Tuesday, 29 January 2013

Neuropathy: In A Nutshell

If you're tired of lengthy scientific articles describing neuropathy which leave you needing a dictionary for every other word; today's post from thenpmom.wordpress.com (see link below) may help you understand the disease better. It doesn't overload you with information but sticks to the main facts and describes them in terms that everybody can understand. Definitely worth a read if you are new to the disease.

Peripheral Neuropathy: Feel the Burn!
Posted by The NP Mom in A Daily Dose, Health Care Provider Tools,Peripheral Neuropathy: 09 Monday Apr 2012

Have you ever heard friends or family describe burning and/or tingling in their hands, feet, or legs? This is actually called peripheral neuropathy. Read more about it:

What Is Peripheral Neuropathy?

Peripheral neuropathy, a result of nerve damage, often causes numbness and pain in your hands and feet. People typically describe the pain of peripheral neuropathy as tingling or burning, while they may compare the loss of sensation to the feeling of wearing a thin stocking or glove.

What are the Causes of Peripheral Neuropathy?

It’s not always easy to pinpoint the cause of peripheral neuropathy, because a number of factors can cause neuropathies. These factors include:

Alcoholism. Many alcoholics develop peripheral neuropathy because they make poor dietary choices, leading to vitamin deficiencies.

Autoimmune diseases. These include lupus, rheumatoid arthritis and Guillain-Barre syndrome.

Diabetes. When damage occurs to several nerves, the cause frequently is diabetes. At least half of all people with diabetes develop some type of neuropathy.

Exposure to poisons. These may include some toxic substances, such as heavy metals, and certain medications — especially those used to treat cancer (chemotherapy).

Infections. Certain viral or bacterial infections can cause peripheral neuropathy, including Lyme disease, shingles (varicella-zoster), Epstein-Barr, hepatitis C and HIV/AIDS.
Inherited disorders. Examples include Charcot-Marie-Tooth disease and amyloid polyneuropathy.

Trauma or pressure on the nerve. Traumas, such as motor vehicle accidents, falls or sports injuries, can sever or damage peripheral nerves. Nerve pressure can result from using a cast or crutches, spending a long time in an unnatural position or repeating a motion many times — such as typing.

Tumors. Growths can form directly on the nerves themselves, or tumors can exert pressure on surrounding nerves. Both cancerous (malignant) and noncancerous (benign) tumors can contribute to peripheral neuropathy.

Vitamin deficiencies. B vitamins — B-1, B-6 and B-12 — are particularly important to nerve health. Vitamin E and niacin also are crucial to nerve health.

Other diseases. Kidney disease, liver disease and an underactive thyroid (hypothyroidism) also can cause peripheral neuropathy.

Who is at Risk for Developing Peripheral Neuropathy?

Peripheral neuropathy risk factors include:

Diabetes, especially if your sugar levels are poorly controlled
Alcohol abuse
Vitamin deficiencies, particularly B vitamins
Infections, such as Lyme disease, shingles (varicella-zoster), Epstein-Barr, hepatitis C and HIV/AIDS
Autoimmune diseases, such as rheumatoid arthritis and lupus, in which your immune system attacks your own tissues
Kidney, liver or thyroid disorders
Exposure to toxins
Repetitive physical stress, possibly from occupational activities

How is Peripheral Neuropathy Diagnosed?

Peripheral neuropathy can basically be diagnosed based on a physical examination and the patient’s symptoms.

Blood tests. These measure various levels, such as vitamin and blood sugar levels; and bodily functions, such as thyroid, liver and kidney.

Imaging tests. Your doctor may request a CT scan or MRI to look for herniated disks, tumors or other abnormalities.

Nerve function tests. These may include electromyography — which reads electrical activity in your muscles to determine if your weakness is caused by muscle damage or nerve damage — and nerve conduction studies — which assess how your nerves and muscles respond to small electrical stimuli, generated by a probe and measured by an electrode placed along the nerve’s pathway.

What is most important is figuring out the root cause of the peripheral neuropathy, and treating it effectively.

Treatment of Peripheral Neuropathy:

Anti-seizure medications. Drugs such as gabapentin (Gralise, Neurontin), topiramate (Topamax), pregabalin (Lyrica), carbamazepine (Carbatrol, Tegretol) and phenytoin (Dilantin, Phenytek) were originally developed to treat epilepsy. However, doctors often also prescribe them for nerve pain. Side effects may include drowsiness and dizziness.

Antidepressants. Tricyclic antidepressant medications, such as amitriptyline and nortriptyline (Aventyl, Pamelor), were originally developed to treat depression. However, they have been found to help relieve pain by interfering with chemical processes in your brain and spinal cord that cause you to feel pain. The serotonin and norepinephrine reuptake inhibitor duloxetine (Cymbalta) also has proved effective for peripheral neuropathy caused by diabetes. Side effects may include nausea, drowsiness, dizziness, decreased appetite and constipation.

Transcutaneous electrical nerve stimulation (TENS) may help to relieve symptoms. In this therapy, adhesive electrodes are placed on the skin, and a gentle electric current is delivered through the electrodes at varying frequencies. TENS has to be applied regularly.

Pain relievers. Mild symptoms may be relieved by over-the-counter pain medications. For more-severe symptoms, your doctor may recommend prescription painkillers. Drugs containing opiates, such as codeine, can lead to dependence, constipation or sedation, so these drugs are generally prescribed only when other treatments fail.

If you or someone you know is experiencing symptoms of peripheral neuropathy take the time to make an appointment with your health care provider – after all, you shouldn’t have to “feel the burn.


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