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Old 03-02-2015, 06:48 AM
glenntaj glenntaj is offline
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Join Date: Aug 2006
Location: Queens, NY
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glenntaj glenntaj is offline
Magnate
 
Join Date: Aug 2006
Location: Queens, NY
Posts: 2,857
15 yr Member
Default Length dependent neuropathy--

--which is a more "typical" presentation, refers to the fact that quite often the nerve endings farthest from the center of the body and the seat of circulation are affected first. This is where the phrase "stocking-glove distribution" comes from--often the first nerves affected are at the tips of the feet; this gradually moves up towards the knee and/or affects the fingers and hands.

Neuropathy that presents that way is often thought to have a toxic, metabolic, or autoimmune circulatory cause--the theory is that the body has to transport nutrients and oxygen farther to those nerves, which also have to transport their waste products farther for excretion, so if something is compromising circulation (diabetes is very much a disease of damaged blood vessels, as are a number of the anti-nuclear antibody autoimmunities) it makes sense for the far away nerves to take the hit first.

There are, of course, neuropathies that are not length dependent and may be felt all over the body. The causes may overlap (autoimmune, nutritional, toxic in particular) but the key here is that it is not the far away nerve endings that are preferentially damaged. Often, it is though that these stem from damage to the neural cell bodies themselves; this is often referred to as a "neuronopathy" by the technically inclined. A damaged cell body will effect the functioning of the whole nerve tract, not just the more distant endings. Sjogren's, for example, as a condition that causes mucosal attack and drying, will affect the cell bodies in the dorsal root ganglia near the spine, and this can effect entire tracts.
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