Peripheral Neuropathy

What Are the Types of Peripheral Neuropathy in Children?

There are more than 100 types of peripheral neuropathy. Causes, symptoms and treatments of these neuromuscular disorders can vary depending on the specific condition.

Acquired Peripheral Neuropathy

Health conditions and medical treatments cause acquired peripheral neuropathy. Types include:

• Chemotherapy-induced peripheral neuropathy (CIPN): CIPN occurs when chemotherapy treatments for cancer damage peripheral nerves.
• Chronic inflammatory demyelinating polyneuropathy (CIDP): CIDP is an autoimmune disorder. It occurs when the immune system attacks the protective coverings (myelin sheath) that surround peripheral nerves.
• Guillain-Barré syndrome (GBS): GBS is an autoimmune disorder. It occurs when the immune system attacks and damages peripheral nerves. GBS is also called acute inflammatory demyelinating polyradiculoneuropathy (AIDP).

Inherited Peripheral Neuropathy

Inherited peripheral neuropathy affects members of the same family. A child inherits a gene change (mutation) from a parent that causes the condition. Types of inherited peripheral neuropathy include:

• Charcot-Marie-Tooth (CMT) disease: CMT disease affects the peripheral nerves that control movement and aid sensation. It’s the most common inherited peripheral neuropathy.
• Friedrich ataxia: This condition causes progressive damage to motor and sensory nerves.

What Causes Peripheral Neuropathy in Children?

Inherited peripheral neuropathy occurs when a child inherits a gene from a parent that has a known or random mutation. Acquired peripheral neuropathy can occur from a gene change that occurs for no known reason. Sometimes, the cause remains unknown.

Possible causes of acquired peripheral neuropathy include:

• Autoimmune diseases, such as juvenile idiopathic (rheumatoid) arthritis and lupus
• Diabetes
• Excess or lack of certain B vitamins
• Exposure to toxins
• Fractured bones, sprains and strains
• Infections, such as Lyme disease and West Nile virus
• Medications, including chemotherapy
• Thyroid gland problems, including hyperthyroidism and hypothyroidism

What Are the Signs and Symptoms of Pediatric Peripheral Neuropathy? 

Signs of peripheral neuropathy in children depend on the specific condition and affected nerves. 

Motor Nerve Damage Symptoms

Damage to peripheral motor nerves can cause:

• Difficulty crawling or walking 
• Muscle cramps 
• Muscle loss (atrophy), weakness or paralysis

Sensory Nerve Damage Symptoms

Damage to peripheral sensory nerves can cause:

• Balance problems and clumsiness
• Difficulty coordinating movements like buttoning a shirt
• Inability to feel temperatures, pain or vibrations
• Pain, numbness and tingling 

Autonomic Nerve Damage Symptoms

Damage to peripheral autonomic nerves can cause:

• Digestive problems, such as constipation or diarrhea
• Difficulty swallowing (dysphagia)
• Excess or lack of sweating
• Heat intolerance
• Increased heart rate or rapid breathing
• Speech impairments
• Too high or too low blood pressure

What Are the Complications of Pediatric Peripheral Neuropathy?

Nerve damage from peripheral neuropathy can cause long-term complications, such as:

• Chronic pain
• Loss of mobility and paralysis
• Difficulty walking, using one’s hands and completing daily tasks

How Is Peripheral Neuropathy in Children Diagnosed?

Pediatric neurologists at Lurie Children’s diagnose and treat peripheral neuropathy. The cause and type of peripheral neuropathy can be challenging to diagnose. Our doctors perform comprehensive tests to provide an accurate diagnosis and develop a customized treatment plan. 

Neuromuscular Tests

Nerve and muscle tests take place at our Clinical Neurophysiology Laboratory. It has one of the few accredited pediatric electromyography (EMG) and nerve conduction study (NCS) labs in the country. Our lab’s “Accreditation with Exemplary Status” from the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) reflects our ability to perform tests on children with the highest level of quality and integrity. 

