Re: drug induced neuropathy

Posted By CCF Neurology MD:NT on November 18, 1998 at 22:40:15:

In Reply to: drug induced neuropathy posted by LYN J on October 31, 1998 at 23:32:04:






Dear Dr.
Can  you tell me if a drug induced sensory neuropathy can resolve in time if it is to your small fiber nerves or nerves just below the skin that have been affected?  I called the drug manufactuer as post marketing adverse reaction listed paresthesia on the insert.  But, they said they have no information they could give me. because it was post marketing information. All my doctors feel this caused my problem. What do you think the chances are that something like this will resolve in time?  I assume you must have had some other cases. I appreciate what your opinion is.




Dear Lyn:
A small fiber sensory neuropathy can occur from a variety of causes, and some drugs are certainly on the list. Finding "parathesia" listed on the list of side effects in the insert or in the PDR does not mean that the drug is a potential cause of a neuropathy. In fact, paresthesias are very nonspecfic symptoms and are on the list of side effects of numerous very innocuous drugs.
Reading your description I am not quite sure that you suffer from a neuropathy. Besides a clinical examination, additional tests such as EMG, quantitative sensory and autonomic tests, and blood tests, and even a nerve or skin biopsy may be needed to make a definite diagnosis.
The troubles caused by sensory neuropathy are of three types. The commonest is severe pain. The less common symptoms are clumsiness and incoordination, and damage to distal extremities and skin from the loss of protective benefits of normal pain and sensation. Some of these troubles may or may not recover depending upon cause and severity. Paim may be controlled with drugs.
Good luck!