Bilateral neuropathy describes a number of nerve disorders that generally affect the hands and feet, but can include other systems in the body as well. The term bilateral means affecting both the left and right side of the body. Neuropathy is a blanket term for any disease or disorder of the nervous system. In medical literature, bilateral neuropathy generally refers to a collection of symptoms affecting both left and right arms and hands, or both left and right legs and feet. It is also commonly called peripheral neuropathy to distinguish it from other types of neuropathy that affect the central nervous system.
The symptoms of bilateral neuropathy vary according to the type of nerve affected and the severity of the disease. When the motor nerves are affected, muscle weakness may occur, as well as problems with coordination. If the sensory nerves are affected, there will be loss of feeling, numbness and tingling. Pain is also a symptom with both types of nerves. Bilateral neuropathy in the legs can lead to an increased risk of falling because of muscle weakness or lack of coordination due to numbness.
The most common single cause of peripheral neuropathy is diabetes, accounting for about 30% of diagnosed cases in the United States. Other causes can include vitamin deficiencies, exposure to toxins, and systemic infection such as HIV. Excessive alcohol or drug use has also been found to cause neuropathy in some patients. Neuropathy can be a result from a direct injury, and it can also be caused by hereditary conditions such as Charcot-Marie-Tooth disease. In about 30% of diagnosed neuropathy cases, the cause is unknown.
Early diagnosis is important to slow the progression of nerve damage, and in some cases, reverse the existing damage before it becomes permanent. Diagnosis is often made by a neurologist after studying the patient's medical history, including any underlying conditions that may contribute to neuropathy. A physical exam in the office may reveal abnormalities in reflex reactions, muscle reactions and grip strength. More detailed testing is sometimes required and may include an electromyogram (EMG) which studies muscle contractions, as well as nerve conduction tests.
Treatment will start with diagnosing and treating any underlying or contributing cause, such as diabetes. Physical therapy and occupational therapy may be necessary to alleviate pain and improve mobility. Orthopedic devices such as splints may be worn to ease pain by stabilizing the injured area during healing. Medication is also commonly used to treat neuropathy; pain medication and anticonvulsant medications may be used to ease the symptoms of bilateral neuropathy.