Periphreal Neuropathy Tests and Diagnosis

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Part 7 pf this series from the Mayo Clinic website

Tests and Diagnosis

Tests and diagnosis

By Mayo Clinic staff

Peripheral neuropathy isn’t a single disease, but rather a symptom with many potential causes. For that reason it can be difficult to diagnose. Your doctor will need to determine where the nerve damage is and what’s causing it.

Diagnosis usually requires:

  • A full medical history. This includes your symptoms, your lifestyle, exposure to toxins, drinking habits and a family history of neurological disease.
  • Neurological exam. This may include checking your tendon reflexes, your muscle strength and tone, your ability to feel certain sensations, and your posture and coordination.
  • Physical exam. Your doctor will likely do a complete physical exam.

Your doctor may order tests, including:

  • Blood tests. These measure various levels, such as vitamin and blood sugar levels; and bodily functions, such as thyroid, liver and kidney.
  • Imaging tests. Your doctor may request a CT scan or MRI to look for herniated disks, tumors or other abnormalities.
  • Nerve function tests. These may include electromyography — which reads electrical activity in your muscles to determine if your weakness is caused by muscle damage or nerve damage — and nerve conduction studies — which assess how your nerves and muscles respond to small electrical stimuli, generated by a probe and measured by an electrode placed along the nerve’s pathway.
  • Nerve biopsy. Your doctor may recommend this procedure to try to determine what’s damaging your nerves. A small portion of a nerve is removed and examined for abnormalities.
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Periphreal Neuropathy Complications

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Part 5 of the series on neuropathy from the Mayo Clinic website.

Complications

Complications

By Mayo Clinic staff

Complications of peripheral neuropathy may include:

  • Reduced feeling. Because parts of your body may be numb, you may be less likely to feel temperature changes or pain. This can make you more susceptible to burns or skin trauma.
  • Infection. Make sure to check your feet, as well as any other areas lacking usual sensation, regularly so that you can treat minor injuries before they become infected. This is especially important for people with diabetes, who tend to heal more slowly.

Periphreal Neuropathy Symptoms

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Continuation of the series on periphreal neuropathy from the Mayo Clinic.

Symptoms

Symptoms

By Mayo Clinic staff

The nerves of your peripheral nervous system send information from your brain and spinal cord (central nervous system) to all other parts of your body and back again. Nerves that may be affected by peripheral neuropathy include:

  • Sensory nerves that receive sensations such as heat, pain or touch
  • Motor nerves that control how your muscles move
  • Autonomic nerves that control functions such as blood pressure, heart rate, digestion and bladder function

Most commonly, peripheral neuropathy starts in the longest nerves — the ones that reach to your toes. Symptoms vary, depending on which types of nerves are affected. Signs and symptoms may include:

  • Gradual onset of numbness and tingling in your feet or hands, which may spread upward into your legs and arms
  • Burning pain
  • Sharp, jabbing or electric-like pain
  • Extreme sensitivity to touch, even light touch
  • Lack of coordination
  • Muscle weakness or paralysis if motor nerves are affected
  • Bowel or bladder problems if autonomic nerves are affected

Peripheral neuropathy may affect one nerve (mononeuropathy), two or more nerves in different areas (multiple mononeuropathy) or many nerves (polyneuropathy).

When to see a doctor
Seek medical care right away if you notice any unusual tingling, weakness or pain in your hands or feet. Early diagnosis and treatment offers the best chance for controlling your symptoms and preventing further damage to your peripheral nerves. If your symptoms interfere with your sleep or you feel depressed, your doctor or pain specialist may be able to suggest treatments that can help.

Periphreal Neuropathy Definition

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Well, in light of the progression of my neuropathy, I decided to check out more information. I went to the Mayo Clinic website and found this information. I have re-read the information in light of the new developments in my case. As with any portion of our lupus, or autoimmune journeys always talk to your doctor before starting any new treatments.

From Mayo Clinic website:

Periphreal Neuropathy

Definition

By Mayo Clinic staff

Peripheral neuropathy, a result of nerve damage, often causes numbness and pain in your hands and feet. People typically describe the pain of peripheral neuropathy as tingling or burning, while they may compare the loss of sensation to the feeling of wearing a thin stocking or glove.

Peripheral neuropathy can result from problems such as traumatic injuries, infections, metabolic problems and exposure to toxins. One of the most common causes is diabetes.

In many cases, peripheral neuropathy symptoms improve with time — especially if the condition is caused by an underlying condition that can be treated. A number of medications often are used to reduce the painful symptoms of peripheral neuropathy.

 

Nervous System Involvement in Lupus

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I am studying up on this segment of lupus and the nervous system involvement. I have found several interesting sources of information and thought it would be nice to share them with you.

The first one is is from the LFA’s website. Here is the information they have:

The Nervous System

Lupus is an autoimmune disease that can affect almost any part
of your body, including your joints, skin, kidneys, heart, lungs, or blood.
Lupus can also affect the nervous system and brain. There are several terms
doctors use to describe this: neuropsychiatric lupus (NP-SLE), neurocognitive
dysfunction, or central nervous system lupus (CNS lupus). Your nervous system
has three parts, any of which may be affected by lupus.

    • The central nervous system (CNS) consists of the brain and the
      spinal cord.
  • The peripheral nervous system (PNS) is a network of nerves that connects the
    brain and spinal cord to the rest of the body, and gives skin and muscles the
    signals needed for sensation and movement.
  • The autonomic nervous system (ANS) allows communication between spinal and
    peripheral nerves and the brain and internal organs, and controls functions like
    breathing, blood flow, and heart rate.

