Friday, April 15, 2016

N is for Neuropathy

Symptoms of neuropathy

Sensory Neuropathy
  • Tingling and numbness.
  • Pins and needles and hypersensitivity.
  • Increased pain ,or the loss of ability to feel pain.
  • Loss of ability to detect changes in heat and cold.
  • Loss of co-ordination and proprioception.
  • Burning, stabbing, lancing, boring, or shooting pains - which may be worse at night.
  • Skin, hair or nail changes.
  • Foot and leg ulcers, infection and gangrene.

Foot pain is the most common reason for people with diabetes to seek medical treatment for neuropathy, and loss of sensation can lead to injuries.
Motor Neuropathy
  • Muscle weakness - causing unsteadiness and difficulty performing small movements, such as buttoning the shirt.
  • Muscle wasting.
  • Muscle twitching, and cramps.
  • Muscle paralysis.
Autonomic Neuropathy
  • Dizziness and fainting (because of sudden changes in blood pressure).
  • Racing heart.
  • Reduction in sweating.
  • Inability to tolerate heat.
  • Loss of control over the bladder function, leading to incontinence, or retention of urine.
  • Bloating, constipation, or diarrhea.
  • Difficulties in achieving, or maintaining an erection (impotence).
Examples of Mononeuropathies
  • Postherpetic neuralgia - following shingles. Sensory neuropathy can last for many months, after the rash disappears.
  • Ulnar nerve palsy - following an injury to the elbow.
  • Carpel tunnel syndrome - caused by compression of the nerves, in the sheath of the wrist.
  • Peroneal nerve palsy - caused by compression of a nerve in the leg, that runs by the neck of the fibular (the calf bone, between the knee, and ankle).
  • Radial nerve palsy - caused by draping an arm over the back of a chair, for a long time during deep sleep.
  • Bell's Palsy,is a single-nerve neuropathy, that affects the face.

Diagnosing neuropathy

History:
  • Symptoms.
  • General health.
  • Any history of neuropathy in the family.
  • Any current or recent medication.
  • Any exposure to poisons (toxins).
  • Alcohol consumption.
  • Sexual history.
Examination:
  • Looking at the skin thoroughly.
  • Checking the pulses.
  • Checking the sensation.
  • Testing vibration sensation with a tuning fork.
  • Tendon reflexes.
Nerve Conduction Studies:
  • Nerve conduction studies check the speed with which nerves send messages.
  • Special electrodes are placed on the skin over the nerve being tested.
  • These electrodes give off very small electrical impulses, that feel a bit like a small electric shock, which stimulate the nerve.
  • Other electrodes, record the electrical activity of the nerve.
  • The distance that the impulses travel, to the other electrodes, and the time that this takes, allows the speed of the nerve impulse to be calculated.
  • In peripheral neuropathy, this speed is reduced.
Electromyography:

Electromyography (EMG) is used to diagnose muscle weakness caused by neuropathy
  • This test looks at the electrical activity of the muscles.
  • A very thin needle with an electrode attached, is inserted through the skin into a muscle.
  • This is connected up to a recording machine, called an oscilloscope.
  • The way that the muscle responds when it is stimulated by nerves, can then be monitored using the oscilloscope, and recorded.
  • In peripheral neuropathy, the electrical activity will be abnormal.
Nerve Biopsy:
This is the removal of a small part of a nerve, so that it can be examined under a microscope.
Skin Biopsy
  • This is a new technique, that has been developed to examine the peripheral nerves.
  • It can be used to look for early peripheral neuropathy, and also to monitor progression of neuropathy, and response to treatment.
  • Amongst other things, the density of nerve fibres in the area of skin is measured.
  • In peripheral neuropathy, the density of the peripheral nerves is reduced.


16 comments:

  1. The husband of a friend of a friend was having this issue. Along with others. I have no idea how it worked out, though. (The wife passed suddenly, and the friend lost contact with the husband.)

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  2. Hello, thank you for your visit to my blog. I have to say that I have not been to a doctor for many years. I have had a miraculous healing, other healings and a 'death experience', which brought me to become what people call a 'born again Christian', a believer in Christ.

    There is a passage in the Bible which says, regarding the man Job, that the very things he feared came upon him, and I believe sometimes this can happen. I also came to live next door to a lady who had been told by her doctor that she had two months to live. She told me she had gone down on her knees, and prayed to God to help her. She lived twenty two years after she was told she had two months to live. I believe that doctors do their best to help people but what man can not do God is able to do.

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  3. I don't have diabetes, however, I do suffer from Neuropathy, thanks to an injury. Terrible disease...just saying...

    Thank you for being truthful and honest in your posts Denise. Blessings

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  4. I learned a lot more about neuropathy from your post today! I didn't realize it covered so much more than problems with sensation in hands and feet! I appreciate all the good information you're providing here this month!
    Josie
    from Josie's Journal

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  5. Yikes! Not fun. Lots of good information here, though, as to what symptoms to watch for and what tests to get ran.

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  6. Interesting...my mother-in-law suffers with neuropathy in her legs and feet.

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  7. Neuropathy is one of the many diabetic "gifts" that David lives with. The pain at times is incredible and it causes him trouble sleeping. Sometimes the medicines offered to treat it, though, are worse than the neuropathy itself. One time, the doctors had him on two medicines at the same time. Turns out that both were anti-depressants (but he wasn't depressed). These medicines worked against each other and caused all manner of problems for him.

    I hope that you're doing fine in regards to neuropathy. I hope they have you on the medicine that is right for you.

    Have a blessed weekend!

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  8. Neuropathy, and especially a sudden onset of Bell's Palsy, can be scary.

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  9. Very interesting. I have neuropathy in my leg as a result of a tumor on my spinal cord. I've got some pain, but grateful to be able to walk. Take good care.

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  10. Oh wow, this sounds rough!! Thanks for being such a kind follower of my blog! *Hugs*

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  11. This is an exhaustive info on neuropathy that is most educational to digest. the coverage is enough to make one not just aware but concerned of the implications.

    Hank

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  12. Have you ever seen pictures of diabetic feet? We had a slide presentation in our diabetes support group once and it was enough to scare us all straight. This is an excellent post. Would you mind if I printed it out? It raised some questions for me that I would like to discuss with my endo doctor when I see her next week.

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  13. This is really informative. What an eye-opener.

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  14. I have had to learn about this stuff the hard way due to a spinal cord issue. Great synopsis.

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  15. I have neuropathy. It is excruciating. Important post.

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