionally, numbness or pain may be present. [3] Complications can include trouble breathing. [3] The cause of most cases is unclear as of 2018. [4]
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