Neuropathy: The Private Paralyzer
Submitted by Kelly
1. Name two types of neuropathy.
2. List three symptoms of neuropathy.
3. Explain three types of treatment for neuropathy.
Imagine the feeling of a burning cigarette gently being
pressed into your joints or skin. As the cigarette is pressed harder and
deeper into the area, it radiates to other areas away from the original place
of contact. You feel the pain dissipating slowly as though someone is removing
the cigarette. You get out of bed in the morning and you expect to
feel the soft carpet below your feet, but instead of the carpet it's as though
someone placed pebbles and rocks there in the carpet's place. As you walk
on the "pebbles" your balance is not normal, but is off because of
the uneven distribution of the ability to feel every thing under your
feet. Now imagine someone taking a live wire from the outlet and tap the
end of your toes with it. Digestion changes seem to be taking place; you don't
go to the bathroom as regularly as you used to. You find that you are
bloated, but don't have much of an appetite and you are more prone to episodes
of diarrhea. You notice your heart rate has changed from your normal
rate. You can't feel the temperature of your feet, but when you touch
them with your hands, you find they are ice-cold. You notice also that
the hair on your arms and legs or toes isn't as thick as it used to be.
When a person begins to have nerve damage, the changes manifest
in touching senses such as the fingers, toes, or feet and then work their way
inwards to affect the bodily functions such as the digestion process, heart
rhythm, muscle wasting or any combination of those functions. These
include the endocrine and immune systems, soft tissues, all digestion activity,
heart and blood vessel function such as blood pressure, temperature control,
pupil activity, and most apparent mobility.
Peripheral neuropathy is a problem with the nerves that carry information to and from the brain and spinal cord. This can produce pain, loss of sensation, and an inability to control muscles. Autonomic neuropathy is a form of peripheral neuropathy. It is a group of symptoms, not a specific disease.
Autonomic neuropathy involves damage to the nerves that run through a part of the peripheral nervous system. The peripheral nervous system includes the nerves used for communication to and from the brain and spinal cord (central nervous system) and all other parts of the body, including the internal organs, muscles, skin, and blood vessels.
Damage to the autonomic nerves affects the function of areas connected to the problem nerve. For example, damage to the nerves of the gastrointestinal tract makes it harder to move food during digestion. Autonomic neuropathy affects the nerves that regulate vital functions, including the heart muscle and smooth muscles. Damage to the nerves supplying blood vessels causes problems with blood pressure and body temperature.
Peripheral and autonomic neuropathy causes mild to severe paralysis to the body. It comes on slowly, starting on the outside and working its way inward. The loss of feeling can be so gradual that one may not even realize at first what is happening. Incrementally the pain and numbness creeps in to overtake isolated areas of the body. This may cause the loss of the feeling sensations until one may lose the ability to walk or develop a wound which eventually could lead to amputation of an extremity. With the gradual loss of normal abilities, there is a realization that the body doesn't work as efficiently as it used to and one may not even remember back when the first evidences of the paralysis and pain first occurred.
The most common people to be affected by a neuropathy are
those with diabetes mellitus. Though common among people with diabetes,
not all diabetics have a neuropathy. Symptoms may occur when diabetes is not
managed well. When blood glucose levels are
out of control, nerves may be damaged. Besides lack of blood glucose
control, there are other contributing factors that can lead to any type of
neuropathy: gender, age diabetes being diagnosed, blood glucose levels.
"The prevalence of diabetic neuropathy varies according to duration
of diabetes ranging from 10% within 1 year of diagnosis to more than 50% after
25 years of the disease." In a study with over 2800 diabetics, over
40 years of age, almost 15% were tested positive for peripheral neuropathy and
only one-fourth had had prior symptoms. Symptoms of digestive and bladder
problems are observed in 50% of those with diabetes. The changes may occur
without one person realizing it is a nervous system condition. Digestive
conditions may be noticed in reduction of appetite, nausea, vomiting, abdominal
distention, with 60% of diabetics noticing constipation. Bladder changes
may include the inability for the bladder to completely empty, some
incontinence, as well as other bladder dysfunctions. Impotence affects
75% of males with diabetes and is thought to be one first indicators of
Though neuropathy is most common among those with diabetes
mellitus, diabetics are not an isolated group. Neuropathy can also be
inherited or caused by an infectious disease, toxins or trauma. .
“Variable symptoms make peripheral neuropathy difficult to diagnose. A thorough neurological examination is usually required and involves taking an extensive patient history, performing tests that may identify the cause of the neuropathic disorder, and conducting tests to determine the extent and type of nerve damage.
A general physical examination and related tests may reveal the presence of a systemic disease causing nerve damage. Blood tests can detect diabetes, vitamin deficiencies, liver or kidney dysfunction, other metabolic disorders, and signs of abnormal immune system activity. An examination of cerebrospinal fluid that surrounds the brain and spinal cord can reveal abnormal antibodies associated with neuropathy. More specialized tests may reveal other blood or cardiovascular diseases, connective tissue disorders, or malignancies. Tests of muscle strength, as well as evidence of cramps or fasciculations, indicate motor fiber involvement. Evaluation of a patient’s ability to register vibration, light touch, body position, temperature, and pain reveals sensory nerve damage and may indicate whether small or large sensory nerve fibers are affected. ” (http://www.ninds.nih.gov)
One may believe they must suffer with the neuropathy pain, not realizing there is treatment available. Peripheral nerves have the ability to regenerate, as long as the nerve cell itself has not been killed. Symptoms often can be controlled, and eliminating the causes of specific forms of neuropathy often can prevent new damage. One should consult their physician to find out the best treatment available.
