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What is Axonal Neuropathy?

By Carey Reeve
Updated Mar 03, 2024
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Axonal neuropathy is a condition in which the nerve cells begin to function abnormally because the axons are degenerating. The effects of the condition can be felt as tingling, burning, weakness, numbness, or as a loss of motor function. Several descriptions are used for various symptom profiles including axonal peripheral neuropathy or motor axonal neuropathy, and different versions of the condition may be chronic or acute in nature. It can be caused by a number of diseases and disorders such as diabetes or a genetic neurological disorder called giant axonal neuropathy. The options for treatment depend on the initial cause of the neuropathy.

Symptoms can occur in various combinations and depend partly on the extent of the damage. Tingling, pricking, and burning sensations are often the earliest symptoms, but they can continue as the condition advances. Numbness can be felt with or without an effect on motor function; likewise, loss of motor function or weakness may present with or without loss of feeling. A patient may also lose some sensitivity to temperature in the affected area.

Axonal neuropathy is different from demyelinating neuropathies in that it involves degeneration of the entire axon rather than only degeneration of the myelin sheath around the axon. If demyelinating neuropathies are not caught and treated early enough, however, they may lead to degeneration of the axons as well. Axonal peripheral neuropathy begins in the nerves of the extremities like the hands and feet and may involve either sensory or motor signal interruption or both. Motor axonal neuropathy specifically affects the movement of the muscle tissue and may or may not include changes in sensory information.

Many genetic diseases like Charcot-Marie-Tooth and Spinocerebellar ataxia with axonal neuropathy cannot be cured and, of course, are considered chronic. Some conditions cause axon degeneration as a type of side effect to the primary illness; an example would be a deterioration of the bones in the spine that leads to bone compression that damages nerves. This type of neurpathy is also known to be a possible complication of chronic conditions such as diabetes, alcohol abuse, and leprosy. Guillain-Barr is the predominant example of acute axonal neuropathy; porphyria, alcohol abuse and diabetes can also cause acute cases.

When the symptoms are secondary to a condition like diabetes, managing that condition is the main focus of treatment. Various other causes may respond to intravenous immunoglobulin, plasma exchange, some immunosuppressant drugs, corticosteroids, or even infrared therapy. Many elderly patients experience idiopathic axonal neuropathy, i.e., that it has no known cause, for which there is no treatment at this time.

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Discussion Comments

By anon995900 — On Jun 07, 2016

Dear anon311978, firstly can I say I hope you find the answers you are searching for and reach out for all available support, medically, mentally and best of all socially.

I am also in limbo with regard to my prognosis. At my hospital review I was subjected to electrical testing on my arms and legs - no response all bloods came back as healthy. I said. "Ooohh. I'm okay then?" to the neurologist. She stated, "No, you have a very serious condition" -- and no further comments!

I visited my local doctor and asked him for further info with regard to my condition and he explained my nerves had been stripped, like a covered electrical wire with the coating being stripped! It wasn't very informing and I still don't know my prognosis! I do not know if I am classified as having a motor neuron disease or not! What I have found is denial can keep you up there for a while, however on a blue day (two at the moment) I keep myself either very busy or have a good pillow/cushion cuddle or use them as a temporary punching bag. I wish you the very best of luck with your "challenge". Remember people are thinking of you and I wish you all the very best. Take care.

By bvaughan69 — On Oct 20, 2014

What are the long term effects of severe axonal sensory motor polyneuropathy?

By anon971632 — On Sep 28, 2014

I have listened to my mother cry out in pain, walk in her sleep due to lack of it, because of a terrible burning and tingling all over her body, and have loud ringing in her ears.

She has been suffering with this for almost 20 years. Every time the doctor gives her a new medication, it works for about three months and then seems to add to her pain and burning. She then stops all medication even her blood pressure meds. She seems to believe that everything and anything that she comes into contact with will make her burn. She thinks its diet Pepsi, the ointment she uses for her psoriasis, cinnamon, red sauce, seasoning salts, garlic, just about everything. This burning she suffers has got to have a cure! She has never smoked, been a drinker or used drugs. She has been battling with a 50 pound overweight problem all her life. (yoyo)

She says the doctors have named her symptoms as Axonal neuropathy. Please if anyone has found relief for these symptoms please respond to this post.So far what she has tried are Neurontin, Cymbalta and Klonopin. Please help. Thank you. We pray every day!

By anon963009 — On Jul 27, 2014

Your doctor probably didn't know enough about it. You need to see a specialist in Charcot Marie-Tooth disease; it's one of the diseases covered under the Muscular Dystrophy Association! Good luck!

By anon344081 — On Aug 05, 2013

Can you shed any light on how doctors tell the difference between Axonal and the demyelinating version, aside from the patient losing muscle control? From what you write in the content, it seems they have several symptoms in common. (My doctor is watching my neuropathy but has only said that we should watch to see if the pain/tingle/burning progresses to loss of motor function, which is a little worrisome. It's like watching a mass to see if it's benign or malignant.

By anon311978 — On Jan 04, 2013

This article was informative. I am trying to get a diagnosis. I have motor loss in both legs. My EMG nerve test was abnormal. The result said, "motor axon loss," but the doctor refuses to explain my test results. I got a copy of my test results from the medical record office. I am searching on my own for answers. I filed a complaint with the ombudsman, and still did not get any answers. I live in Cleveland, Ohio.

Maybe someone will reply on this site with some insight. FYI: 100,000 patients die each year from medical errors. (Research this; it is true!) Why aren't doctors held accountable?

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