Treatment Of Diabetic Neuropathy Medscape

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.

What Is Vertigo Why Do We Get It

You might think vertigo is a problem thatpeople have when they're afraid of heights.or are Jimmy Stewart. Nope! Vertigo is all inyour head.specifically, your ears. Hey guys, Lissette here for Dnews. Vertigois one of the four main categories of dizziness it's a subjective experience that makesyou feel like you've lost a sense of your surroundings. But there are some very realcauses behind it in some cases, vertigo can even lead to nausea, vomiting and youreyes to twitch from side to side. There are two types of vertigo: peripheralvertigo and central vertigo. Central vertigo is a neurological problem usually in thebrain stem or cerebellum which can be caused

things like multiple sclerosis, stroke, andtumors. But the most common by far, and what we'll be focusing on here, is peripheralvertigo. Because, as a 2002 study in The British Journal of General Practice reports, at least93% of patients with vertigo, are those with peripheral vertigo.which has a lot to dowith problems in your ears. Your ears are super important for keepingyour balance and navigating the world. They help you orient yourself in it. In your innerear, there are these tiny hairs called stereocilia, that line a pouchlike structure called thesaccule. And interspersed between these hairs, is a sticky goop called glycoprotein thatholds tiny crystals in place. These guys are

made up of calcium carbonate, and move wheneverwe move, which causes them to bang up against the hairs in our ear. When the hairs sensethe crystals moving, they send signals through nerves in our ears to our brain that giveit information about our vertical and horizontal movement essentially, these crystals tellour brains where the heck we're going and help us keep our balance. On top of these nerves, crystals, and hairs,we also have fluid in our ears. Like the crystals, the fluid moves when we move and that'spicked up by our hairs which send information to our brain. Our brain uses the informationcoming from both ears to figure out whether

we're stationary or moving, and how we areoriented! Vertigo occurs when something in this systemgoes wrong. The spinning sensation or dizziness is your brain trying to figure out what theheck is going on. It's getting cues that don't make sense. And a number of differentconditions can cause this. In the cases of vestibular neuritis and labyrinthitis, partsof your ear become inflamed, usually because of a viral or bacterial infection. When oneof your two ears is inflamed particularly the ear's nerves it causes your brainto get imbalanced information so you can end up with vertigo. Meniere's disease, althoughit's not well understood, it's thought

to be caused by too much liquid in your ear,which causes the same dizzying symptoms. And researchers think migraines can cause vertigobecause they cause changes in our vascular and nervous systems, which affect parts ofour ears. Finally, one of the most common causes of vertigo benign paroxysmal positionalvertigo has to do with the crystals. Sometimes these crystals fall out of place possiblydue to a head injury or because the goop that holds them in place in the inner ear becomestoo weak. When they fall off, these crystals can end up in places where they don't belong,like the middle ear, and cause our brain to receive signals that don't make sense toit. They throw everything off!

Luckily, this one can often be fixed by simplyfollowing a set of head movements that move the crystals out of where they don't belong.Invented by John Epley in the 1980's, this noninvasive procedure can be effectivein up to 90% of these vertigo cases. Other causes of vertigo can be treated with medication,although in more extreme cases surgery may be necessary. As nasty as that sounds, some people do undergothese procedures, because vertigo can be horrible. It can last anywhere from hours to monthsat a time and can be debilitating. On top of that, just moments of Vertigo can causea lot of harm. If we lose our balance and

Category: Neuropathic Pain

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