chemotherapy related neurppathy

[dpwrs]

My 23 year old daughter is in remission from lymphoma.  She finished six rounds of chemotherapy (ABVD) in February 2005.  Her last radiation treatment was in April.  She returned to college in August.  Beginning shortly thereafter, several times a day she experienced tingling in her feet and legs.  Further, after about 5 minutes of walking, she now feels a weakness in her knees and must sit down.  There is no pain or other weakness.  Tests for low thyroid and vitamin B deficiencies were negative.  Any ideas regarding the diagnosis or what we should do next?

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

Chemotherapy drugs can cause a peripheral neuropathy - the small nerve fibers at the longest nerves ie at the end of the legs, are the most susceptible. They can affect either the sensory (more common) and/or the motor nerves.

It is important to come to the correct diagnosis though and other conditions should also be tested for such as vitamins, B12 ,Lyme, thyroid, HIV, can exclude other causes of a neuropathy in her age group

An EMG needle study and electrical nerve conduction study can tell which nerves, what pattern of nerves, and what kind of injury is taking place, which can tell you something about prognosis.

Usually the symptoms will stabilize over time adn start to get betterm but there may be some degree of residual nerve damage.

[onyx15]

Just want to let you know your daughter is not alone.  I am 33 and was diagnosed with Colon Cancer a year ago and it spread to my liver.  The surgery to remove the tumor in my colon was successful.  I then started chemo for my liver and had to stop during treatment in May pending another surgery which didn't take place until August.  A few weeks after I stopped chemo, I too started feeling tingling in my hands and feet. I thought it was normal, the after affects of chemo, so at that point I wasnt too worried about it because it was told to me that whatever affects I get from chemo would go away when I stopped. I had an MRI and CT scan all came out negative so I still wasnt very worried at that point and my oncologist didn't seem to be too worried about this. Then I had another surgery in August to remove my right ovary and tube because of cysts like things on them.  During surgery I had complications and had to have a blood transfusion.  Stayed in the hospital for 8days. As soon as I came to, I noticed my legs and feet felt different but I this point I couldnt tell what was normal from abnormal. The day I got home is when I realized my life has changed.  I woke up the day after in extreme pain in my feet, mainly the toes.  It feels like they are burning, like i am walking on broken toes, throbbing, numb and tingling all at the same time.  Lets not talk about how it feels when you sleep or walk on it after a long period of not walking on it.

What I'm trying to get at is find a good Neurologist and get this taken care of before it escalates.  It has been said it they can get to the source early, they might be able to reverse the process.  I had symtoms in June, escalated to pain in August and only now referred to a Neurolgist last week.  It is confirmed for me that I have Periphial Neuropathy, which from my understanding if it gets to this point there is no cure only trying to find a way for pain management. It has been about a month (32days to be exact) of this 24/7 pain. It is a task to even walk to the bathroom.  I am on 2100mgs of Neurontin ( soon to be increased I'm sure) and pain meds (which really doesnt work) There is very little comfort but the pain is still extreme. Dont take your time with this and if your not comfortable with your Neurologist or not satisfied with the results find another Neurologist. Dont be like me, I should have seen a Neurologist a long time ago, who knows what my life would be like.  For now, it has taken a sharp turn and it literaly turned my life upside down.  

Learn from my mistake, do whatever it takes to get an answer to fix it.  Don't wait because I found out the hard way time is valuable. Good luck to your daughter and to her recovery.