Neuropathy - General Information

[plgerrard]

I thought some basic information for those newly diagnosed with neuropathy might be helpful. Here are some of the articles and resources I have found to be particularly informative:

Articles:


Neuropathy Patient Information: (http://docs.google.com/fileview?id=0BwCG-SGqEWUrZWUzZWNkYzMtM2NmNi00MGZhLTk5YjYtZmQ2NzAxZWE 3ODJl&hl=en) The neurologist gave me this handout when I was first diagnosed with PN.
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What is Neuropathy? - Health-cares.net (http://neurology.health-cares.net/neuropathy.php): This can be a good starting place. It describes neuropathy in general, with links to articles for specific types of neuropathy, symptoms and treatment.
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Peripheral Neuropathy Fact Sheet: (http://docs.google.com/fileview?id=0BwCG-SGqEWUrOWE1YmE0YzYtNzg4ZC00ZjcxLWIwNDQtNTNlMTFlNTZ mZDhm&hl=en) Fact sheet published by the National Institute of Neurological Disorders and Stroke (http://www.ninds.nih.gov/disorders/peripheralneuropathy/peripheralneuropathy.htm). This is what I downloaded from NINDS in 2005. If you visit their site today, you will find the information very abbreviated compared to what they had at that time.*
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Preview of Medifocus Guidebook on Peripheral Neuropathy (http://www.medifocus.com/2009/preview.php?gid=NR021): This preview of the Guidebook was published in April 2010, and contains about a third of the full Guidebook. The second chapter, ‘The Intelligent Patient’, has the first 30 pages of the original 60, and is filled with good, basic information.
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NEUROMUSCULAR DISORDERS: Disorders of Peripheral Nerve, Neuromuscular Junction, and Muscle (http://medinfo.ufl.edu:8050/year3/neurology/Neuromuscular_disease.pdf): Describes 5 categories of neuropathy, with diagrams of body locations affected.
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An Algorithm for the Evaluation of Peripheral Neuropathy (http://www.aafp.org/afp/980215ap/poncelet.html): Describes types of neuropathy, causes and diagnosis.


Other Resources:


University of Chicago – Center for Peripheral Neuropathy (http://peripheralneuropathycenter.uchicago.edu/learnaboutpn/index.shtml)
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The Neuropathy Association (http://www.neuropathy.org/site/PageServer?pagename=About_Facts)


Recommended Reading:

John Senneff Books:
Numb toes and aching soles
Numb toes and other woes
Nutrients for Neuropathy

Norman Latov Books:
Peripheral Neuropathy: When the Numbness, Weakness, and Pain Won't Stop
You Can Cope with Peripheral Neuropathy: 365 Tips for Living a Full Life

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*Note: Over the years I have saved information from websites in pdf format. As I started to copy links to add here, I found that many links were no longer valid, and others, like NINDS, had changed the information. If you would like to save websites in pdf format, see my post here: FREE pdf creator - 3 easy steps (http://neurotalk.psychcentral.com/thread120375.html)
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[mrsD]

This site is a wonderful resource to show the anatomy of the feet and placement of the nerves.

https://www.northcoastfootcare.com/footcare-info/foot-anatomy.html

There are interactive pain diagrams also which are helpful.

https://www.northcoastfootcare.com/footcare-info/foot-pain-finder.html

I think this is one of the best sites for the feet I've seen over the years.

Your feet may have mechanical problems in addition to the PN, which may be causing the PN or contributing to MORE pain for you. So please just take a look at this site and see what strikes you as helpful. For example, I found the shoe lacing suggestions very helpful. ;)

[plgerrard]

Thanks mrsD. That is a great site, and reminded me of one I know about. It isn't about PN specifically, but does describe and demonstrate (through videos) a complete neurologic exam:

NeuroExam.com (http://www.neuroexam.com/content.php?p=2)

So, if you have recently been referred to a neurologist and are waiting for your first appointment, this will show you what to expect:

Or, if you have ever seen your medical records and wondered what "Muscle Strength = 3/5" or "Deep Tendon Reflexes = 3+" indicated, you will find the answers here.

