Sensorimotor Polyneuropathy A Rose By Any Other Name

Today's post from health.nytimes.com (see link below) is a useful description of neuropathy as a medical condition. The article is entitled 'Sensorimotor Polyneuropathy' which may confuse many people but it's basically a description of the disease we all know and hate and the information is handy for everybody with any form of neuropathy with standard symptoms. One of the problems for ordinary patients trying to learn about their condition, is the number of terms used to describe it! You can easily be baffled by the terminology alone. 'Sensorimotor' is another word for 'sensory' neuropathy which may be more familiar but if you think in terms of polyneuropathy in its many forms and with its many causes, this article may be of value to you.

Sensorimotor Polyneuropathy
New York Times Saturday, September 28, 2013

Sensorimotor polyneuropathy is a condition that causes a decreased ability to move or feel (sensation) due to nerve damage.

Alternative Names

Polyneuropathy - sensorimotor

Causes

Neuropathy means a disease of, or damage to nerves. When it occurs outside of the brain or spinal cord, it is called a peripheral neuropathy. Mononeuropathy means one nerve is involved. Polyneuropathy means that many nerves in different parts of the body are involved.

Neuropathy can affect nerves that provide feeling (sensory neuropathy) or cause movement (motor neuropathy). It can also affect both, in which case it is called a sensorimotor neuropathy.

Sensorimotor polyneuropathy is a body-wide (systemic) process that damages nerve cells, nerve fibers (axons), and nerve coverings (myelin sheath). Damage to the covering of the nerve cell causes nerve signals to slow down. Damage to the nerve fiber or entire nerve cell can make the nerve stop working.

Nerve damage can be caused by:
Autoimmune (body-wide) disorders
Conditions that put pressure on nerves
Decreased blood flow to the nerve
Diseases that destroy the glue (connective tissue) that holds cells and tissues together
Swelling (inflammation) of the nerves

Some diseases lead to polyneuropathy that is mainly sensory or mainly motor. Possible causes of sensorimotor polyneuropathy include:
Alcoholic neuropathy
Cancer (called a paraneoplastic neuropathy)
Chronic inflammatory neuropathy
Diabetic neuropathy
Drug-related neuropathy
Guillain-Barre syndrome
Hereditary neuropathy
Vitamin deficiency (vitamins B12, B1, and E)

Symptoms
Decreased feeling in any area of the body
Difficulty swallowing
Difficulty using the arms or hands
Difficulty using the legs or feet
Difficulty walking
Pain, burning, tingling, or abnormal feeling in any area of the body (called neuralgia)
Weakness of the face, arms, or legs, or any area of the body

Symptoms may develop quickly (as in Guillain-Barre syndrome) or slowly over weeks to years. Symptoms usually occur on both sides of the body. Most often, they start at the ends of the toes first.

Exams and Tests

An exam may show:
Decreased feeling (may affect touch, pain, vibration, or position sensation)
Diminished reflexes (ankle most commonly)
Muscle atrophy
Muscle twitches (fasciculations)
Muscle weakness
Paralysis

Tests may include:
Biopsy
Blood tests
Electrical test of the muscles (EMG)
Electrical test of nerve conduction
X-rays or other imaging tests

Treatment

Goals of treatment include:
Finding the cause
Controlling the symptoms
Promoting a patient's self-care and independence

Depending on the cause, treatment may include:
Changing medicines, if they are causing the problem
Controlling blood sugar level
Not drinking alcohol
Taking daily nutritional supplements

PROMOTING SELF-CARE AND INDEPENDENCE
Exercises and retraining to maximize function of the damaged nerves
Job (vocational) therapy
Occupational therapy
Orthopedic treatments
Physical therapy
Wheelchairs, braces, or splints

CONTROL OF SYMPTOMS

Safety is important for people with neuropathy. Lack of muscle control and decreased sensation can increase the risk of falls or other injuries.

