Peripheral Neuropathy Specialists and Care Centers
The Peripheral Neuropathy Clinic at Northwestern Memorial Hospital offers a multidisciplinary approach to care, including a specially trained care team provides diagnostic, treatment, rehabilitative and supportive services for individuals with peripheral neuropathy, and their family members and caregivers. Our multidisciplinary team includes:
- Neurologists specializing in nerve and muscle diseases
- Nerve surgeons
- Plastic surgeons
- Physical therapists
- Nutritionists
- Hematologists/oncologists
- Genetic counselors
- Pain specialists
Northwestern Memorial Hospital offers one of few Charcot-Marie-Tooth Association (CMTA) Centers of Excellence in the country, and is one of few hospitals in the region with a plastic surgeon who specializes in nerve surgery.
Our clinic is one the few neurological consortium partner clinics established by the Foundation for Peripheral Neuropathy (FPN), with the goal of building the Peripheral Neuropathy Research Registry (PNRR). Through the Center for Translational Pain Research at Northwestern University we aim to understand the mechanisms of pain and develop non-opioid treatments for managing and relieving acute and chronic pain conditions of varying types.
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"I first saw Dr. Lovitt when he was in Fellowship training. He was wonderful at taking care of me and made me feel a part of my own treatment plan. He always treated me with courtesy and respect. I was sad when he completed his training and moved to San Antonio. Eight years later, I found Dr. Lovitt again when I was looking for a new neurologist. Imagine my surprise when he not only remembered me but also remembered almost all of my medical history! I appreciate that he will spend a lot of time with me discussing my complicated problems. I also appreciate that I rarely have to wait longer than a few minutes to see him. If you have neuromuscular problems - Dr. Lovitt is the doctor to see."
Peripheral neuropathy is generally a result of nerve damage that causes numbness in the extremities (hands and feet). While one of the most common causes for nerve damage like this is diabetes, the condition can also be a result of: Peripheral neuropathy can occur in sensory nerves, motor nerves, or
autonomic nerves, and most often starts in the nerves that reach to the toes. Symptoms depend on the affected nerves, but look out for the following: The condition can affect one, two, or even several nerves. Early diagnosis is key, so as soon as you experience symptoms, seek professional help
from a neurologist. Our number one goal here at the Neurology Center is to manage the condition causing the neuropathy. Often, once this underlying condition is properly addressed, peripheral neuropathy goes away on its own. We may also help relieve your pain with medications or simple lifestyle changes. Contact The Neurology Center today
to start living your life free of crippling pain. Call us at 713-795-0074.Peripheral Neuropathy
Symptoms & Treatment
Possible Symptoms of Nerve Damage
Treatments
Peripheral Neuropathy, Polyneuropathy, and Other Neuropathies
Overview
Duke neurologists use advanced diagnostic tools and therapies to pinpoint, treat, and even reverse neuropathy. Our specialists are experienced in caring for all types of neuropathy, even rare ones that can be difficult to treat. Our goals are to help you reduce symptoms, avoid falls, and improve your daily life.
About Neuropathy
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Neuropathy is a disorder of the nerves -- the body’s system for transmitting messages from the body to the spinal cord and brain, and vice versa. Common symptoms include tingling, numbness, weakness, changes in sensation, and pain. There are many different types of neuropathy, based on which nerves are affected and how many. These are the overarching categories:
- Autonomic neuropathy: Affects nerves that control involuntary, or autonomic, body functions
- Focal neuropathy: Also known as mononeuropathy, this affects one nerve
- Polyneuropathy / peripheral neuropathy: Generalized neuropathy that is symmetric (the same on both sides of your body)
- Multifocal neuropathy: Multiple mononeuropathies affecting different nerves
Neuropathies can be caused by many different conditions, including:
- Cancers, like multiple myeloma and paraneoplastic syndromes
- Diabetes and other endocrine disorders, like thyroid disease
- Infectious diseases, like herpes, leprosy, sarcoidosis, Lyme disease, HIV, and hepatitis
- Organ failure
- Toxins, like certain medications, chemotherapy, and heavy metals
- Trauma
- Vitamin deficiencies
Rare Neuropathies
Many of our neurologists have significant experience
treating uncommon types of neuropathy, including:
- Acute and chronic immune-mediated neuropathies: Guillain-Barré syndrome (GBS), also known as acute inflammatory demyelinating polyradiculoneuropathy (AIDP), GBS variants, and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP)
- Amyloidosis neuropathy
- Hereditary neuropathies: Charcot-Marie-Tooth disease, familial amyloid, mitochondrial disorders, hereditary sensory and autonomic neuropathies (HSAN), hereditary spastic paraplegia with neuropathy, and hereditary peripheral nerve channelopathies
- Vascular/ischemic neuropathy
Our Locations
Duke Health offers locations throughout the Triangle. Find one near you.