Nerve and muscle tests for peripheral neuropathy include:

• Electromyography (EMG) to test motor nerves and muscles 
• Nerve conduction study (NCS) to assess peripheral motor and sensory nerves

Other Diagnostic Tests for Peripheral Neuropathy

Your child may also get one or more of these tests:

• Blood tests to look for vitamin deficiencies, autoimmune diseases and inflammation
• Bone scan to assess bone strength and density
• Genetic screening (blood or saliva test) to look for gene changes that cause inherited peripheral neuropathy
• Imaging tests, including neuroimaging, neuromuscular ultrasounds and MRIs, to check for brain, nerve and spinal cord issues
• Nerve biopsy to look for changes in nerves 
• Skin biopsy to look for changes in nerve fibers in the skin 
• Spinal tap (lumbar puncture) to look for signs of inflammation or infection in cerebrospinal fluid around the brain and spinal cord, which can rule out other conditions 

How Are Pediatric Peripheral Neuropathies Treated?

Lurie Children’s offers a range of therapies to ease symptoms, helping your child to have the best chance for a full, active life. Treatments depend on the cause and type of peripheral neuropathy, as well as your child’s symptoms. Our doctors develop a personalized treatment plan for your child’s specific needs.

Peripheral neuropathy treatments include: 

• Medications to ease pain and other symptoms
• Neuromuscular rehabilitation services, including outpatient physical therapy and occupational therapy, or inpatient rehabilitation at Shirley Ryan AbilityLab
• Orthopedic and general pediatric surgeries to treat scoliosis, hip disorders, foot problems and other conditions 
• Orthotics, such as leg braces, shoe inserts and other devices, to aid mobility, stability and function
• Clinical nutrition services to address vitamin deficiencies and help your child grow
• Speech therapy to aid speech and swallowing 

What Is Lurie Children’s Approach to Caring for Children With Peripheral Neuropathy?

Lurie Children’s provides an interdisciplinary approach to caring for children with peripheral neuropathy. Specialists in different fields work together to address every aspect of your child’s medical needs. U.S. News & World Report ranks Lurie Children’s among the nation’s best for pediatric neurology and neurosurgery. 

Our specialized services include:

• Specialty neuropathy clinics: At our Hereditary Peripheral Neuropathy Clinic, your child sees specialists in neurology, rheumatology, endocrinology, orthopedics and other fields. 
• Dedicated CMT disease care: Children with Charcot-Marie-Tooth disease receive specialized care at our CMT Center of Excellence. This designation from the Hereditary Neuropathy Foundation (HNF) reflects our ability to provide your child with the latest evidence-based treatments. We also offer supportive CMT services at our Muscular Dystrophy Association (MDA) Clinic. 
• Focus on bone health: Our Bone Health Program offers comprehensive services to strengthen bones in children with limited mobility. Our experts closely monitor for problems like scoliosis, ensuring your child receives timely treatment.
• Expert diagnostic testing: Advanced nerve and muscle testing takes place at our Clinical Neurophysiology Laboratory, one of the few accredited pediatric EMG/NCS laboratories in the country. 
• Support for patients and families: Our Child Life Specialists help keep your child comfortable during procedures. We also have psychiatrists, psychologists and social workers to support your family. 
• Genetic testing and counseling: Our genetic counselors provide guidance and education to families with inherited peripheral neuropathy. 
• Research and clinical trials: Our team’s active involvement in national pediatric neuromuscular research and clinical trials means your child may benefit from promising new therapies.

Lurie Children’s Mazza Foundation Neuromuscular Program

Lurie Children’s Hereditary Peripheral Neuropathy Clinic is part of Lurie Children’s Mazza Foundation Neuromuscular Program. We provide compassionate care for children with all types of peripheral neuropathy and other neuromuscular disorders. Your child’s personalized treatment plan features the latest evidence-based therapies to help them enjoy life to the fullest.

Learn more about our Neuromuscular Program.