If you have movement difficulties, these measures can help keep you safe:
Leave lights on.
Remove obstacles (such as loose rugs that may slip on the floor).
Test water temperature before bathing.
Use railings.
Wear protective shoes (such as those with closed toes and low heels).
Wear shoes that have non-slippery soles.

Other tips include:
Check your feet (or other affected area) daily for bruises, open skin areas, or other injuries, which you may not notice and can become infected.
Check the inside of shoes often for grit or rough spots that may injure your feet.
Visit a foot doctor (podiatrist) to assess and reduce the risk of injury to your feet.
Avoid leaning on your elbows, crossing your knees, or being in other positions that put prolonged pressure on certain body areas.

Medicines used to treat this condition:
Over-the-counter and prescription pain relievers to reduce stabbing pain (neuralgia) Anticonvulsants or antidepressant
Lotions, creams, or medicated patches

Avoid pain medicine whenever possible, or use it only when necessary. Keeping your body in the proper position or keeping bed linens off a tender body part may help control pain.

Support Groups

For additional information and support, see: www.neuropathy.org.

Outlook (Prognosis)

You can fully recover from peripheral neuropathy if your health care provider can find the cause and successfully treat it, and if the damage does not affect the entire nerve cell.

The amount of disability varies. Some people have no disability. Others have partial or complete loss of movement, function, or feeling. Nerve pain may be uncomfortable and may last for a long time.

Occasionally sensorimotor polyneuropathy causes severe, life-threatening symptoms.

Possible Complications
Deformity
Injury to feet (caused by bad shoes or hot water when stepping into the bathtub)
Numbness
Pain
Trouble walking
Weakness

When to Contact a Medical Professional

Call your health care provider if you have loss of movement or feeling in a part of your body. Early diagnosis and treatment increase the chance of controlling the symptoms.

References

Katitji B, Koontz D. Disorders of the peripheral nerves. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC. Bradley’s Neurology in Clinical Practice. 6th ed. Philadelphia, PA:Elsevier Saunders; 2012:chap 76.

Shy ME. Peripheral neuropathies. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 428.

http://health.nytimes.com/health/guides/disease/sensorimotor-polyneuropathy/overview.html

More Problems For Cipro And Other Antibiotics Vid

Today's post from naturalhealth365.com (see link below) is another hard-hitting article warning of the dangers of certain antibiotics (fluoroquinolones), with special reference to neuropathy. This blog has covered this subject many times before but while doctors across the world are still prescribing Cipro, Levaquin and the others, as the standard drug of choice, we have to continue warning of the inherent dangers associated with fluoroquinolones, especially for people who already have nerve damage of some sort. This article tells you all you need to know on the subject and the video is useful. That all said, in the end the best advice is to discuss the matter with your doctor and listen to what he or she says. If they claim that fluoroquinolones are perfectly safe then you may wish to produce some evidence that shows they're clearly not. Even the US FDA has expressed deep concern about these drugs and ordered warning labels to be put on all packaging. Your doctor will be able to prescribe an alternative - there are enough around.

Antibiotics cause peripheral neuropathy plus other damaging side effects
Posted by: Dena Schmidt, staff writer in Drug Dangers May 31, 2015 

(NaturalHealth365) A stunning 1 in 15 Americans – that’s 20 million people – have peripheral neuropathy. Peripheral neuropathy refers to issues with the peripheral nervous system that leads to nerve damage and symptoms such as muscle tingling, numbness and muscle weakness.

Sadly, in advance cases, this condition can lead to a persistent burning pain, muscle wasting, paralysis, organ and breathing issues, and even organ failure. And, to top it off, conventionally-trained physicians rarely provide a solution.

What are the causes of peripheral neuropathy?

