Peripheral Nerve Disorders and Neuropathy

More than 20 million Americans have peripheral neuropathy, which can cause chronic pain, weakness, tingling, numbness and balance issues. Peripheral Neuropathy — a disorder of the peripheral nerves that affects the hands and feet — can be helped, and in some cases cured.

Peripheral Neuropathy Clinic and CMT Clinic

For the best outcome, experience is key. The specialists of the Department of Neurology at Michigan Medicine have the experience, the newest treatments, and a multidisciplinary team to provide comprehensive, coordinated care. For patients with acquired neuropathy, our referral-only Peripheral Neuropathy Clinic is a designated center of the Neuropathy Association — one of a select few in the country. The clinic has also been named a Center of Excellence by the GBS|CDIP Foundation International.

For patients with inherited neuropathy, or Charcot- Marie-Tooth Disease (CMT), our CMT multidisciplinary clinic, a part of the international Inherited Neuropathy Consortium, offers the access to a neurologist, physical medicine and rehabilitation specialist, PT, OT, orthotics and genetic counseling, all in one visit.  Our physicians are all board-certified subspecialists who are often called in for second opinions.

Neuropathic Conditions We Treat

Between the two clinics, we treat the full spectrum of peripheral nerve disorders and neuropathy, including:

  • Neuropathy associated with diabetes, prediabetes, and metabolic syndrome
  • Nutritional neuropathy: B12, thiamine, and post-bariatric surgery neuropathy
  • Paraproteinemic neuropathies associated with such conditions as amyloid and IgM neuropathy
  • Autoimmune neuropathies such as chronic inflammatory demyelinating polyneuropathy (CIDP) and Guillain-Barre Syndrome (GBS)
  • Vasculitic neuropathies such as those associated with rheumatoid arthritis, non-systemic vasculitic neuropathy
  • Traumatic neuropathy

Symptoms and Diagnosis

The peripheral nervous system consists of all the motor and sensory nerves that connect the brain and spinal cord to the rest of the body. Symptoms and physical findings associated with peripheral neuropathies vary from person to person, and often can be extremely complex.

To diagnose a specific neuropathy, we start with a comprehensive history, along with a standard panel of tests. Depending on your conditions, we may order a skin biopsy, a nerve biopsy, MRI, electromyography/nerve conduction study (EMG/NCS) to measure the electrical activity of your muscles, and autonomic testing to check your autonomic nervous system.

We collaborate within a multidisciplinary team framework when possible, with a podiatrist collaborating with neurology for our diabetic and prediabetic neuropathy patients, and a physiatrist working with neurology within our hereditary neuropathy clinic.

Treatment

Treatment depends on the type of neuropathy. Our CMT clinic offers those with hereditary neuropathy the opportunity to be a part of ongoing clinical research aimed at finding interventions that can modify and one day cure the disease, while having their day-to-day symptoms addressed by specialists.  

For diabetic neuropathy, symptoms can be lessened with lifestyle counseling and pain control. Autoimmune disease neuropathy can be treated with immunosuppressant medications. For toxic neuropathy, we identify and discontinue the source. Patients undergoing chemotherapy may benefit from oral medications that can limit the extent of the neuropathy. And for traumatic neuropathy, options include rehabilitation or surgery.

We support and are actively involved in a number of research trials, for which you may be eligible to participate in, aimed at therapeutic and symptomatic treatment of neuropathy.

Make an Appointment

Schedule an appointment with the Peripheral Neuropathy Clinic or the CMT clinic by calling 734-936-9020.