Neuropathy

PENN-DEL NEUROPATHY

NETWORK SUPPORT GROUP

Presented By:

Kevin Sirman

Robin Carlson

A Neuropathy Association Support Group

ESPECIALLY PREPARED FOR

Hahnemann Chapter

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DISCLAIMER The information on this power point

presentation or guidance provided is intended to be educational and informative and not medically prescriptive or diagnostic. All patients are encouraged to consult with their own medical doctor when considering any information contained on our support group presentation.

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WHAT IS NEUROPATHY

Neuropathy is a disorder resulting from injury to the peripheral nerves – the motor, sensory and autonomic nerves.  The main function of the peripheral nervous system is to connect the central nervous system (CNS) to the limbs and organs.

Unlike the CNS, the PNS is not protected by the bone of spine and skull, or by the blood brain barrier, leaving it exposed to toxins and mechanical injuries.

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AFTER THE PNS IS DAMAGED! The deterioration of the peripheral nerves

disrupts the body’s ability to communicate with its muscles, organs and tissues.

Neuropathy is like the body’s wiring system going haywire, causing unusual or unpleasant irritations including tingling, burning, itchiness, crawling sensation, dizziness, clumsiness and many many more!

If ignored, as this is done often these symptoms can lead to numbness at one extreme to unremitting pain at the other.

It can come and go, slowly progress over many years or become severe and debilitating.

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NEUROPATHY – A RARE ILLNESS ??? Rare not at all! It is estimated that up to

20 million Americans have it. The full extent of and importance of it

have not been recognized. Often it is misdiagnosed or thought of

merely as a side effect of another disease such as diabetes or cancer or even kidney failure.

It can occur at any age however it is more common among older adults.

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At first you might feel numbness or stabbing or burning in your feet.

Sock Sensation – Your feet feel like they have socks on but they are bare.

It gradually spreads to your legs and hands.

You find it harder to walk, your legs feel heavy and you have to drag yourself up the stairs!

You lose your balance and stumble on things.

As for your hands you think your keys are gripped tight and you drop them!

HOW DO YOU KNOW YOU HAVE IT?

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IT IS IMPORTANT TO PAY ATTENTION!

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TESTS TO EVALUATE NEUROPATHY Electrodiagnositic Tests1. Nerve Conduction Studies -

evaluates how the nerves transmit electrical stimuli.

2. Electromyography – (EMG) measures the electrical activity of muscles in response to nerve stimulation.

Skin Biopsy – Small Fiber Neuropathy cannot be diagnosed with EMG and nerve conduction studies that only measure the large fibers.

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MORE TESTS TO EVALUATE PN

Autonomic Tests – The Quantitative Sudomotor Axon Reflex Test (QSART) measures the autonomic nerve fibers that stimulate sweating. This is a tilt table test which measures your changes in blood pressure and pulse from prone to vertical positions. It also detects autonomic nerve involvement.

Nerve Biopsy – A Nerve Biopsy provides tissue for pathological examination. It will show if vasculitis or inflammation of the blood vessels as well as deymyelination that is missed by electrodiagnostic studies. Vasculitis can decrease the oxygen supply to the peripheral nerves and will quickly cause damage to nerve tissues.

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OF COURSE……….OTHER TESTS In addition to procedures, your neurologist may

order a number of blood and urine tests as well as radiologic tests in order to help find the cause of your neuropathy.

These include tests for: Diabetes Autoimmunity Infections Nutritional Deficiencies Toxins Hereditary Conditions Certain Cancer and Cancer Treatments

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MORE RESEARCH TO BE DONE!

Peripheral neuropathy (or neuropathy) has reached epidemic proportions, impacting over 20 million Americans. According to the National Institute of Neurological Disorders and Stroke, “More than 100 types of neuropathy have been identified, each with its own characteristic set of symptoms, pattern of development, and prognosis.” And, although there are more questions about the various neuropathies than there are answers, we are learning more and more about this devastating disease every day.

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TYPES OF NEUROPATHY

Autonomic Neuropathy Cancer-Related Neuropathies Compressive Neuropathies Diabetic Neuropathy Drug-Induced and Toxic Neuropathy G.I. and Nutrition-Related Neuropathies Hereditary Neuropathies Immune-Mediated and CIDP Infectious Diseases and Neuropathy Neuropathic Pain Chemotherapy Induced Neuropathy

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FOR LOTS OF PEOPLE!

If no cause can be found, the neuropathy is called IDIOPATHIC! Thirty percent of all people with neuropathy are in this category!

In the case of idiopathic it can be helped by controlling the pain with medication or physical therapy.

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INDUCED NEUROPATHY

Tacrolimus has been often described to induce neuropathy in liver-, pancreas-, and renal-transplanted patients. There is a report the first case of a 56-year-old woman who developed a progressive symmetric demyelinating sensorimotor polyneuropathy in the distal muscles of the lower limbs after therapy with tacrolimus because of heart transplantation. This condition suddenly reverted after the tacrolimus was stopped.

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MEDICINES THAT CAN CAUSE NEUROPATHY

Heart disease and high blood pressure are sometimes treated with drugs that can induce peripheral neuropathy, such as amiodarone, hydralazine, perhexiline and indapamide, which is sold as Lozol.

Statins such as Zocor, Crestor, Lipitor have been linked to Neuropathy

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WHAT TO WATCH FOR

Deficiencies in Vitamins! Especially B-12! But, B-6 in high doses can damage nerves!

Foot Care – You need podiatrist for foot checkups and additional foot care. Autonomic Neuropathy causes dry skin which can crack. There are many other reasons for a podiatrist checkup and we will discuss this later. Diabetic Neuropathy – Glycemic Control is most important. Gender may be a differential factor depending upon the type of neuropathy.

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STANDARD TREATMENT…….

The following list are standard medications prescribed for those with Neuropathy

Gabapentin

Metanx

Cymbalta

Lyrica

Amitriptyline

In addition to these medications there are ointments and creams used by patients. Biofreeze, Capsaicin, Zostrix along with RX Compounding Creams

Oxycodone, Hydrocodone and as well as other opiates are often prescribed for neuropathy pain.

Patients have described getting relief from rebuilders, acupuncture, reflexology and anodyne light therapy. In more severe cases of Neuropathy patients have turned to Plasmapheresis.

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PENN-DEL NEUROPATHY NETWORK SUPPORT GROUPS’ MISSION IN CONJUNCTION WITH THE NEUROPATHY ASSOCIATION FOCUSES ON HELPING AND HEALING PEOPLE WITH PERIPHERAL NEUROPATHY. BECAUSE OUR MISSION ENCOMPASSES PROVIDING NEUROPATHY AWARENESS, EDUCATION, SUPPORT, ADVOCACY AND RESEARCH, OUR ACTIVITIES SUPPORT OUR MISSION AS FOLLOWS:

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Awareness: Increase public awareness of the nature and extent of peripheral neuropathy.

Education: Educate the public andhealthcare providers on the need for earlyintervention.

Support: Support patients by providing platforms for exchanging information and experiences

Advocacy: Urge legislators, government agencies and medical providers to deliver proper coverage, care and treatment for people with peripheral neuropathy

Research: Encourage the funding if research to understand peripheral neuropathy’s causes, develop more effective therapies, and ultimately find cures for neuropathy.

PENN-DEL NEUROPATHY NETWORK SUPPORT GROUP

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ACKNOWLEDGEMENTParts of this Powerpoint have been taken from information provided by The Neuropathy Association.

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