While the causes of peripheral neuropathy are primary linked to diabetes, a recent article in the Journal Neurology reported that the risk of peripheral neuropathy doubles in anyone who takes fluoroquinolones. Fluoroquinolones are a class of antibiotics with a host of alarming side effects; one of the most prescribed has the brand name Cipro. While most of Western medicine doesn’t think much about this product, David Perlmutter, M.D. has many reservations and reveals the hazards of peripheral neuropathy and fluoroquinolones such as Cipro in this YouTube video below:



Those who are diabetic can take steps to change their diet and lifestyle to help minimize the risk of peripheral neuropathy. Peripheral neuropathy caused by Cipro, however, is another matter; the risk factors and side effects of Cipro tend to be grossly understated.

In fact, despite the clear health risks, this drug continues to be prescribed in hospitals and clinics all around the United States.

The side effects of Cipro are horrible

Adverse reactions and side effects of Cipro in adult patients include diarrhea, nausea, migraines, abnormal liver function, vomiting, skin rash, abdominal pain, and pain in the extremities. Cardiovascular effects include palpitation, ventricular ectopy, atrial flutter, hypertension, angina, cerebral thrombosis, myocardial infarction, and cardiopulmonary arrest.

There are also an alarming number of central nervous system effects as well as gastrointestinal, musculoskeletal, renal and respiratory risks, among others. The list of possible side effects of Cipro is truly staggering, and it is also a primary cause of peripheral neuropathy.

Warning: Fluoroquinolones can cause permanent disability

While just about every drug on the market has some potential side effects, most are transient and tend to cease when the person stops taking the drug. However, when it comes to Cipro, this is not the case; a great many of the side effects of Cipro can be permanent, causing lifelong disability. The maker of Cipro does not disclose this fact anywhere on the warning label.

All fluoroquinolones have a black box warning, and Cipro now has two of them. More than half of the fluoroquinolones that were on the market in the past have been pulled due to their dangers and horrific side effects; however, Cipro and others such as Avelox and Levaquin remain in use.

The slogan of the medical profession is “Above all, do no harm.” The continued prescribing of fluoroquinolones like the antibiotic Cipro despite its grave risks is completely unethical. Cipro’s status as one of the top causes of peripheral neuropathy should result in a permanent ban.

Simply put, the fact that this crap is still on the market – despite being linked to so many health problems – is truly criminal.

References:
http://www.ninds.nih.gov/disorders/peripheralneuropathy/detail_peripheralneuropathy.htm
http://www.neurology.org/content/early/2014/08/22/WNL.0000000000000846.short
http://floxiehope.com/fluoroquinolones-links-resources
http://www.ciproispoison.com
https://www.youtube.com/watch?v=y98eHM0Z9-g

http://www.naturalhealth365.com/side-effects-of-cipro-fluoroquinolones-1440.html

Is Metabolic Neuropathy Much Different To Other Forms Of Nerve Disease

Today's post from nytimes.com (see link below) is an article that may help clear up one of the many problems people have with the language of neuropathy. A patient new to the disease may be diagnosed in terms that leave him or her bewildered and because the neurological vocabulary used by doctors is so broad, you may not be aware precisely what your diagnosis means in relation to other forms of neuropathy. Take the subject of this article for instance. You'd be forgiven for thinking that 'metabolic' neuropathy is a completely different form of nerve damage to other common neuropathies, when in fact it's another general term describing pretty much the same symptoms and problems that millions of others have. Metabolism (change) is life-sustaining chemical transformations within the cells of living organisms. There is an argument that all neuropathies are metabolic in nature but the word in itself shouldn't confuse you:- if you have metabolic neuropathy, you have neuropathy, in the same way that millions of others have. It's very often used in connection with diabetes and is therefore attached to diabetic neuropathy because that's the most common neuropathic cause. Diabetes is a metabolic disease, because it affects the body’s ability to capture glucose from food for use by the cells. You're probably more confused than ever now (I haven't explained it very well - apologies😓) but the symptoms and treatment are very much the same as other forms of neuropathy, peripheral or not and metabolic or not.

