Neuritis: what it is, causes, symptoms and types

Your fingers go numb as if a thin glove had been put on your hand: you feel pressure but not texture. Then burning, a shooting pain, or a feeling that your foot turns over on level ground. The word "neuritis" hides exactly this scenario, and breaking it down piece by piece is easier than it seems.

What neuritis is

Neuritis is an inflammatory disease of the peripheral nerves in which, along with pain, deficits are detected: loss or reduction of sensation, as well as paralysis and paresis. The peripheral nervous system is the network of nerves outside the brain and spinal cord; it includes sensory fibers (transmit pain and touch), motor fibers (control muscles) and autonomic fibers (regulate blood pressure, bladder function and other automatic functions). When such nerves are damaged, one or more of them stop working properly — this is called neuropathy. Neuritis is its inflammatory variant.

Types of neuritis: which nerves are affected

A distinction is made between damage to a single nerve (mononeuritis), several nerves, and polyneuritis — a form in which many nerves are involved. Some polyneuritis is caused by a neurotropic virus, and then the spinal nerve roots are affected at the same time (polyradiculoneuritis), often along with the spinal cord and even the brain. Polyneuropathy is the most common type: it starts with the longest nerves, so symptoms appear in the feet, gradually "creep" upward and later affect the hands. Facial nerve neuritis, in which the muscles of facial expression are affected, is discussed separately.

Causes of neuritis

In facial nerve neuritis, inflammation of the middle ear (otitis), infectious agents — for example, the shingles virus, bacterial toxins (diphtheria), injuries and cold-related factors are relevant. Polyneuritis is more often associated with chronic intoxications: alcohol, botulinum toxin, lead, diabetes, uremia.

The most common cause of peripheral nerve damage is diabetes: high blood sugar levels over time destroy the fibers. Next come autoimmune diseases (rheumatoid arthritis, lupus), chronic kidney disease, infections (HIV, shingles, hepatitis C), deficiency of vitamins B1, B6, B12, hypothyroidism, tumors, hereditary conditions, prolonged pressure on a nerve (for example, in carpal tunnel syndrome), heavy metal poisoning, and certain medications. Sometimes the cause cannot be found.

Symptoms of neuritis

The picture depends on which nerves are affected. The main manifestations are:

• numbness and tingling in the feet or hands;
• burning, stabbing or shooting pain;
• loss of balance and coordination;
• muscle weakness, especially in the feet, the foot turning over, difficulty with buttons;
• disruptions in internal organs: bloating and heartburn after a small portion of food, constipation or loose stools, dizziness on standing up, urinary incontinence.

In polyneuritis there may be pain in the limbs, muscle atrophy and paresis, changes in skin color, sweating, coldness — mainly in the area of the hands and feet. Due to reduced sensation, a person may not notice a cut, a callus or water that is too hot.

How neuritis differs from neuralgia and neuropathy

Neuritis is about inflammation and deficits. We do not discuss neuralgia in this material: it is a separate condition, and a doctor's examination helps distinguish it from neuritis. Neuropathy is a broader term: it refers to any disruption of peripheral nerve function, whatever its cause — diabetes, alcohol, pressure, heredity.

How neuritis is diagnosed and when a neurologist is needed

The doctor asks about symptoms and health history and performs an examination. Blood and urine tests are ordered to look for the cause. Then electromyography (checking the electrical activity of muscles), nerve conduction studies (the speed at which the signal travels), nerve or skin biopsy, genetic testing, and lumbar puncture — analysis of cerebrospinal fluid when inflammation or infection is suspected — may be possible. If necessary, the patient is referred to a neurologist.

Neuritis by itself is not a reason to call an ambulance. 103 or 112 — if the condition is life-threatening: this is how emergency help is called for stroke, heart attack, or severe injury.

If pain, tingling or loss of sensation in the feet, loss of balance or weakness, or a cut or ulcer on the foot that does not heal appear, this is a reason to see a doctor without delay. People with diabetes need regular check-ups. The earlier the diagnosis is made, the higher the chance of limiting the damage.

This text is for reference: it explains how neuritis works but does not replace a consultation with a doctor who sees you, not a description of symptoms.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer