Doctor insights on:
Weakness, numbness, and pain from nerve damage, usually in the hands and feet.
Depends: I think the problem may possibly have been caused by you not taking the active form of b6. When the inactive form is taken, there is a rate limiting factor in conversion, resulting in a relative deficiency of the active form. This can result in neuropathy. It is possible that taking the active form, pyridoxal 5 phosphate, may help. ...Read more
Weakness, numbness, and pain from nerve damage, usually in the hands and feet.
I've been diagnosed with peripheral neuropathy. My right calf and leg are numb all of a sudden. No other symptom. Is this neuropathy symptom or clot?
More info needed: Sudden onset of numbness in the leg is unusual, and needs investigation. The numbness sounds more like a neurological problem than a clot in a leg vein, and I believe a consultation with a neurologist is in order. If you have pain, swelling, redness of the leg or change of color of the overlying skin, please see a doctor immediately. ...Read more
Right sterno sticks out/clicks, right shldr blade clicks, ribs sore, Thoracic O.S symptoms/neuropathy. Esoph spasms, always swallowing air. All related?
Can B but not direct: Your right sternum and shoulder blade, rib complex can be related musculoskeletally to create the clicking action. The thoracic outlet syndrome with neuropathy is usually a lower extremity (arm/neck) issue. Esophageal spasm can occur from vagal nerve roots, and/or cervical ganglion issues. So, taking advil or ibuprofen can cause gastritis, and spasms. ...Read more
See belwo: Gabapentin is a very commonly used medications for people who have painful symptoms due to problems with their nerves (neuropathy). It was origiannly designed as a medicine for epilepsy (seizures) but is used much more for pain conditions. It is considered safe after over 20 years of use and does not interact with other medications. Itcan have side effects such as weight gain, swelling, drowsiness. ...Read more
I work really hard to stay in shape and eat right. Now I have a diagnosis of neuropathy. What else can I do so that it doesn't affect my overall health?
Many things: Maintain ideal body weight (bmi 18-24), avoid alcohol, treat any underlying condition that is causing the neuropathy (diabetes, thyroid condition, rheumatoid arthritis, emphysema/copd, sleep apnea), take a b complex vitamin once daily, and check your feet daily for sores. Neuropathy may cause pain, numbness, tingling, imbalance, & weakness; only rare & severe types of neuropathy cause disability. ...Read more
What tests can diagnose small fiber neuropathy and is it common to have facial numbness first then the extremities?
Biopsy: The best way is a biopsy in the lower leg. This is relatively painless and only requires some local anesthesia in the skin. Most small fiber neuropathies begin in the extremities. Facial numbness is more concerning for a possible central nervous system issue. I would recommend seeing a neurologist. ...Read more
The two tests: nerve conduction velocity/electromyogram, usually done together can help determine your neuropathy. It is often done by a neurologist, but other docs do them as well.
If you have symptoms/concerns, consult your doc who can help you find the answer/work-up appropriate for your case...Good luck. ...Read more
Any specialty: Any physician (md or do) or podiatrist can order. The test itself should be performed by a physiatrist (physical medicine and rehabilitation physician) or neurologist. ...Read more
Nerve Biopsy: There are new test that help diagnosis the degree and severity of diabetic neuropathy. Epidermal nerve fiber testing is a new way to test for neuropathy. Also having a emg/ncv (nerve flow test) perfomred will also assist in diagnosing neuropathy. A thorough clinical exam by your docotor will also help in diagnosisng your problem with tunning forks, and monofilament testing. ...Read more
After all else fails, I've tried everything for peripheal neuropathy pain. Whay else is given? Don't know the cause of pn yet. Gng to mayo in sept
Fuzzy Question: Patients need to tell us what, where, when, why, how, who, etc. When did problem start, is constant, what type pain, does pain radiate, what diagnosis from other doctor, does activity incite symptom, does lying down or food worsen, what body part affected, any injuries, etc. Doctors need clues to increase guessability. ...Read more
Neuropathy causes: The most common causes of neuropathy are high blood glucose, vitamin B12 deficiency, and alcohol toxicity. Less common causes include medicine side effects, infections, heavy metal toxicity, blood chemistry changes such as paraproteinemia, and inherited causes. Sometimes the cause is never found. ...Read more
Nonspecific term: Any pathology affecting the optic nerve could be described this way. However, the cause needs to be uncovered, as one could have ischemic process due to atherosclerosis, optic neuritis due to multiple sclerosis, compression of optic nerve due to tumor, etc. So, if vision is being lost, need attention asap. ...Read more
Is neuropathy associated with guilain barre syndrome treatable and if so, how do I treat it and relieve the painful symptoms? My neurosurgeon just informed me that I have g.B.S. And had it since may 2011 following a stomach flu I had 2 weeks before my sym
Your case presents a few dilemmas. Gbs is a group of autoimmune diseases targeted at the peripheral nerves and causing acute progressive weakness, usually an ascending paralysis.
