Peripheral neuropathy represents a slow dying of the neuron bodies. Since the nucleus for the nerve body is located in the spinal cord, the nerves with the longest processes are affected first-the nerves in the leg. As the nerves slowly get damaged and die the shorter nerves are affected. There are numerous causes for peripheral neuropathy. The evaluation should start with a complete physical and proceed to nerve conduction testing if no underlying disease is found.
Nerve biopsy is necessary in progressive cases.
The most common cause of peripheral neuropathy is Diabetes Mellitus. Control of the Diabetes will slow the disease. Currently, research is ongoing with different drugs to minimize Diabetic peripheral neuropathy. These are probably 2-3 years away from being released. The most easily treated causes are B12 Deficiency and Hypothyroidism.