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.
Why am I losing my peripheral vision
A loss of peripheral vision can be suddenand very scary, or gradual without noticing in the onset. There are many symptoms of peripheralvision loss, and they range from tripping, struggling with walking in the dark, difficultydriving, seeing a curtain or spiderweb off to the side in your line of sight, and shimmersof light followed by tunnel vision lasting ten to twenty minutes. There may also be almostno symptoms at all. If you experience any noticeable decreaseto peripheral vision, especially if the loss is sudden, you should immediately make anappointment with your of Optometry. All optometrists see patients with these symptomson a regular basis, and many optometrists
hold emergency appointments in their schedulefor patients who require urgent care. No referrals are necessary. Causes of peripheral vision loss can be asmild as an ocular migraine or a vitreous floater, to more serious, like a retinal detachmentor a pituitary tumour. Other causes include glaucoma, stroke, retinitis pigmentosa, andbrain aneurysms. s of Optometry are better prepared to deal with your peripheralvision loss than a general practitioner or the emergency room â€“ optometrists have thetraining, experience and the specialized equipment necessary to find the cause of peripheralvision loss.
Development of Glaucoma Animation Open Angle vs Angle Closure Glaucoma
Glaucoma is a group of eye diseases in whichthe optic nerve is damaged leading to irreversible loss of vision. In most cases, this damageis due to an increased pressure within the eye.The eye produces a fluid called aqueous humor which is secreted by the ciliary body intothe posterior chamber a space between the iris and the lens. It then flows through thepupil into the anterior chamber between the iris and the cornea. From here, it drainsthrough a spongelike structure located at the base of the iris called the trabecularmeshwork and leaves the eye. In a healthy eye, the rate of secretion balances the rateof drainage.
In people with glaucoma, the drainage canalis partially or completely blocked. Fluid builds up in the chambers and this increasespressure within the eye. The pressure drives the lens back and presses on the vitreousbody which in turn compresses and damages the blood vessels and nerve fibers runningat the back of the eye. These damaged nerve fibers result in patches of vision loss, andif left untreated, may lead to total blindness. There are two main types of glaucoma: openangleand angleclosure. Openangle glaucoma , or chronic glaucoma,is caused by partial blockage of the drainage canal. The angle between the cornea and theiris is quot;openquot;, meaning the entrance to the
drain is clear, but the flow of aqueous humoris somewhat slow. The pressure builds up gradually in the eye over a long period of time. Symptomsappear gradually, starting from peripheral vision loss, and may go on unnoticed untilthe central vision is affected. Progression of glaucoma can be stopped with medical treatments,but part of vision that is already lost can not be restored. This is why it's very importantto detect signs of glaucoma early with regular eye exams.Angleclosure glaucoma, or acute glaucoma, is caused by a sudden and complete blockageof aqueous humor drainage. The pressure within the eye rises rapidly and may lead to totalvision loss quickly. Certain anatomical features
of the eye such as narrow drainage angle,shallow anterior chamber, thin and droopy iris, make it easier to develop acute glaucoma.Typically, this happens when the pupil is dilated and the lens is stuck to the backof the iris. This prevents the aqueous humor from flowing through the pupil into the anteriorchamber. Accumulation of fluid in the posterior chamber presses on the iris causing it tobulge outward and block the drainage angle completely. Acute angleclosure glaucoma isa medical emergency and requires immediate attention.