Peripheral Neuropathy Overview

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.

Peripheral Neuropathy Overview Full Information and Treatment of Peripheral Neuropathy

Peripheral Neuropathy is a commoncondition occurring when injury or disease damagesyour peripheral nervous system originating from your brain and spinalcord peripheral nerves extends to your skinmuscle and tissues or peripheral nervous system relaysvital information between your body and the brain in theform of electrical impulses there are three types of peripheralnerves motor nerves regulate the movements loveyour body skeletal muscles

sensory nerves transmit sensations such as heat vibration touch and pain to the brain comic nerves regulate the activities upinternal organs and glands each nerve is made up of manyinterconnected cells called neurons that transmit impulses at lightning speed this constantexchange allows your brain to respond to vitalinput from your body

however damage to the nerves disruptsthis critical link resulting in peripheral neuropathy damage to a single nerve called MononaRobert B usually results from injury orrepetitive stress an example %uh Monona Robert E is carpaltunnel syndrome repeated impact to the nerve in yourwrist may cause tingling pain and weakness in your hand arm and shoulder

government have multiple nerves calledPaulina Robert the is far more common damaged typically begins in the nervesfarthest from the central nervous system and progresses symmetrically Paulina Robert the can be caused bydiabetes and other systemic diseases infections or exposure to toxic substances

one or all the three nerve types may be affectedand symptoms are specific to each damage to sensory nerves characteristic have diabetes can lead to numbness inyour hands and feet with diminished ability to detecttemperature insensitivity to pain or over sensitivity to pain Paulina Robert the may also cause damageto your motor nerves

which can result in muscle weakness twitching and pain common signs %uh nerve damage include intolerance to heat loss of bladder control gastrointestinal disturbances impairment a breathing

Fluoroquinolones and Peripheral Neuropathy

Peripheral neuropathy, this is an often devastatingcondition in which people develop pain and numbness in their hands and feet. Basicallythey're told on the evening news that they should be taking this or that medication sothat they can get through life. That's treating the smoke and ignoring thefire. Those medicines that you're seeing advertised don't treat the neuropathy, they only treatthe symptoms. But what's causing peripheral neuropathy? Well we know that in America,one of the biggest causes of peripheral neuropathy is being diabetic, which is clearly relatedto the foods that you eat by and large. Becoming a type 2 diabetic dramatically increases yourrisk for having peripheral neuropathy and

in fact being devastated by it. This is adisease that effects 1 in 15 Americans. Let's take a look. So again this is 1 in 15 Americans—thisis 20 million Americans afflicted by this disease, that aside from diabetes, we're toldthe cause is unknown. Well maybe that's not exactly true. Last month, in the journal Neurology,an incredible study was published describing a relationship between what are called fluoroquinolones,and the risk of developing a peripheral neuropathy. You may not know what fluoroquinolones are,but chances are you may have actually been exposed to fluoroquinolone. These are antibioticsused for treating things like upper respiratory

infections and even urinary tract infections.Things like Levaquin and Cipro are commonly used in walk in s. If you have a urinarytract infection, you may have received these mediations. Well, here's what the study showedus: So this is a study published in September2014 that looked at men between age 45 to 80 years of age followed for a 10 year periodand in this group there were over 6,000 cases of peripheral neuropathy. And they comparedthese individuals to about 25,000 aged match controls, and what they found was that riskfor developing this devastating condition called peripheral neuropathy was doubled inthose individuals exposed to this class of

antibiotics called fluoroquinolones. And whatthe researchers also told us is that, and I quote, quot;Fluoroquinolones have been shownto neurotoxic. Oral fluoroquinolones have also been associated with reported cases ofpsychosis and seizures, which similar to peripheral neuropathy have been shown to be acute eventsoccurring within days of fluoroquinolone use. In light of strong evidence of unnecessaryprescribing of oral fluoroquinolones in the United States, ians must weigh the riskof PN against the benefits of prescribing FQ when prescribing these drugs to their patients.quot; We've got to practice medicine under the dictumof quot;above all do no harm.quot; One of our most

well respected peer review journals is nowtelling us that the use of these medications—these fluoroquinolone antibiotics is associatedwith doubling of the risk of peripheral neuropathy. A disease which often is not treatable. Sokeep that in mind the next time you think you need an antibiotic for this or that problem,discuss this study with your treating physician. I'm David Perlmutter.

Category: Neuropathic Pain

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