The Mystery Of Neuropathy

Today's post from daytondailynews.com (see link below) is a reader-friendly description of neuropathy and how it affects us. Less focussed on the science but more on how we feel when we have neuropathic symptoms. Relating it to other systems which we're more aware of, is always useful - it helps put neuropathy in a meaningful context in people's minds and especially reassures them that they're not alone in feeling as they do. It includes the very sensible statement that the best neuropathy diagnosis is obtained by listening to the patient's testimony but can be followed up by certain diagnostic tests - if only most doctors agreed with that order of events!

Peripheral neuropathy’s cause remains mystery for millions of Americans
By Premier Health Monday, June 22, 2015

A person’s brain and spinal cord serve as the mainframe from which important messages are sent throughout the body via the peripheral nervous system.

The peripheral nervous system helps the body’s internal organs function properly and provides important signals regarding its response to the outside environment such as when a person’s feet are hot or their hands are cold. Trauma, infections, disease and injury can all cause damage to the peripheral nervous system and when this happens, a person may notice the feelings they have taken for granted all these years have become distorted or are suddenly gone.

This condition, known as peripheral neuropathy, causes numbness and tingling in a person’s extremities, and in extreme cases, can limit a person’s mobility and affect their ability to breathe. According to the National Institute of Neurological Disorders and Stroke (NINDS), peripheral neuropathy affects more than 20 million Americans, and for a significant number of individuals the cause of the disease is unknown.

“Peripheral neuropathy distorts the messages that travel from the brain and spinal cord to the outlying parts of the body including hands, feet and sometimes a person’s face,” said Christopher Scheiner, MD, PhD, a neurologist with the Clinical Neuroscience Institute. As the NINDS describes it, the disease is much like static on a telephone line, interrupting messages that should be carried throughout a person’s body, but which never properly reach their destination.

Dr. Scheiner said in most cases, symptoms of peripheral neuropathy happen gradually. As a result, individuals may dismiss symptoms until the disorder progresses to a point where they can no longer deny their existence. Carpal tunnel syndrome, where the median nerve in the wrist is damaged, is one of the better known peripheral neuropathies where this is often played out, Dr. Scheiner said.

“People may attribute the loss of sensation in their hands simply to their positioning on the steering wheel,” Dr. Scheiner said. “However, they will begin to notice that it is happening more often and becoming more painful. But it is when they do something outside of their normal routine such as holding a paintbrush for five minutes that they realize something is wrong.”

Peripheral neuropathy is best diagnosed through a clinical exam in which a neurologist will ask a series of questions about a patient’s symptoms. A physician’s diagnosis can then be supported through additional testing. One common test that is done is an electrodiagnostic test called an electromyography (EMG). An EMG delivers electricity through a small shock to the areas of the body where a patient is having symptoms. This enables a doctor to determine any damage to the nerves in that area.

Dr. Scheiner said it’s important to be evaluated for peripheral neuropathy because in some cases it could signal an underlying health issue that needs immediate attention. The most common form of peripheral neuropathy is diabetes. Up to 70 percent of diabetics have the disorder, according to the Foundation for Peripheral Neuropathy. In some cases, diabetes may be discovered through the presence of peripheral neuropathy, he said.

HIV/AIDS patients and those taking certain chemotherapy drugs also experience the disorder. According to the Foundation for Peripheral Neuropathy, the disorders affect up to 40 percent of chemotherapy patients and a third of all HIV/AIDs patients.

The disorder can sometimes be cured when an underlying health issue is brought under control. In some cases, peripheral neuropathy can cause a person pain and when this happens medication can be prescribed to help alleviate it.

“These medications help to turn off the nerves that are causing pain,” Dr. Scheiner said. “They are different than what a patient would receive from an over-the-counter medication like Tylenol, but still allow a patient to function without the sensation that they are being controlled by a substance.”

ABOUT PREMIER HEALTH SPECIALISTS: Premier Health Specialists is one of the largest groups of specialty care practices in Southwest Ohio. More than 130 physicians serve patients in a variety of specialties such as bariatric, breast care, burn and wound, cardiology, cardiothoracic surgery, cardiovascular-thoracic surgery, general surgery, gynecologic oncology, hand and reconstructive surgery, infectious diseases, maternal-fetal medicine, neurosciences, obstetrics and gynecology, orthopedic surgery, orthopedic spine surgery, ophthalmology, palliative care, physiatry, plastic surgery, podiatry, psychology, pulmonology, sports medicine and urology. Premier Health Specialists is part of Premier Health, which includes Miami Valley Hospital, Good Samaritan Hospital Dayton, Atrium Medical Center and Upper Valley Medical Center. For more information, visit www.premierhealthspecialists.org.

http://www.daytondailynews.com/news/lifestyles/health/peripheral-neuropathys-cause-remains-mystery-for-m/nmhw7/