Peripheral Neuropathy and Peripheral Artery Disease

[Leghurts]

After EMG/NCS, I  (57 years old) have been diagnosed with sensory-motor, axonal distal peripheral neuropathy.  It is asymmetric in nature with more marked changes on the left.  All the usual tests for a cause were negative.  Labeled idiopathic.

For a few years prior to testing I had a mild numbness on the lower, lower outside of left leg which ran across ankle and top of foot.  Sometimes I thought my big to had "gout."  I had some severe cramping, boring pain on the front of leg down to toes in 2003 but that stopped.

After onset of severe neurological symptoms in Dec 2004, it was discovered that I had moderate to severe peripheral artery disease in the left leg.

My neurolgist has not said that PAD could cause PN and did not discuss PAD as even a possible cause of my neurological damage.

Can PAD cause neuropathy?  And can neuropathy in one leg cause nerves in the opposite leg to "act up" or become "sympathic." My EMG shows nerve damage in right leg but it is not expressed.

Should I insist on a complete vascular exam?  Thanks. Leghurts

[CCF-Neuro-M.D.-PW]

Up to 30% of peripheral neuropathies, no cause is found and they are labelled 'idiopathic'. Whereas peripheral arterial disease can cause wasting and skin changes in the legs, usually only if severe is there nerve damage, I do not know how severe your peripheral artery damage is. Commonly there is a common cause such as diabetes - routine diabetes tests can miss early diabetes which can cause such a neuropathy - a glucose tolerance test or a skin biopsy looking at epidermal nerve fiber density can help the diagnosis in this case. Neuropathy in on eleg does not cause the other leg to become involved - this kind of peripheral neuropathy is because some form of body toxin or lack of nutrients is present (such as in diabetes) and this effects the longest, most peripheral nerves first hence the bilateral lower extremity involvement.
If you know you have peripheral arterial disease, then it may be advisable to have a complete vascular assessment, as other arteries may be involved also
Good luck

[CAtransplant]

I also had a numb left calf.  I'm 51 and it had been numb for three years.  I began cycling about six months ago with no change until I got a new bike with clip on pedals.  Within three weeks the numbness was completely gone.  All I can figure is that the full motion pedaling that the clip ons allow add to the muscle development and blood circulation.  I ride about 10 miles a day and a 50 to 70 mile ride about once or twice a month.  Cycling may be the key for you also.  I have read of others with neuropathy that have had symptoms lessen or disappear completely.

[snoopy_301]

I am curious to know more about you initial diagnosis.  My EMG showed sensory problems too.   I have had pain in both legs with cramping, burning, twitching and numbness that goes in both legs and feet and bounces all around them with no rhyme or reason.  I've had MRI's and blood tests and nothing else shows up. The weird thing is that I was an active healthy person and just one day, my feet started hurting and within three days all these symptoms appeared and it has been 3 months with no improvement.  I am 39 and otherwise healthy.  Is this how yours started?  Thanks

[CAtransplant]

Mine started about six years ago with small shooting pains and numbness in my left calf.  The pains have gone as well as the numbness with the cycling.  The only symptom I have now is that the bottom of my left foot feels like something is crawling around in it and itches when there is no pressure on it.  Mostly bothers me when I am trying to go to sleep or sitting.

My dad, who has since passed away said his started in his late 40s with the same type of symptoms.  By his seventies he had real difficulty walking and shooting pain in both legs.

[spitfire77]

What I don't understand is what the clip on the cycle pedals did for your workout and your health.  All that does is keep your feet on the pedals better, if I am thinking of the same clip that you are talking about.

If you excersied cycling for 6 months then suddenly the pain stopped and the only thing that changed was the clip on the pedals, then maybe it took that long for it to buildup the health benefit to your legs.

I have been walking outside and on a treadmill, but if you think that cycling is better, then I will be happy to try that.  I am certainly tired of this pain and I worry that it's an indication of a more serious thing.

I've had leg pain that started summer 2004 as tingling for three days, then went away for 3 weeks, then came back as pain and has remained since.  Some days are better or worse.  Sitting, standing, or walking makes no difference.

I see my GP and a neurologist for migraines.  The GP says the pain could be vascular and to excercise, if pain does not get better probably vascular.  The neurologist says maybe nerve problems, but when he tests he can't find anything.

Each doctor sees the problem in their area of speciality.  I read that in other posts here too.

I'm a 40-year-old male.  I've had migraines 2 years, gallbladder sugery during that time also.  I have had 2 head MRI's, in 2003 and 2004, a EEG test (normal), and a EMG of my legs(normal).  MRI showed only that fluid spaces of my brain are slightly larger than in most people my age, 2nd MRI one year later showed no change from 1st MRI.

[gotherpeslifeisover]

Can any neuropathies actually be TREATED, or do you just spend thousands of dollars to diagnose what it is then learn to live with it? It sounds like the majority of the cases go undiagnosed, so how do u treat what you can't diagnose? Scary stuff man.