Neuropathy Tests
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During your initial exam, your neurologist will ask questions to learn about your symptoms and medical history. They will also perform physical and neurological exams to test muscle strength and sensation. Your doctor may also order one or more of these tests:
Blood Tests
Bloodwork can help identify genetic mutations, vitamin deficiencies, toxins, endocrine diseases, or other conditions that could be causing neuropathy.
Imaging
Ultrasound,
CT, or MRI scans can detect spine problems, enlarged nerves, and tumors that could be causing symptoms.
Nerve Conduction Study (NCS)
Small, flat electrodes are taped to the skin over a muscle or nerve. Nerves are then stimulated with small electrical shocks from a probe placed against the skin. These
results are analyzed to help identified any nerve dysfunction.
Electromyogram (EMG) Test
A thin, sterile needle electrode is inserted through the skin into a muscle. The needle measures how much electrical activity is generated by the nerve and sent to the muscle. This helps determine whether it’s the nerve or muscle that is malfunctioning.
Nerve Biopsy
A small piece of nerve is removed and examined under a microscope. This can help
identify the underlying cause of a neuropathy.
Neuropathy Treatments
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Neuropathy treatments vary widely based on type, cause, and symptoms. Treating contributing conditions is crucial to reducing neuropathy symptoms and possibly reversing nerve damage. Duke offers the full range of therapies, from traditional treatments to breakthrough options.
Pain Management
Our
neurologists are experienced in treating neuropathic pain and partner with pain medicine specialists to reduce or eliminate debilitating pain caused by neuropathy. From medications to transcutaneous electrical nerve stimulation (TENS) therapy, we have an array of options so we can find what works best for you.
Peripheral Nerve Stimulators and Spinal Cord Stimulators
New surgically
placed devices like peripheral nerve stimulators and spinal cord stimulators use electricity to relieve certain types of chronic pain. Spinal cord stimulators are FDA approved to treat diabetic neuropathy symptoms.
Research shows they can help reduce pain and improve function.
Steroids
Oral or intravenous steroids treat neuropathies caused or worsened by inflammation.
Intravenous Immunoglobulin (IVIG)
This IV medication can reverse nerve damage caused by autoimmune neuropathies like GBS and CIDP.
Amyloid-Reducing Medications
These medicines can stall or reverse symptoms of amyloidosis neuropathy by slowing down the
production of defective proteins called amyloid that can cause neuropathy.
Antibody Therapy
This infusion medication is administered every four to six months to help stabilize or reverse neuropathic nerve damage caused by vasculitis or inflammation.
Plasma Exchange Therapy
Also called PLEX or plasmapheresis, this can treat neuropathies caused by inflammation and autoimmune disorders. Through a central line in your upper chest or an IV in your arm, a special machine withdraws your blood, removes cells that cause inflammation and destructive antibodies, and then returns the blood along with extra fluid. Duke is one of only a handful of centers in North Carolina that offers plasma exchange therapy.
Related Conditions and Treatments
Avoiding Complications
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Major risks of neuropathy include loss of feeling in your hands and feet and balance problems, which can lead to dangerous falls, injuries, and skin infections.
Our physical and occupational therapists evaluate your function and recommend lifestyle changes, orthotic shoes, and other assistive devices to help you maintain independence and avoid these complications.
Best Hospital for Neurology, Neurosurgery in NC
Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our neurology and neurosurgery program is nationally ranked, and the highest ranked program in North Carolina by U.S. News & World Report for 2022–2023.
Why Choose Duke
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Center of Excellence
Duke was named a center of excellence by the
GBS|CIDP Foundation International in recognition of our expertise, research capabilities, and available treatments for rare types of neuropathy. We take pride in caring for our patients and their families.
Team Approach
Our neurologists work with a range of other specialists to treat your neuropathy and its symptoms. We partner with pediatric experts and genetic counselors to monitor for inherited neuropathies in children, and we ensure they transition seamlessly to
adult care.
Convenient Care
Our clinics are equipped with the latest diagnostic technology. In our hospital-based clinic, EMG and nerve conduction labs are located within our neuromuscular clinic, so patients can undergo nerve testing and see a doctor on the same day.
Advancing the Science
Many Duke neurologists attend yearly
conferences to learn about new neuropathy diagnostics and treatments. We aim to move the field forward by sharing knowledge and participating in clinical trials studying new advances.