“In general, adopting healthy habits-such as maintaining optimal weight, avoiding exposure to toxins, following a physician-supervised exercise program, eating a balanced diet, correcting vitamin deficiencies, and limiting or avoiding alcohol consumption-can reduce the physical and emotional effects of peripheral neuropathy. Active and passive forms of exercise can reduce cramps, improve muscle strength, and prevent muscle wasting in paralyzed limbs. Various dietary strategies can improve gastrointestinal symptoms. Timely treatment of injury can help prevent permanent damage. Quitting smoking is particularly important because smoking constricts the blood vessels that supply nutrients to the peripheral nerves and can worsen neuropathic symptoms. Self-care skills such as meticulous foot care and careful wound treatment in people with diabetes and others who have an impaired ability to feel pain can alleviate symptoms and improve quality of life. Such changes often create conditions that encourage nerve regeneration.
Systemic diseases frequently require more complex treatments. Strict control of blood glucose levels has been shown to reduce neuropathic symptoms and help people with diabetic neuropathy avoid further nerve damage.
Neuropathic pain is often difficult to control. Mild pain may sometimes be alleviated by analgesics sold over the counter. Several classes of drugs have recently proved helpful to many patients suffering from more severe forms of chronic neuropathic pain. These include mexiletine, a drug developed to correct irregular heart rhythms (sometimes associated with severe side effects); several antiepileptic drugs, including gabapentin, phenytoin, and carbamazepine; and some classes of antidepressants, including tricyclics such as amitriptyline. Injections of local anesthetics such as lidocaine or topical patches containing lidocaine may relieve more intractable pain. In the most severe cases, doctors can surgically destroy nerves; however, the results are often temporary and the procedure can lead to complications.
Mechanical aids can help reduce pain and lessen the impact of physical disability. Hand or foot braces can compensate for muscle weakness or alleviate nerve compression. Orthopedic shoes can improve gait disturbances and help prevent foot injuries in people with a loss of pain sensation. If breathing becomes severely impaired, mechanical ventilation can provide essential life support. (http://www.ninds.nih.gov)
The ReBuilder, an electronic neuro-transmitter device, is
another method of treatment, which sends an electrical current to awaken those
nerves that have been damaged by sending an "exact copy of a healthy nerve
signal" from one foot to the other. The ReBuilder's inventor, David
B. Phillips, PhD, states that because of the lack of oxygen the nerves have
become dormant and the ReBuilder acts to stimulate the dormant nerves, thus
waking them up. Getting the vitamin B-12 levels within normal range can
also help. As the ability for feeling increases, treatment should not be eliminated,
but continued to aid the flow of nerve signals. The best treatment for
diabetics is to keep blood glucose levels under good management.
Strengthening exercises along with proper treatment may also help.
It is difficult to understand the severity of pain and the adjustment
neuropathy causes. When someone you know has neuropathy, it can cause a strain
on the relationship because you can't visually see the pain. The person
tells you about it, but it is very difficult to fully understand what they're
going through. They act normal in just about every aspect of life and may
not even communicate the changes taking place because they don't fully
understand the changes themselves. They feel inadequate and remorseful
because they can no longer function as normally as before. That is the
most debilitating aspect of this private paralyzer.
Many of the descriptions used are drawn from my husbands own personal experience with this disease. He has been using the ReBuilder mentioned and has had great outcome using this device.
Neurol Clinic 25, (2007), Autonomic Peripheral Neuropathy by Roy Freeman, M.D., Department of Neurology, Harvard Medical School, Center for Autonomic and Peripheral Nerve Disorders, Beth Israel Deaconess Medical Center, Boston, MASS
Diabetic Neuropathy: Clinical
Management Second Edition, Edited by Aristidis Veves, MD, DSc Beth Israel
Deaconess Medical Center Harvard Medical School
Boston, MA and Rayaz A. Malik, MBChB PhD Manchester Royal Infirmary
and University of Manchester, Manchester, UK; © 2007 Humana Press Inc.
999 Riverview Drive, Suite 208
Totowa, New Jersey 07512
Accessed April 2010
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1. When one has neuropathy, what can carpet feel like
beneath the feet?
a. needles b. sponges c. pebbles d. water
2. Peripheral nerves carry information to and from:
a. spinal cord and blood vessels b. the heart and smooth muscles
c. the brain and spinal cord d.
smooth muscles and internal organs
3. What are the two most common types of neuropathy?
a. peripheral and autonomic b. neuromuscular and automaticity
c. neurogenetic and autogenic d. periphery and autonomous
4. What percentage of diabetic patients develop neuropathy after 25 years?
a. 10 b. 15 c. 25 d. 50 or more
5. Neuropathic pain may be treated with what type of medication:
a. antibiotics b. anticoagulants c. antiemetics d. antiepileptics
6. What patient group is most affected by neuropathy?
a. diabetic patients b. kidney failure patients
c. meningitis patients d.
7. In male diabetics, what is one of the first indicators of autonomic neuropathy?
a. loss in feeling of hands b. inability to swallow
c. digestion changes d.
8. By what means can a person not get neuropathy?
a. inherited b. infection disease c. toxins d. kissing
9. A foot brace is an example of what type of neuropathic treatment?
a. exercise b. healthy lifestyle c. mechanical aid d. pain reliever
10) Which of the following statements about neuropathy is false?
a. Adapting health habits can lessen the effects
b. Neuropathy symptoms can be controlled
c. Peripheral nerves do not have the ability to regenerate
d. Strict control of blood glucose levels can reduce