People with lupus can experience a number of complications when
their nervous system is affected. The symptoms may come on suddenly or may come
and go, but they will vary depending upon the location and extent of the tissue
injury. These symptoms also can be present in other diseases, so diagnosing
lupus-related nervous system disorders is often difficult.

Neurologists are the physicians who specialize in the nervous
system. They may rely on a number of diagnostic tools to determine whether lupus
is involved in your cognitive problems:

    • x-rays
  • brain scans (magnetic resonance imaging (MRI) and computed tomography (CT)
  • electroencephalograms (to capture the electrical pattern of brain activity)
  • spinal tap (to examine fluid in the spinal column)

Behavioral and cognitive tests may also be done to find out if
your memory or other mental abilities have been affected.

Depending on the symptoms, a variety of medications are
available to treat lupus-related nervous system disorders, including
non-steroidal anti-inflammatory drugs, antimalarials, and steroids. Your
response to treatment may be rapid or gradual over several months. For many
people with lupus, nervous system involvement is completely
reversible.

Central Nervous System (CNS)

When lupus affects your central nervous system, many symptoms
may occur, including:

    • headaches
  • confusion
  • fatigue
  • depression
  • seizures
  • strokes
  • vision problems
  • mood swings
  • difficulty concentrating

Drugs used to treat lupus can cause side effects that are
similar to the symptoms of CNS lupus. If you have symptoms of CNS lupus you
should consult a neurologist who can determine which symptoms are side effects
of medication and which are due to lupus. The drugs most known for causing
symptoms like those of CNS lupus are:

  • Non-steroidal anti-inflammatory drugs (NSAIDs) – may cause
    headache, dizziness, confusion, and in rare instances, meningitis-like
    symptoms
  • Antimalarials – in very high doses (not usually given for
    lupus) may cause manic behavior, seizures, psychosis
  • Corticosteroids – may cause agitation, confusion, mood swings,
    psychosis, depression
  • Anti-hypertensive medications – may cause depression or loss of
    sex drive

A serious form of lupus called CNS vasculitis may occur when
there is inflammation of the blood vessels of the brain. Characterized by high
fevers, seizures, psychosis, and meningitis-like stiffness of the neck, CNS
vasculitis is the most dangerous form of lupus involving the nervous system and
usually requires hospitalization and high doses of corticosteroids to suppress
the inflammation.

Peripheral Nervous System (PNS)

The nerves of your peripheral nervous system control your motor
responses and sensation, so symptoms of numbness or tingling, or inability to
move a part of your body, may be the result of lupus affecting these nerves.
Known as peripheral neuropathies, symptoms of PNS nerve damage are caused by
inflammation of the nerves or by compression of the nerves due to swelling in
the tissue around them. The types of symptoms you might experience
include:

    • vision problems
  • facial pain
  • ringing in the ears
  • dizziness
  • drooping of an eyelid
  • carpel tunnel syndrome

Autonomic Nervous System (ANS)

The autonomic nervous system regulates many of your body’s
functions that happen almost automatically: heart rate, blood pressure, feeling
hot or cold, bladder and bowel functions, release of adrenalin, breathing,
sweating, and muscle movement. Lupus can cause these nerve signals to be
overactive, which can lead to a wide range of symptoms:

    • numbness
  • burning
  • tingling
  • mental confusion
  • headaches
  • gastrointestinal problems such as nausea, vomiting, constipation, or
    diarrhea

Raynaud’s phenomenon

Raynaud’s phenomenon is a condition of ANS involvement caused by
inflammation of nerves or blood vessels. Blood vessels in your hands and feet go
into spasm and restrict blood flow, usually as a reaction to cold temperatures,
with the tips of the fingers or toes turning red, white, or blue. Raynaud’s can
also cause pain, numbness, or tingling in fingers and/or toes. People who have
Raynaud’s phenomenon are advised to avoid cold conditions when possible, and may
have to wear gloves or mittens when in air-conditioned surroundings.

Livedo reticularis and palmar erythema are two other skin
disorders that may affect you if you have autonomic nerve damage. Both of these
conditions can cause a bluish, lacelike mottling under your skin, especially on
your legs, giving your skin a “fishnet” look.

Cognitive Dysfunction

As many as half of all people with lupus describe feelings of
confusion, fatigue, memory loss, and difficulty expressing their thoughts. This
collection of symptoms is termed cognitive dysfunction, although many people
call it “lupus fog.”

Cognitive dysfunction most often affects people with mild to
moderately active lupus. The causes of these symptoms, and the reasons that the
symptoms tend to come and go, are not known. Living with cognitive dysfunction
can be very frustrating. However, you can learn to improve your concentration
and lessen confusion and memory loss with a variety of coping skills, including
puzzles, games, biofeedback, using a daily appointment calendar, and balancing
daily activities to reduce stress.

Lupus Headache

Compared with the general population, people with lupus may be
twice as likely to experience migraine-like lupus headaches, commonly known as
lupus headaches. The features of lupus headaches are similar to migraines and
may be seen more often in people who also have Raynaud’s phenomenon. However,
headaches can also be caused by vasculitis, a symptom of active lupus due to
inflammation of the blood vessels. If you are experiencing headaches that are
not improved by an over-the-counter headache medication, be sure to tell your
doctor
s.