Neuropathy Progression
NORMAL
At the top of the image, the first nerve is normal. The actual nerve is the smaller part in the middle and protruding to the left. It’s wrapped in myelin and receiving good blood flow. This is what a nerve should look like. This patient won’t be experiencing neuropathy symptoms.
Initial Damage
The second nerve, labeled “Initial Damage” shows stage 1 neuropathy. At this point blood flow is starting to be impeded and the myelin sheath is starting to be damaged. You can see some small “nicks” starting to come out of the myelin. At this point symptoms are minimal: pain, intermittent decreased sensation, and perhaps decreased sweating. Someone at this stage may not even realize they have an issue.
Moderate Damage
The third nerve, labeled “Moderate Damage” shows stage 2 neuropathy. Blood flow has decreased noticeably and symptoms are more severe and more frequent, if not constant. The nerve damage has likely been an issue for years, if not longer.
Severe Damage
The fourth nerve, labeled “Severe Damage” shows stage 3 neuropathy. Blood flow is almost gone and the myelin sheath is extremely damaged. This person sadly has very severe symptoms and is likely taking significant amounts of medication with little or no relief. While the nerve is still alive, recovery at this point is difficult.
Stage 4 Neuropathy
Stage 4 is not pictured. Sadly, at this point, the nerve has died, and we are unable to help the patient. This person likely has had an infection or even an amputation. The best we can hope for is symptom management.