neuropathy and leg blockages

[Robin-Tashjian]

    
      Re: neuropathy and leg blockages
    


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Posted by CCF NEURO MD on June 09, 1997 at 11:34:09:

In Reply to: neuropathy and leg blockages posted by Robin Tashjian on June 02, 1997 at 14:53:50:

: 45 yr. old male has severe diabetic neuropathy for several years--on morphine patch and antidepressants.  Pain is severe but, in addition to this, there are substantial blockages in arteries.  Has been treated unsuccessfully with angioplasty and stents and one month ago a complete by-pass and each time the blockage recurs immediately.  Doctors are reluctant to re-open these arteries again.  It is difficult to separate the neuropathy pain from this blockage pain but walking and working are now a battle.  Is there currently research on why this occurs and is anything new on the horizon to hope for.
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Peripheral neuropathies refer to changes that occur in the nerves which result in a loss of normal
sensation or development of weakness, due to damage to the sensory and motor nerves.  These symptoms can be
quite painful and debilitating. The symptoms often develop in the hands and feet first and may
gradually progress up the extremities, depending on the cause. Diabetes is a common cause of neuropathy. There are a number of symptomatic
treatments for neuropathies such as tricyclic antidepressants, tegretol, neurontin and mexilitine to give
a few examples. To diagnose a peripheral neuropathy and to determine the severity and extent of
involvement, a EMG test is used. This uses electrical shocks to test the conduction of the nerves and
a small needle to assess how much damage has occurred to the muscle supplied by the nerve.
Your situation is a difficult one, because the diabetes has most likely caused your arterial disease as well as the peripheral neuropathy.  Differentiating betweeen the two can be difficult particularily at the severe stages of the disease processes. EMG testing would be able to tell the extent of your neuropathy.  Neuropathy will generally produce constant pain which is worse at night.  Vascular disease early on, produces pain with exertion, but late may also occur at rest.  It is likely that you may be experiencing pain from both.  Unfortunately, treatment for peripheral neuropathy is limited at this point to symptomatic treatment as listed above.  There are some investigational studies ongoing about nerve growth factors but is unlikely to help people in progressive disease.
If you would like to be evaluated at the Neuromuscular department at the Cleveland Clinic Call 1-800-223-2273 ext 45559. There is no ongoing treatment trials at this time for diabetic peripheral neuropathies.  I will also give you some support group information.  
Information may also be available from the following organizations:
The Neuropathy Assoc., Inc.
P.O. Box 2055
Lennox Hill Station
New York, NY 10021
[phone]
American Chronic Pain Association, Inc.
P.O. Box 850
Rocklin, CA 95677
[phone]
National Chronic Pain Outreach Association
7979 Old Georgetown Rd.
Suite 100
Bethesda, MD 20814-2429
[phone]
Peripheral Neuropathy
National network. Founded 1994. Self-help group for people with peripheral neuropathy (damaged
nerves in the peripheral nervous system connecting the brain and spinal cord, such as with diabetes,
injuries or traumas, etc). Newsletter ($12). Phone support, pen pals, information and referrals. For
information, send self-addressed stamped envelope. Assistance in starting groups. Write: Peripheral
Neuropathy, 19579 Temescal Canyon Rd., Suite 1002, Corona, CA 91719. Call Linda at
[phone]; FAX: [phone] or Lu at [phone].
- Peripheral Nerve Disease mononeuritis multiplex mononeuropathy
- polyneuropathy
This information is provided for general medical education purposes only.  Please consult your physician for diagnostic and treatment options of your specific medical condition.