Peripheral Nerves in Chronic Obstructive Pulmonary Disease: A Review

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a common preventable and treatable disease. It is characterized by persistent progressive airflow limitation and associated with an enhanced chronic inflammatory response in the airways and the lungs to noxious particles or gases. Globally, it is the fourth leading cause of death and the incidence is rising every year. COPD is a chronic inflammatory disease. Cardiovascular diseases, skeletal muscle dysfunction, metabolic syndrome, osteoporosis, depression, lung cancer and peripheral neuropathy are some of the complications of COPD. Out of all the complications, Peripheral neuropathy (PN) has received very scanty importance. Studies on COPD to assess PN, has assessed varied spectrum of subjects. The prevalence of PN is COPD shows wide range. Compared to clinical PN, subclinical PN is more common in COPD. Nearly one-third of COPD patients have clinical peripheral neuropathy. Two-thirds have abnormal electrophysiological findings suggestive of subclinical peripheral neuropathy. Some patients with no clinical symptoms of peripheral neuropathy do have electrophysiological deficit suggestive of peripheral neuropathy. Studies have found various correlating factors viz: age, smoking, hypoxia, duration and severity of disease with PN. These are the probable etiological factors of PN in COPD. Predominantly PN in COPD is axonal and demyelinating type. It is more pronounced in Lower limbs as compared to upper limb. Physicians should take into consideration treatment of PN, while planning treatment and rehabilitation of COPD patients to improve overall quality of life of them.