small fiber neuropathy

[begonia1956]

I've been diagnosed with small fiber neuropathy. I have painful feet, summer and winter. About the same time this started I also developed a small tremor in my left hand(I am left-handed). This was 2 years ago. Since that time the tremor has been diagnosed as essential tremor. I can not write with my left hand or do any fine work with it. I am learning to write right-handed. My question: Is the neuropathy and tremor related in any way? I sometimes feel my whole body is shaking, especially in bed at night or when still, reading.etc. This internal tremor sometimes drives me crazy. My neurologist first dx me with Park. Dis. but later decided the tremor was essential. I take Primidone 200 mg at night and have taken that for 2 years. But it seems to be not working for the tremor or the feet any longer. Thanks.

[Cleveland Clinic]

Thanks for the email. Most patients with small fiber neuropathies are diagnosed without a known cause and are called idiopathic. Common known causes include diabetes. If one does not know the underlying cause of the neuropathy then it will be very difficult to determine the relationship of the tremor. Most neuropathies are symmetric and usually affect the feet before the hands. usually both hands are affected at the same time so if the neuropathy was the cause of the tremor you would expect it to affect both arms. Essential tremor commonly affects the arms and is usually worse when doing an activity. The term essential means that it is not linked to other disease states. Parkinson's tremor is usually present at rest and then goes away with activity. some patients with essential tremor have a familial cause and hence other family members are affected. Often we check for thyroid abnormalities or heavy metal problems. There are several medications other than primidone and some patients will undergo surgery in severe cases. Sounds like it might be reasonable to see a movement disorders specialist if you have not done so. Best on luck, GS

[RunningL8]

I don't know anything about tremors.  But have you tried alpha lipoic acid (600 mg. daily, in divided doses) for your small-fiber neuropathy?  It has helped the s.f.n. in my hands and feet tremendously.  You can buy alpha lipoic acid at vitamin stores like GNC, and it is widely prescribed in Europe.  (You can google the term for more information.)

[williams123456]

Can you make a recommendation for a good neurological textbook
that would explain small fiber neuropathy in detail.
thks

[kiwipie]

A related discussion, polyneuropathy was started.