The history usually entails the following:
â€¢upper respiratory or diarrheal disease within previous 1â€“3 weeks in 50â€“70%: c. Jejuni (~40%), cytomegalovirus (13%), epstein-barr virus (10%), mycoplasma pneumoniae (5%), or hiv
â€¢dysesthesias (painful tingling), paresthesias (tingling) of the feet and hands are usually the earliest symptoms.
â€¢pain is common- especially back pain which can radiate to the legs and not usually associated with myalgias (muscle pain).
â€¢gait disorder common in all age groups- this is the most common presentation in children
â€¢neck muscle weakness, dysphagia, and dysarthria are predictors of respiratory failure.
The physical exam frequently reveals the following:
â€¢acute, symmetric, and usually ascending weakness of limbs within days of dysesthesias
â€¢areflexia (no reflexes) or hyporeflexia (reduced reflexes) and muscle weakness, decreased position and vibratory sensation
â€¢respiratory muscle paralysis 30% if untreated
â€¢cranial nerve involvement <50%; usually facial weakness, 10â€“20% ophthalmoparesis (loss of eye movement)
â€¢dysautonomia (abnormal autonomic nervous system responses) (50%): labile blood pressure, arrhythmias, ileus (paralysis of bowel function), urinary retention;
â€¢miller-fisher variant: ophthalmoplegia, ataxia, areflexia
important lab tests
â€¢csf: elevated protein and normal white blood cells (wbcs; albuminocytologic dissociation) are characteristic with a normal opening pressure.
â€¢emg: this shows a pattern of demyelination with prolonged latencies and a reduced motor compound action potential.
The medications usually used are one or more of the following:
â€¢immune globulin (ivig)
â€¢plasmapheresis or plasma exchange
most patients reach the plateau phase within 3 weeks of admission, and muscle strength is expected to improve. The prognosis is:
â€¢complete recovery: 50%
â€¢some residual disability: 45%
â€¢severe permanent disability: 5%
hence, the dilemma as you report no improvement and in fact worsening. Furthermore, a lesion within the spinal cord (myelopathy) can present with similar symptoms as the ones you provide. A few pertinent questions to help discern the cause would include whether you have had a lumbar puncture and EMG and what did these results show?
I hope this answers your questions. Good luck and well wishes. ...Read more
Most Rx limited help: The central nervous system is made up of the brain and the spinal cord; all the nerves to the rest of the body stem from the cns, and is called peripheral nervous system; neuropathy (n) is a disorder of the peripheral nerves. Examples are diabetic neuropathy, alcohol-induced n. And carpal tunnel, a n. Of the median nerve in the wrist. Gabapentin, lyrica, (pregabalin) tegretol etc may help but no cures, yet. ...Read more
Depends on cause: Do you indeed possess biopsy proven small fibre neuropathy, and have blood and urine studies been completed to uncover causation? (gastroparesis and small fibre issues can be seen in diabetes for example.) sometimes, an increase in fiber consumption will help. Although the medical food metanx may help peripheral nerves, not clear if it affects gastroparesis, but worthwhile trying. ...Read more
New Medicines: In the past, no, however there are now various medical regimes that can be tried to alleviate some of this pain. See your primary care doctor for options. ...Read more
How do I get rid of neuropathy pain from shingles? I've had the pain for almost 2 years. I'm taking 800 mg of gabapentin and it just barely takes
Consider topicals: 60-min capsaicin patch 8% applied by your dr topical Lidocaine (lidoderm 5%) can be tried but results less predictable. Your dr may be able to recommend safe & effective topicals through a compounding pharmacy. Tricyclic antidepressants (desipramine>amitriptyline) work for most, but be patient, may take 3-4 weeks to kick in. Gabapentin dose is too low. Lyrica (pregabalin) and Depakote may help. ...Read more
Does the prescription drug metanx cause neuropathy to get worse before any improvement is noticed? I am a type II diabetic and was recently diagnosed with mild neuropathy in my feet. I was prescribed metanx. I noticed that my discomfort in my feet got wo
Metanx should not cause you to get worse but in my view it is expensive and of very minimal benefit. Metanx has not been shown to be better than a combination of b vitamins.
There are far more effective lower cost medications for pain from diabetic neuropathy. Imipramine, gabapentin, cymbalta, and Lyrica (pregabalin) are the main ones.
I find that most (about 95%) people get substantial relief with low dose Imipramine taken at bedtime. It costs pennies.
Daniel weiss md cde facp pns cpi. ...Read more
I have taken aspartine tablets in my drinks for around thirty years, I have stopped now, and use brown sugar. My neuropathy improved?
A complete nerve transection will leave an area totally numb. The distribution of the numbers depends upon where the nerve was cut. A partial nerve injury may leave the area tingly or incompletely numb. Finally even if the nerve is not cut the swelling and bruising to the tea can affect the nerve as well. Usually we consider sharp penetrating injuries as likely having nerve lacerations when sensation is lost. A hand surgeon can examine the hand and pinpoint the site or extent of nerve injury and recommend ...Read more