Small Fiber Neuropathy Symptoms Diagnosis and Treatment
Small fiber neuropathy is really an interestingcondition because it consists typically of just burning, numbness, pain of the feet,sometimes the hands later on without necessarily having any abnormalities on your EMG or nerveconduction study. So what I tell patients and actually residents or students who trainunder us is that a normal nerve conduction study does not exclude a neuropathy. And wewill confirm this by doing additional testing, specifically the nervous the the examinationat the bedside asking patients about their symptoms, for example, loss of sensation tocool or or hot temperatures, loss of pain sensation and also doing skin biopsies wherewe look at nerve densities in the skin both
from the calf and the thigh as well as doinga special test that looks at sweat function both in your foot in in the legs as well asthe feet to gauge the level of small fiber nerve damage. Small fiber neuropathy typicallywill progress unless the underlying cause is identified and reversed. Diabetes of coursebeing the most common cause is always screened for. But once the more common causes are excludedand the focus becomes on excluding any underlying secondary disease process but also controllingpain because if patients' symptoms of pain are generally controlled they tend to do prettywell and really have no other major functional deficits. I've really become interested overthe years is how interconnected neurology
and rheumatology are and one thing I oftendo on patients who have unexplained small fiber even autonomic neuropathy is have themsee rheumatology or get evaluated for connective tissue disorders like lupus or Sjogren's orsarcoid and sometimes even if we are not directly involved in treating the patients, this canbe the first sign of an underlying connective tissue disorder that can then be brought tothe attention of rheumatology and addressed from their standpoint.
Treating Neuropathy and Nerve Pain in the Feet
Let me start with I'm a diabetic. I developedneuropathy, which basically you lose all sensation in the feet, but it's over a period of time.It was very painful. I would have sensations in my feet like I was standing on fire, walkingon glass. Last October it got so bad that I couldn't sleep at night. Then I met Bullard, because he's just a great physician. I wouldn't think twice, I'd recommendhim to anybody. Very compassionate, very thorough, I can't say enough about Bullard. He'sjust a great physician and I don't know if there's anything he couldn't do hecould probably move mountains if he wanted to!Glen, probably one of the biggest questions
people are asking you is what'd we do, what'shappened. Of course, you had a tremendous improvement in your pain and the tinglingand the numbness. Easiest explanation is, to tell everybody, that this big nerve here,which is on the inside part of your left foot, was getting strangled. There was a noose aroundit. What we did is we went in and loosened the noose, and that allows that nerve to beginto function and work like it's supposed to.Now, the sensation is coming back, it's something that's going to take time butI can feel more. My quality of life has greatly improved since I had the procedure done by Bullard. There's no other physician
that I would recommend.Glen, in the next couple weeks, what we're going to do is make sure that the swellingis improving, hopefully begin to transition you out of your compression socks, becauseI know it's kind of hot right now, and then look at making sure that your shoe gear andthings like that are where they're supposed to be, fitting you well, protecting your feetand stuff. Ok? Very good. Thank you, I appreciate it, havea good weekend! You do the same. Alright, see ya.
Seeing Pain New approach to diagnosing and treating nerve damage Chris McCurdy TEDxUM
When I was a young childI lost my favorite uncle to alcohol abuse. It made me wonder why does this happen? How can someone be consumed by a substance that's around us all the time? So, I made it my life's missionto become a drug expert, and I went to pharmacy school. I went to pharmacy schoolto understand what it is about drugs
that can make us heal or can hurt us. When I was in pharmacy school, I found out I fell in lovewith the research. Not only did I fall in lovewith the research I fell in love with this passionto educate others. And so, knowing that,I had to move forward. I had to move forward with my education so that I could carry those thingsout of my future;
and I went on and earned a atein medicinal chemistry; that's drug design not designer drugs. (Laughter) That enabled me to move forward and really pursue some of the basisof drug abuse and addiction. Here I am now, a professorof medicinal chemistry and pharmacology. And I've dedicated my careerto solving problems in drug abuse and actually findingbetter pain medications
because after all, painis the most common reason that individuals seek medical care. It's also the most common reason that we end upwith drug abuse and addiction. Moving from there, I've been ableto establish a laboratory here, at the University of Mississippi, where we've done a lotof groundbreaking work that I'll get to in a little bit to move us forward in those endeavors.
Now, how many people here have had to seek medical treatment that resulted in pain prescription? Yes, most all of us. How many of you ended up getting something like morphine, or codeine,or Hydrocodone, or Oxycontin? Yeah. Any of you had to take that for more than 2 or 3 weeks,maybe a month, maybe a couple?
If so, there's a high likelihoodyour body became physically dependent. So why does that mean? What do we mean when we talkabout physical dependence and drug abuse? Let's define these thingsa little more clearly. So drug abuse is simply the concept that you take a drug out of the contextthat it was prescribed. So, every now and then,all of us are guilty of taking a little more ibuprofen,or something, than it says on the bottle.