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.
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.
Helping the body regrow nerves Science Nation
â™«MUSICâ™« MILES O'BRIEN: Combat, cancer and accidents all can cause devastating nerve injuries. Sometimes, the body heals on its own. CHRISTINE SCHMIDT: Your peripheral nerves are the ones in the arms and the face, have an inherent ability to regenerate but only under ideal circumstances. MILES O'BRIEN: With support from the National Science
Foundation, University of Florida Biomedical Engineer Christine Schmidt is working to restore nerve function when injuries are more complicated. SURGEON: Took that muscle and rotated it, took it over the back of his elbow to cover â€“ MILES O'BRIEN: Surgeons can sometimes move a nerve from one part of a patient's body to another. Schmidt has developed a method that grafts cadaver tissue onto the damaged area to
act as a scaffold for nerves to regrow themselves. CHRISTINE SCHMIDT: Basically what we're doing is removing all the cellular material that would cause rejection but leave behind the native architectures. You're putting this graft into the site of injury. And now, that graft is providing a scaffold for your blood vessels to grow in. And then once you have that recellerization your nerve fibers can then regrow, so then, ultimately regain that muscle function.
MILES O'BRIEN: Navy Veteran Edward Bonfiglio, wounded in Afghanistan, faced the prospect of an amputation. A graft was a welcome option. The company, AxoGen, distributes the grafts, which were developed based on work done in Schmidt's lab. JILL SCHIAPARELLI: And his family pressed the s to say, quot;Are there any alternatives?quot; He was a young, healthy, vibrant guy. And they had a great surgeon at Walter Reed who was willing to work with them to find those options.
CHRISTINE SCHMIDT: This is some of the micronized nerve that you're working with. MILES O'BRIEN: Schmidt and her team are also looking at other approaches to directly stimulate nerve growth using natural sugar molecules found in the body as building blocks, eliminating the need to transplant tissue. CHRISTINE SCHMIDT: So you don't have to actually take it from somebody's body. You can grow it.
MILES O'BRIEN: While the ultimate goal in nerve regeneration is reversing paralysis, Schmidt says intermediate successes, like improving lung or bladder function, can be invaluable to patients and their families. CHRISTINE SCHMIDT: So rather than saying we're going to try to tackle this humongously complex beast and try to get the patient to necessarily be exactly like they were before, why not provide some function that will have merit