[glenntaj]

--that cycelops found at the Washington University at St. Louis Neuromuscular Disorders site:

http://neuromuscular.wustl.edu/over/print/walwebn2ie2.pdf

[mrsD]

Here is a new article about a study from Mayo....

Inflammatory damage to nerves following surgery:

http://www.medicalnewstoday.com/articles/202127.php

[Kathi49]

Thank you for the article Mrs. D. It makes complete sense in my own case. There is one thing I am confused about though. It speaks to immunotherapy. For those of us who have had fusions we are not allowed to take any anti-inflammatories as inflammation is part of the healing process. Or, I should say, we aren't allowed to take any until about 6 weeks or so after surgery. So, I wonder if I am confused or not quite undertanding what immunotherapy would consist of.

Anyway, thank you again because I did NOT have Neuropathy until, like the article states, about 30 days after surgery. It didn't come on suddenly...just over a matter of a few weeks.

[mrsD]

I really don't know either... maybe IVIG? IVIG use is increasing quite a bit in the past 5 years. If you look on Google, I found a list once that filled a whole page! I was amazed there were so many conditions now it is being used in. The IVIG may only have to be a few infusions, and not lengthy as it is for PN and MG.

There are papers out there on post-surgical RSD...which is also a neuropathic thing. In those they used calcium channel blockers soon after appearance of the pain, like nifedipine.

[Kathi49]

Thanks again Mrs. D. When I was reading you first post I immediately thought of IVIG only because my niece had Guillian Barre and that is what was used for her. I just didn't mention it because I was really unsure. But it makes complete sense. I am just glad that Mayo has come out with this. Hopefully, it will help others in the future. :)

[mrsD]

That is only a guess on my part. Other immune therapies could be Imuran, or Cellcept.

The restrictions on fusion surgeries and anti-inflammatories involve those which suppress cox-2 ... the Cox -2 cytokines have also healing ones included as well as inflammatory ones.
(Ibuprofen, Aleve, Celebrex, etc interfere with fusions, but I don't think the Imuran type do).

So don't quote me on IVIG... it is just a guess on my part!;)

[LizaJane]

For those newly diagnosed with peripheral neuropathy, as well as anyone wanting to take control of organizing his or her own lab test results:

www.Lizajane.org

This is a site I put up years ago, and which is popular with pn-ners world wide. It contains lists of tests which should be done to make diagnoses in cases where the cause of neuropathy is unclear.

The charts can be downloaded into an Excel Spreadsheet. You can fill in the charts on your computer, or just print them out and fill them in by hand. You can print them out and take them to your doctor. (Despite trepidation, nobody has yet had a doctor be anything other than grateful to see them).

The charts indicate tests for primarily sensory and primarily motor neuropathy. They include tests for genetic, toxic, and metabolic causes. There is a checklist to keep track of what tests you've had, and which your doctor says is unnecessary.

Even routine labs, like blood sugars, can be put into the charts, and you can follow them over time to see your progress, good or bad.

Please feel free to use them, and to contact me if you have any questions or suggestions.

LizaJane

[DaveH]

Hi Liza,

I'm a new member to NT and am trying to learn my way around the site. I not sure where or who to start with, but thought you could steer me in the right direction. I have been diagnosed with PN, but have felt my doctor isn't too much on top of my case or guiding me. I must admit I feel very hopeless right now. The pain is getting worse and I don't know what to do. I read part of your post that says it gets better. I just need some hope.

Thanks,
Dave

[mrsD]

This is a very good article on neuropathies, with definitions, tables, lists, etc:

http://www.medscape.com/viewarticle/510706

An Approach to the Evaluation of Peripheral Neuropathies

Mark B. Bromberg, MD, PhD

You can join Medscape for free...if you don't belong already. It is a wonderful resource to have at hand to consult on many medical conditions, new drugs, etc.

[mrsD]

This is an excellent illustrated model showing how pain is generated from the periphery and perceived in the brain:

http://www.georgiapainphysicians.com/l2_edu_pharma_mod2_slides.htm

Thanks to boytos for finding this link and sharing it here.