The Difference Between Peripheral Neuropathy and MS

Multiple sclerosis and peripheral neuropathy share some symptoms in common

Peripheral neuropathy can result in partial paralysis.
Peripheral neuropathy can result in partial paralysis. Huntstock/Getty Images

Peripheral neuropathy and multiple sclerosis (MS) can cause some of the same symptoms because both affect the nervous system. Symptoms common to both conditions include abnormal sensations, including tingling, burning, a pins-and-needles feeling, numbness, and pain. Muscle weakness can also occur with both conditions.

While some symptoms of peripheral neuropathy and MS overlap, they are completely different diseases in terms of their underlying cause, treatment, disease course, and who is most likely to be affected.

An accurate diagnosis proves essential for managing the symptoms of both MS and peripheral neuropathy.  

Different Underlying Abnormalities

Peripheral neuropathy refers to nerve damage involving the peripheral nervous system—those nerves outside the brain and spinal cord. The damaged peripheral nerves malfunction and provoke abnormal sensations, pain, and numbness. These sensory abnormalities most commonly affect the feet, lower legs, and hands. Muscle weakness can also occur in people with severe or long-standing peripheral neuropathy. 

Unlike peripheral neuropathy, MS affects the central nervous system—the brain and spinal cord. The nerves in this part of the nervous system sustain damage over time, which interferes with their ability to communicate with the peripheral nervous system. This can cause abnormal sensations, pain, and numbness indistinguishable from that caused by peripheral neuropathy.

Muscle weakness also frequently develops with MS, occurring more frequently and with greater severity than usually seen with peripheral neuropathy. 

Different Underlying Causes

Peripheral neuropathy encompasses a group of disorders with different underlying causes. It can affect a single nerve but most often involves several.

Diabetes is the most common cause of peripheral neuropathy among Americans, reports the National Institute of Neurological Diseases and Stroke. Many other diseases and conditions might also lead to peripheral neuropathy. Some examples include:

  • Chronic kidney disease
  • Hypothyroidism
  • HIV infection
  • Toxins, such as lead, mercury, and heavy alcohol intake
  • Injury-related nerve damage

MS occurs as a result of recurring or ongoing inflammation in the central nervous system, which damages the nerves located there. Although the exact cause of this inflammation remains incompletely understood, an errant attack by the body's immune system on the tissues of the brain and spinal cord seems to be a key contributor.

Diagnosing Peripheral Neuropathy vs. MS

Although you may be tempted to delay seeing your doctor, nervous system symptoms should not be ignored. If you're experiencing symptoms that could be related to either peripheral neuropathy or MS, your doctor will do the necessary assessments to make the correct diagnosis. While you're waiting for your appointment date, it is helpful to keep a log of your symptoms so you can describe them in detail, along with any patterns in their occurrence, and any aggravating or provoking factors.

Determining the cause of your symptoms begins with a complete medical history, including a careful review of all symptoms you've been experiencing. Next is a thorough physical with a complete neurological examination. Depending on the outcomes of these initial assessments, your doctor might recommend additional testing that could include blood work, an MRI, and/or nerve tests to determine how well specific nerves conduct the electrical signals by which they communicate with your brain. Once a diagnosis is made, you and your doctor will work together on a treatment plan to manage your symptoms and their underlying cause.

Sources:

Aminoff MJ, Daroff RB, eds. Encyclopedia of the Neurological Sciences. 2nd ed. Waltham, MA: Academic Press; 2014.

Hersch CM, Fox RJ. Multiple Sclerosis. Cleveland Clinic Center for Continuing Education website. http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/neurology/multiple_sclerosis/

Levin MC. Multiple Sclerosis (MS). In: Porter RS, Kaplan JL, Lynn RB, et al. Merck Manual Professional Version.http://www.merckmanuals.com/professional/neurologic-disorders/demyelinating-disorders/multiple-sclerosis-ms

Peripheral Neuropathy Fact Sheet. National Institute of Neurological Diseases and Stroke website. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Peripheral-Neuropathy-Fact-Sheet

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