Monday 21 November 2011

Dilemmas concerning Neuropathy treatment

Today's post is another worthwhile video from PainClinician.com (see link below) in which you can hear a realistic assessment of the effectiveness of current neuropathy treatments by a clearly well-qualified expert. Professor Simpson's message is not exactly encouraging but may help you make the best decisions when confronted with the choice of beginning certain accepted treatments or not. You may be surprised to learn that several medications have been proved to have no more effect than a placebo but are still routinely prescribed for neuropathy because they fit into the sequence of 'what we must try' in the medical texbooks. Taking the potential side effects into account may help you decide whether to go ahead or not. Although a good discussion with your specialist is always advised, it may help to show your doctor this videoclip, (or other posts from the blog on the same subject). It is important not to feel bullied into something you're not completely comfortable with.
The text above the video is the introductory text that accompanies it on the site.


Neuropathic Pain in HIV Disease

David M. Simpson, MD, Professor of Neurology at Mount Sinai School of Medicine, New York.

Peripheral neuropathy is one of the most common neurologic complications of HIV. In fact, nearly 50% of HIV patients are thought have signs of neuropathy, with increased risk in those with advanced disease. Assessment and treatment of these patients can be complicated by antiretroviral agents, which themselves are often neurotoxic. Neurologic effects may be cognitive, such as impaired memory or vision, and/or sensatory, including numbness, tingling, and pain. Electromyography and skin biopsy may assist in a diagnosis. Attempts at regenerative therapy have not yet proved effective, and treatment of HIV-associated peripheral neuropathy is primarily symptomatic. Of note, placebo-controlled clinical trials of some analgesic agents that are traditionally used to treat neuropathic pain have failed to show significant benefit. Some clinical success, however, has been demonstrated with lamotrigine, gabapentin, and a new high-concentration capsaisin patch. Here, Dr. Simpson discusses current barriers to treatment and available therapeutic options in this challenging disease.


http://painclinician.com/video/neuropathic_pain_in_hiv_disease/

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