Information About Focal Neuropathies

Focal neuropathies include cranial neuropathy, mononeuropathy, radiculopathy, and plexopathy.
Cranial Neuropathy

Cranial neuropathy, also called ophthalmoplegia, affects the third cranial nerve. Typically, it begins suddenly and causes eye pain, headache, and dysesthesia of the upper lip. These symptoms usually occur several days before the patient develops facial palsy. She may develop pronounced ptosis and an inability to move her eye from side to side or up and down. Cranial neuropathy occurs most commonly in the elderly.

To alleviate accompanying double vision, your patient can use an eye patch. After several weeks, her pain should subside, and the muscular function of her eye should return. After 3 to 5 months, she should recover completely.
Mononeuropathy

Mononeuropathy is an isolated neuropathy of one or several nerves. Carpal tunnel syndrome, which results from compression or entrapment of the median nerve in the wrist, is the most common form of mononeuropathy.

Mononeuropathy of the ulnar nerve at the elbow leads to weakness and loss of sensation on the palm side of the ring and fourth fingers. Wristdrop develops with mononeuropathy of the radial nerve; footdrop develops from mononeuropathy of the lateral cutaneous nerve in the thigh and the peroneal nerve at the head of the fibula.

Treatment options include surgical release of the nerve, physical therapy, and protection from further trauma with wrist splints, elbow pads, or ankle braces.
Radiculopathy

Radiculopathy, also known as intercostal neuropathy, results from damage to the root of a single nerve. Signs and symptoms of radiculopathy include pain in the affected area of the chest or abdominal wall, dysesthesia that worsens at night, and diminished or no skin sensation. The patient may also experience profound weight loss. A nonnarcotic analgesic, such as ibuprofen, may help control the pain, which generally subsides in 6 to 24 months.
Plexopathy

Plexopathy, or femoral neuropathy, commonly affects the sacral plexus and femoral nerves, causing pain that extends from the hip to the anterior and lateral surfaces of the thigh. A patient may experience disabling muscle weakness when she flexes or extends her knee. Pain is usually worse at night and occurs mostly among the elderly.

The patient may use a nonnarcotic analgesic, such as ibuprofen, to relieve her pain. The pain generally goes away spontaneously but may recur periodically.