Mononeuropathy

 

Mononeuropathy is known as a condition which causes damage to the nerves which are outside the spinal cord and the brain. This condition is most often caused by an injury to the body through trauma inflicted or an accident. Any long term pressure exerted on the nerve which may result in a swelling is caused by an injury and may result in mononeuropathy.

This condition may be very painful to the patient and also in some cases disabling. If the cause of this can be diagnosed, the possibilities of it being successfully treated is higher. The disability involved in this go to a large extent or  may vary from no disability at all to an extreme case of loss of partial or even a complete loss in the  movement and sensation. Nerve pain is also reported which is very uncomfortable and may last for a long duration of time.

Mononeuropathy is caused when there is a destruction of the sheath of the nerve or a part of the axon (the nerve cell). This covering is called the myelin sheath. Due to this damage, the signals which travel within the nerve cells either slow down or the signals are prevented from travelling. This results in pain, disability of movement, numbness etc. This condition may affect any part of the human body.

Signs and Symptoms

The most commonly reported signs of mononeuropathy are reported to be of two kinds: negative or loss of function and positive or gain of function.

A loss in the function is described as a numbness felt, tremors or even in certain cases, abnormality of gait, weakness or even tiredness.

A gain of function is described as itching, tingling crawling, a feeling described as pins and needles or even pain. In some cases, the pain may be intense enough to need the use of drugs that are narcotic or contain morphine.

A few of the symptoms of this condition may result in, but may not be restricted to the loss of bowel or / and bladder control, loss of sensations, numbness or a decrease in the sensation in any part of the body, a tingling feeling, pain or even paralysis of a part of the body and in some cases weakness in the muscles.

There could also be pain and cramps that are felt in the muscles which lead to autonomic dysfunction of the body.

Prevention

The best way to prevent mononeuropathy is to avoid any kind of trauma or injury that may cause pressure on the nerves. In conditions such as diabetes and high blood pressure, there may be severe pressure on a single artery which can result in affecting the nerve, pressing on it etc. Treating and managing these conditions therefore becomes very important to avoid mononeuropathy.

Treatment

The primary aim of any treatment for mononeuropathy is to allow the patient to be able to use the affected part of the body to the extent that is possible. The first and most important aspect of treatment is that the condition should be properly diagnosed by a qualified physician so that an appropriate treatment may be prescribed. In certain cases, the patient is advised no treatment at all other than a gradual rehabilitation program which may be the only requirement.

In certain cases where there is a swelling of the nerve or the pressure on the nerve which is pinched or is trapped, corticosteroids may be injected in the area which helps in reducing the swelling and pressure. In a few cases, surgery may also be recommended to reduce the pressure on the nerves being affected.

Medications: There are several over the counter prescription medications which may be given for control of the pain. Some medicines available on prescription such as pregabalin, gabapentin, phenytoin, or anti depressants like nortiptyline, duloxetine or amitriptyline may be given to help in cases where stabbing pain is reported. Medications for pain are always prescribed with the caution to reduce their usage as they may have side effects.

Several drugs that work on the central nervous system and have been used in the treatment of depression (anti depressants) or epilepsy have been useful in the management of neuropathic pain.