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Aug 15, 2006
Neuropathy
by SirGan
 When we are saying about neuropathy, then we should know that neuropathy, strictly speaking, is in fact any disease that affects the neurons of the nervous system. It should be pointed out that, in practice, it is recognized as a peripheral disorder, potentially affecting nerves anywhere except the brain or the spinal cord. Well, everyone knows that nerves provide communication between brain and muscles, skin, internal organs and blood vessels. That’s how- logically- when damaged, nerves can't communicate properly, and that miscommunication causes symptoms such as pain or numbness. Sometimes the symptoms are much more serious… No medical treatments exist that can cure inherited peripheral neuropathy. However, there are therapies for many other forms.Types of neuropathiesIt is very important to understand that neuropathies may affect just one nerve- condition called mononeuropathy, or several nerves- condition called polyneuropathy. What exactly is peripheral nervous system? Well, this part of nervous system includes nerves in face, arms, legs, torso, and some nerves in skull. In fact, all of nerves not located in central nervous system — which includes the brain and the spinal cord — are peripheral nerves.
The four major forms of nerve damage are:
The most common form is peripheral polyneuropathy, which mainly affects the feet and legs.
Peripheral polyneuropathy (PN)Like it was been told- peripheral neuropathy is caused by the damage to the peripheral nervous system, which transmits information from the brain and spinal cord to every other part of the body. It could be difficult to describe all the variants because more than 100 types of peripheral neuropathy have been identified, each with its own characteristic set of symptoms, pattern of development, and prognosis.
Symptoms of peripheral neuropathyIt is proven that some people may experience temporary numbness, tingling, and pricking sensations, sensitivity to touch, or muscle weakness, while- others may suffer more extreme symptoms, including burning pain, muscle wasting, paralysis, or organ or gland dysfunction. But, there are some rules! If a sensory nerve is damaged, patient is likely to experience symptoms that may include:
In most cases- these symptoms begin gradually and patient may have a tingling sensation or numbness that starts in toes or the balls of feet and spreads upward. For others, symptoms could be constant, and especially at night may be almost unbearable. Signs and symptoms may include:
It is also proven that, in cases of motor nerves damages - patient may have weakness or paralysis of the muscles controlled by those nerves. Bowel or bladder problems reduced sweating or impotence are also common.
Possible causes of peripheral neuropathyIt is important to know that all neuropathies could be divided into two groups: inherited and acquired! Inherited forms of peripheral neuropathy are caused by inborn mistakes in the genetic code or by new genetic mutations. Causes of acquired peripheral neuropathy include:
Unfortunately, it's not always easy to detect the cause of peripheral neuropathy and it's possible the cause may never be found.
Risk factors for developing PN
Complications of PNThere is no doubt- it is proven that diabetic neuropathy may cause a number of complications. Damage to the nerves in your feet, along with poor circulation, can lead to ulcers and even gangrene.
Other complications include:
Treatment of PN
Several researches done in the past have shown that Acetaminophen and nonsteroidal anti-inflammatory drugs (aspirin and ibuprofen), can help relieving mild symptoms.
Drugs such as gabapentin (Neurontin), Carbamazepine (Tegretol) and phenytoin (Dilantin) are often prescribed for pain and they are very effective!
Antidepressant medications, such as amitriptyline, Nortriptyline (Pamelor), Desipramine (Norpramin) and imipramine (Tofranil), may provide relief for mild to moderate symptoms. They do this by interfering with chemical processes in brain that cause you to feel pain.
Opioid analgesics, such as codeine or oxycodone may be used to relieve pain. Mexiletine (Mexitil), a drug ordinarily used to treat irregular heart rhythms.
Autonomic neuropathy - ANIt is very important to make a difference between the peripheral and autonomic neuropathy because the last represents damage to the nerves that regulate the body functions that patient can't control, including the nerves that regulate heart rate, blood pressure, perspiration and digestion…etc. Logically, similarly to the previous type - autonomic neuropathy results in faulty communication between your brain and the parts of your body that autonomic nervous system serves. Treatment of autonomic neuropathy involves the treatment of the underlying cause, if possible, and managing the signs and symptoms.
Symptoms of autonomic neuropathyLogically - signs and symptoms of autonomic neuropathy depend on which parts of autonomic nervous system are most affected. They may include:
Possible causes of ANA number of conditions can lead to damage of the autonomic nerves and these possible causes are similar to those for peripheral neuropathies! The most common cause is diabetes.
Other causes may include:
AN complicationsThere are several possible complications of autonomic neuropathy and they include:
Treatment of ANSeveral medications are available for treatment of every symptom! They include:
Metoclopramide (Reglan, Metoclopramide HCL), fiber supplements, tricyclic antidepressants…
Sildenafil (Viagra), Vardenafil (Levitra) or Tadalafil (Cialis), vaginal estrogen cream (Premarin, Estrace), vaginal estrogen rings (Estring)…
Bethanechol (Urecholine), Tolterodine (Detrol), Oxybutynin (Ditropan)…
High-salt diet, Fludrocortisone acetate (Florinef), Midodrine (ProAmatine)…
Glycopyrrolate (Robinul, Robinul-Forte), Clonidine (Catapres)…
Therapies
Every patient should know that TENS is about delivering tiny electrical impulses to specific nerve pathways through small electrodes placed on skin.
This method is about learning a patient control certain body responses that reduce pain.
It is proven that acupuncture can be an effective treatment for chronic pain, possibly including the pain of neuropathy.
Although most people don’t believe that this method really works- fact is that many adults can be hypnotized by a trained professional, and relieve most of their symptoms! There is nothing mystical about all this because, during hypnosis, patient just receive suggestions intended to decrease perception of pain, and that’s all!
These relaxation techniques are designed to help reduce the muscle tension. These techniques range from deep-breathing exercises to visualization, yoga and meditation.
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