There are four basic types of neuropathy:
Peripheral neuropathy affects the feet, hands, legs and arms.
Proximal neuropathy, or amyotrophy can cause muscle weakness. It affects the muscles in the upper part of the legs, buttocks, and hips.
Focal neuropathy, by contrast, affects one specific nerve; it’s focused neuropathy. It can also be called mononeuropathy. Focal neuropathy, which comes on suddenly, most often affects nerves in the head (especially ones that go to the eyes). It can also affect the torso and legs.
When focal neuropathy affects the legs, it has different symptoms than proximal neuropathy, which can also affect the legs. Proximal neuropathy, as you can read above, causes muscle weakness in the legs, and it may also cause shooting pain down the leg. Focal neuropathy, however, causes pain in very specific locations on the legs, which you can read more about in the symptoms article.
All of the types of diabetic neuropathy —peripheral, autonomic, focal and proximal—are examples of polyneuropathy. Poly means that they affect many nerves. Autonomic neuropathy is discussed below.
I was diagnosed with peripheral neuropathy in my feet many years ago. More recently I was diagnosed with severe polyneuropathy in my legs. My neurologist used an EMG test to make that diagnosis. My gait is unsteady, and I have dizziness when I stand up from a seated position.
Autonomic Neuropathy (AN) affects the torso, and is especially common after 25 years of diabetes. Here are the more common symptoms from the Mayo Clinic:
"Dizziness and fainting upon standing caused by a drop in blood pressure.
Urinary problems, including difficulty starting urination, urinary incontinence and an inability to completely empty your bladder, which can lead to urinary tract infections.
Sexual difficulties, including problems achieving or maintaining an erection (erectile dysfunction) or ejaculation problems in men, and vaginal dryness and difficulties with arousal and orgasm in women.
Difficulty digesting food, due to abnormal digestive function and slow emptying of the stomach (gastroparesis). This can cause a feeling of fullness after eating little, loss of appetite, diarrhea, constipation, abdominal bloating, nausea, vomiting, difficulty swallowing and heartburn.
Sweating abnormalities, such as excessive or decreased sweating, which affects the ability to regulate body temperature.
Sluggish pupil reaction, making it difficult to adjust from light to dark and causing problems with driving at night.
Exercise intolerance, which may occur if your heart rate remains unchanged instead of appropriately increasing and decreasing in response to your activity level."
My neurologist diagnosed my AN in 2010, after I had mentioned extreme dizziness in the AM, and my occasionally falling down. My BP can drop as much as 30 points after standing, but it is more normal after walking a few steps. I have had some bad falls in the past, but it has been more than a year since the most recent fall. I decreased my BP med to minimum dosage (2.5 mg), and that has helped a lot. I may have to use a walker in the not too distant future.
I have five of the symptoms of AN listed, and they are
gradually becoming more pronounced. Gastroparesis is one of the symptoms, but I do not have that problem at the present time. I hope I never do
Do you have AN, or do you think you do? Feel free to discuss your symptoms, and how you are dealing with them.