1. Presented By:
Kevin Sirman
Robin Carlson
A Neuropathy Association Support Group

2. Hahnemann Chapter
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3.  The information on this power point
presentation or guidance provided is
intended to be educational and informative
and not medically prescriptive or diagnostic.
All patients are encouraged to consult with
their own medical doctor when considering
any information contained on our support
group presentation.
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4.  Neuropathy is a disorder resulting from injury to
the peripheral nerves – the motor, sensory and
autonomic nerves. The main function of the
peripheral nervous system is to connect
the central nervous system (CNS) to the limbs
and organs.
 Unlike the CNS, the PNS is not protected by
the bone of spine and skull, or by the blood
brain barrier, leaving it exposed to toxins and
mechanical injuries.
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5.  The deterioration of the peripheral nerves
disrupts the body’s ability to communicate
with its muscles, organs and tissues.
 Neuropathy is like the body’s wiring system
going haywire, causing unusual or unpleasant
irritations including tingling, burning,
itchiness, crawling sensation, dizziness,
clumsiness and many many more!
 If ignored, as this is done often these
symptoms can lead to numbness at one
extreme to unremitting pain at the other.
 It can come and go, slowly progress over
many years or become severe and
debilitating.
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6.  Rare not at all! It is estimated that up to 20
million Americans have it.
 The full extent of and importance of it have
not been recognized.
 Often it is misdiagnosed or thought of merely
as a side effect of another disease such as
diabetes or cancer or even kidney failure.
 It can occur at any age however it is more
common among older adults.
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7.  At first you might feel numbness or stabbing
or burning in your feet.
 Sock Sensation – Your feet feel like they have
socks on but they are bare.
 It gradually spreads to your legs and hands.
 You find it harder to walk, your legs feel
heavy and you have to drag yourself up the
stairs!
 You lose your balance and stumble on things.
 As for your hands you think your keys are
gripped tight and you drop them!
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9.  Electrodiagnositic Tests
1. Nerve Conduction Studies - evaluates how
the nerves transmit electrical stimuli.
2. Electromyography – (EMG) measures the
electrical activity of muscles in response to
nerve stimulation.
 Skin Biopsy – Small Fiber Neuropathy cannot
be diagnosed with EMG and nerve conduction
studies that only measure the large fibers.
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10.  Autonomic Tests – The Quantitative Sudomotor Axon
Reflex Test (QSART) measures the autonomic nerve
fibers that stimulate sweating. This is a tilt table
test which measures your changes in blood pressure
and pulse from prone to vertical positions. It also
detects autonomic nerve involvement.
 Nerve Biopsy – A Nerve Biopsy provides tissue for
pathological examination. It will show if vasculitis or
inflammation of the blood vessels as well as
deymyelination that is missed by electrodiagnostic
studies. Vasculitis can decrease the oxygen supply to
the peripheral nerves and will quickly cause damage
to nerve tissues.
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11.  In addition to procedures, your neurologist may
order a number of blood and urine tests as well
as radiologic tests in order to help find the cause
of your neuropathy.
 These include tests for:
 Diabetes
 Autoimmunity
 Infections
 Nutritional Deficiencies
 Toxins
 Hereditary Conditions
 Certain Cancer and Cancer Treatments
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12. Peripheral neuropathy (or neuropathy) has
reached epidemic proportions, impacting over
20 million Americans. According to the
National Institute of Neurological Disorders and
Stroke, “More than 100 types of neuropathy
have been identified, each with its own
characteristic set of symptoms, pattern of
development, and prognosis.” And, although
there are more questions about the various
neuropathies than there are answers, we are
learning more and more about this devastating
disease every day.
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13.  Autonomic Neuropathy
 Cancer-Related Neuropathies
 Compressive Neuropathies
 Diabetic Neuropathy
 Drug-Induced and Toxic Neuropathy
 G.I. and Nutrition-Related Neuropathies
 Hereditary Neuropathies
 Immune-Mediated and CIDP
 Infectious Diseases and Neuropathy
 Neuropathic Pain
 Chemotherapy Induced Neuropathy
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15.  Tacrolimus has been often described to
induce neuropathy in liver-, pancreas-, and
renal-transplanted patients. There is a report
the first case of a 56-year-old woman who
developed a progressive symmetric
demyelinating sensorimotor polyneuropathy
in the distal muscles of the lower limbs after
therapy with tacrolimus because of heart
transplantation. This condition suddenly
reverted after the tacrolimus was stopped.
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16.  Heartdisease and high blood pressure are
sometimes treated with drugs that can
induce peripheral neuropathy, such as
amiodarone, hydralazine, perhexiline and
indapamide, which is sold as Lozol.
 Statins
such as Zocor, Crestor, Lipitor have
been linked to Neuropathy
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17. Deficiencies in Vitamins! Especially
B-12! But, B-6 in high doses can
damage nerves!
Foot Care – You need podiatrist for foot checkups and
additional foot care. Autonomic Neuropathy causes dry
skin which can crack. There are many other reasons for
a podiatrist checkup and we will discuss this later.
Diabetic Neuropathy – Glycemic Control is most
important. Gender may be a differential factor
depending upon the type of neuropathy.
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18.  Thefollowing list are standard medications
prescribed for those with Neuropathy
In addition to these Gabapentin Oxycodone,
medications there are
Metanx Hydrocodone and
ointments and creams
Cymbalta as well as other
used by patients.
opiates are often
Biofreeze, Capsaicin, Lyrica prescribed for
Zostrix along with RX
Amitriptyline neuropathy pain.
Compounding Creams
Patients have described getting relief from rebuilders,
acupuncture, reflexology and anodyne light therapy. In
more severe cases of Neuropathy patients have turned to
Plasmapheresis.
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19. Awareness: Increase public awareness of the nature and
extent of peripheral neuropathy.
Education: Educate the public and
healthcare providers on the need for early
intervention.
Support: Support patients by providing platforms
for exchanging information and experiences
Advocacy: Urge legislators, government agencies and medical
providers to deliver proper coverage, care and treatment for
people with peripheral neuropathy
Research: Encourage the funding if research to
understand peripheral neuropathy’s causes, develop
more effective therapies, and ultimately find cures for
neuropathy.
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21. Parts of this Powerpoint have been taken from information provided
by The Neuropathy Association.
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