Metabolic Neuropathies
Metabolic neuropathies are nerve disorders that occur with diseases that disrupt the chemical processes in the body.

Causes

Nerve damage can be caused by many different things. Metabolic neuropathy may be caused by:
A problem with the body's ability to use energy, often due to a nutritional deficiency
Dangerous substances (toxins) build up in the body

Diabetes is one of the most common causes of metabolic neuropathies. People who are at the highest risk of nerve damage from diabetes include:
Those with damage to the kidneys or eyes
Those with poorly controlled blood sugar

Other common metabolic causes of neuropathies include:
Alcoholism
Low blood sugar (hypoglycemia)
Kidney failure
Porphyria
Severe infection throughout the body (sepsis)
Thyroid disease
Vitamin deficiencies (including vitamins B12, E, and B1)

Some metabolic disorders are passed down through families (inherited), while others develop due to various diseases.

Symptoms

These symptoms occur because nerves cannot send proper signals to and from your brain:
Difficulty feeling in any area of the body
Difficulty swallowing
Difficulty using the arms or hands
Difficulty using the legs or feet
Difficulty walking
Pain, burning, pins and needles, or shooting pains in any area of the body (nerve pain)
Weakness in the face, arms, legs, or other area of the body

Usually, these symptoms start in the toes and feet and move up the legs, eventually affecting the hands and arms.

Exams and Tests

An exam may show:
Decreased feeling (may affect touch, pain, vibration, or position sensation)
Reduced reflexes (most common in the ankle)
Muscles becoming smaller (atrophy)
Muscle twitches (fasciculations)
Muscle weakness
Loss of movement (paralysis)

Tests used to detect most metabolic neuropathies:
Blood tests
Electrical test of the muscles (EMG)
Electrical test of nerve conduction

Treatment

For most metabolic neuropathies, the best treatment is to correct the metabolic problem.

Vitamin deficiencies are treated with diet or injections. Abnormal blood sugar or thyroid function may need medication to correct the problem. Alcoholic neuropathy is treated with alcohol abstinence.

In some cases, pain is treated with medications that reduce abnormal pain signals from the nerves (duloxetine, gabapentin, pregabalin). Lotions, creams, or medicated patches can provide relief in some cases.

Clinical trials of new medications include antioxidants, neuroprotectants, insulin-like drugs, and aldose reductase inhibitors.

Weakness is often treated with physical therapy. You may need to learn how to use a cane or walker if your balance is affected. You may need special braces on the ankles to walk better.

Support Groups

For additional information and support, see www.neuropathy.org and http://diabetes.niddk.nih.gov/DM/pubs/neuropathies.

Outlook (Prognosis)

The outlook mainly depends on the cause of the disorder. In some cases, the problem can easily be treated. In other cases, the metabolic problem cannot be controlled and nerves may continue to become damaged.

Possible Complications 
 
Deformity
Injury to feet
Numbness
Pain
Trouble walking
Weakness

Prevention

Maintaining a healthy lifestyle can reduce the risk of neuropathy.
Avoid excess alcohol use.
Eat a balanced diet.
Visit the doctor regularly to find metabolic disorders before neuropathy develops.

If you already have a metabolic problem, regular doctor visits can help control the problem and reduce the chance of further nerve damage.

Patients who already have metabolic neuropathy can reduce the risk of some complications. A foot doctor (podiatrist) can teach you how to inspect your feet for signs of injury and infection. Proper fitting shoes can lessen the chance of skin breakdown in sensitive areas of the feet.

References

Shy ME. Peripheral neuropathies. In: Goldman L, Ausiello D, eds. Cecil Medicine . 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 446.

Montfort EG, Witte A, Ward K. Neuropathic Pain: A Review of Diabetic Neuropathy. US Pharm . 2010;35(5):HS8-HS15.

http://www.nytimes.com/health/guides/disease/metabolic-neuropathies/overview.html