Sunday, 1 May 2011

You may have neuropathy... and HIV but the PN may not come from the HIV!

From an article by Dr. Spitz from the Foot Pain Center, titled, "There are over a hundred causes of neuropathy - Yes, this number is not a typo"

December 12th, 2010
Peripheral neuropathy is due to damage to the nerves and the medical literature cites over 100 causes of this condition-which results in symptoms such as numbness, burning, tingling, pain and “pins and needles sensations,” in the feet. In this blog I will touch on some of the more common instigating factors leading to peripheral neuropathy.
Diabetes-diabetes is closely associated with neuropathy and it is estimated that over 70% of diabetics will ultimately develop neuropathy. Due to circulation problems in the feet and legs, diabetics are at risk for developing serious foot problems such as infections, foot ulcer and amputation.
Chemotherapy drugs-Chemotherapy agents that aggressively “attack” cancer cells often have a neurotoxic effect, damaging the nerve cells as well.
Spinal problems-The nerves that supply the feet originate at the L5-S1 in the spinal column (that is the fifth lumbar vertebrae and the first sacral vertebrae). Damage to the spinal cord in this area such as spinal stenosis-narrowing of the spinal column or a disc protrusion at this level can result in neuropathy symptoms.
Excessive alcohol intake-Prolonged and excessive use of alcohol will invariably have a toxic effect on nerve tissue. Studies have shown that the incidence of alcoholics who develop peripheral neuropathy is up in the 50% range.
Exposure to toxins-Exposure to certain toxins such as lead, mercury, and chemical solvents can cause nerve damage.
Certain prescription medications-certain antibiotics can cause nerve damage such as gentamicin, ciprofloxacin, levoflooxacin, nitrofurantoin and Flagyl.
Statin drugs- Are a class of drugs used to lower cholesterol
Anticonvulsant drugs-Used to treat seizures-phenytoin (Dilantin) and Carbamazepine (Tegretol)-which also is used for treating migraines.
Nutritional Imbalances-Deficiencies of vitamin B12 (cobalamin), B1 (thiamine and B6 (pyridoxine) can cause neuropathy.
HIV/AIDS-Over one-third of people with HIV/AIDS develop neuropathy. Nerve damage can be caused by the medication, the actual virus, or a combination of both.
Infections-Hepatitis, a viral infection primarily affecting the liver, can cause neuropathy. Lyme disease, which is a bacterial infection transmitted to humans by the bite of a black legged tick can also cause nerve damage.
Autoimmune diseases-An autoimmune disease is a condition in which the immune system destroys or attacks its own bodily tissues. Two autoimmune conditions that can cause nerve damage include rheumatoid arthritis and systemic lupus erythematosus.
Guillian-Barre Syndrome-is rare autoimmune disorder that specifically attacks and destroys peripheral nerves.
Cancer-certain cancers can have a detrimental effect on peripheral nerves. Multiple myeloma affects the plasma cells in the bone marrow and can causes destruction to the axon part of the nerve. Chronic lymphocytic leukemia and lymphoma can cause neuropathy.
Injuries-Trauma to the nerves in the lower spinal column, legs and the feet can causes neuropathy. For example injury to the peroneal nerve a major nerve supplying the legs, feet and toes can cause severe neuropathy symptoms. Common causes of peroneal injury include damage to the knee, fracture of a leg bone, habitual leg crossing and injury to the nerve during surgery.
Repetitive motion injuries-Included in this category is a common condition carpel tunnel syndrome. Carpel tunnel syndrome affects the wrist and fingers. A similar condition affecting the feet is called tarsal tunnel syndrome. Tarsal tunnel syndrome is caused by acute or chronic injury. An acute injury that can cause this condition may be a severe ankle sprain or ankle fracture. Chronic overuse such as jogging on hard pavement over many years, may lead to tarsal tunnel syndrome.
Hereditary condition-Certain inherited conditions can specially attack the nerves causing neuropathy, muscle weakness and atrophy. Charcot-Marie Tooth Disease is the most commonly inherited neurological disorder. Damage to the peripheral nerves is caused by gene mutation. The condition is slowly progressive causing numbness, tingling and burning along with muscle weakness and muscle atrophy.
Other Causes
Sarcoidosis an inflammatory process causing small ‘lumps” to accumulate in body tissue
Sjogren’s Syndrome an autoimmune disease in which extra antibodies can “attack” nerve cells
Kidney disease specifically renal failure
Hypothyroidism an underactive thyroid can lead to degeneration of the nerve cell.
Idiopathic neuropathies neuropathies in which no specific cause can be identified are called idiopathic neuropathies. Often such neuropathies occur in people over 60 years old. Studies have shown that almost one-half of all neuropathies can be classified as idiopathic.

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