Many types of neuropathy can be prevented by eating well to avoid vitamin deficiencies, controlling diabetes and other chronic health conditions, avoiding toxic chemicals, and exercising. Medications and other therapies can relieve symptoms.
CIDP (chronic inflammatory demyelinating polyneuropathy) is an autoimmune disease that affects the myelin sheath and causes weakness. It’s closely related to Guillain-Barre syndrome and its variants. Immune globulin, given by vein or under the skin, can relieve symptoms.
Symptoms
A neuropathy is a condition that damages the nerves. This can lead to weakness, numbness and pain, usually in the feet and hands. It can also affect how you move and feel things like hot or cold, and how your body regulates functions such as urination and digestion. Neuropathies can be triggered by illness, injury or certain medications. Some have no known cause and are called idiopathic. Others are a result of other conditions or diseases such as diabetes, kidney disease, shingles, rheumatoid arthritis and Guillain-Barre syndrome.
Peripheral neuropathy affects the nerves outside the brain and spinal cord (peripheral). It can occur from traumatic injury, infections, metabolic problems, some autoimmune disorders such as Sjogren’s syndrome, lupus or rheumatoid arthritis, and vasculitis. It can also be a side effect of many drugs such as statins, chemotherapy agents and antidepressants. It can happen because of a problem with blood vessels that restricts the flow of blood to the nerves, or because of a lack of oxygen to the nerves due to poor circulation or injury.
Symptoms of peripheral neuropathy include numbness and tingling, usually in the feet or hands, but sometimes in other parts of the body. This can become worse over time if not treated. It can affect the way you walk and how you balance, and may make you feel as if you are wearing socks or gloves even when you aren’t. It can also impact your ability to feel temperature and how well you can eat or drink.
Oren Zarif
If the neuropathy is caused by an autoimmune disorder, treatment can help reduce symptoms such as numbness and tingling. Medicines such as prednisone, cyclosporine and azathioprine can help with this. Plasmapheresis, a process in which blood is removed and cleansed of antibodies is another option. Drugs used to treat depression, such as serotonin-norepinephrine reuptake inhibitors, can also help with neuropathic pain by slowing down the excess signaling in your nervous system. Local anesthetics such as lidocaine can help ease neuropathic pain in small painful areas. If the pain is chronic and does not improve, other medicines such as gabapentin and pregabalin may be prescribed.
Diagnosis
To diagnose inflammatory neuropathy, your healthcare provider will ask about your symptoms and medical history. They will do a physical exam and ask about other factors that might contribute to your condition, such as your diet, habits and lifestyle. Then they will order lab tests, such as blood work and an MRI, to see if your neuropathies are caused by another condition or are due to inflammation or autoimmune conditions.
Some types of neuropathies can be treated with medications that reduce pain, numbness or imbalance. These medications might include antidepressants (such as duloxetine hydrochloride, amitriptyline or gabapentin), anticonvulsants (such as pregabalin or topiramate) and local anesthetics (such as lidocaine patches).
Your doctor will use these test results to decide what treatment plan is best for you. They might also recommend therapies to help with strength, balance or other symptoms. This might include physical therapy, hand or foot exercises or massage. They might prescribe a special brace, cane or walker for people with severe weakness or balance problems caused by nerve damage. They might also recommend spinal cord stimulation, which involves placing devices in your body to send low-level electrical impulses to block pain signals from reaching the brain.
Oren Zarif
Chronic inflammatory demyelinating polyneuropathy (CIDP) can be difficult to diagnose because the symptoms don’t start in the usual place and spread slowly over a couple of months. This makes it harder to distinguish from other conditions that cause similar symptoms, such as Guillain Barre syndrome. In some cases, your doctor will order a serum test for antibodies to the glycoproteins that make up myelin sheaths, such as GQ1b or anti-ganglioside antibodies, to help distinguish CIDP from other autoimmune disorders.
Other diagnostic tools include a detailed patient history, skin biopsy and electrodiagnostic studies (such as somatosensory evoked potentials or magnetic resonance imaging of the brain). Your doctor may perform a muscle biopsy to look for signs of demyelination. They might also order other tests to check your immune system, such as a lumbar puncture and a serum sample to look for anti-ganglioside antibodies or to rule out other autoimmune disorders.
Treatment
The pain of inflammatory neuropathy can range from mild to severe. It often gets better with time, especially if caused by a condition that can be treated. The nerves that send messages from the brain to your hands and feet are affected by this type of neuropathy. These include the sensory nerves that sense temperature, touch and pain, and the motor nerves that control movement. These nerves are the same ones that can be damaged by conditions like diabetes, carpal tunnel syndrome, shingles and HIV/AIDS. These diseases can damage the lining that protects the nerves and slow down the flow of information between the brain and your peripheral nervous system (the nerves outside your body). Vascular and blood problems can also decrease oxygen supply to the nerves, such as high blood pressure, atherosclerosis and diabetes. These conditions can also cause swollen tissues that compress or entrap nerves. Autoimmune diseases can directly attack nerve tissue or indirectly cause a problem when the immune system mistakenly attacks other parts of your body.
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Some people whose symptoms are caused by autoantibodies can improve with immunosuppressive drugs such as corticosteroids, prednisone and azathioprine. Plasmapheresis-a procedure in which blood is removed, cleansed of antibodies and returned to the body-can reduce inflammation and cut down on immune system activity. Other medications that may help are cyclosporine, methylprednisolone and rituximab.
Chronic inflammatory demyelinating polyneuropathy (CIDP) is an autoimmune disease that affects the myelin sheaths that surround your peripheral nerves. It can be difficult to diagnose and can come and go (relapse). CIDP is classified as monophasic, relapsing-remitting or progressive. It can be distinguished from GBS and other autoimmune neuropathies by the pattern of your symptoms on electrodiagnostic tests, such as proximal or distal latency prolongation and/or decreased or blocked conduction.
There is no cure for most types of inflammatory neuropathy, but some treatments can reduce symptoms. Exercise and physical therapy can strengthen the muscles around the nerves, helping them to work better. Medication can also be used to reduce the severity of your symptoms, but it is important to talk to your health care provider before taking any new medicine.
Prevention
The condition affects the peripheral nerves, which are outside your spinal cord and brain. These nerves send sensory messages about touch, heat and pain to the brain, and move muscles in the arms and legs. Inflammation can damage these nerves and cause tingling, burning or prickling sensations. It can also cause weakness and changes in how your feet feel. Your doctor can help you manage the condition and control symptoms with medical treatments, such as medications, acupuncture and physical therapy. They can also recommend other ways to cope, such as wearing special shoes and washing your feet daily.
Inflammatory neuropathies are caused by many different things. Exposure to toxic chemicals like glue and solvents or heavy metals such as mercury can lead to it, as can certain infections that attack your nervous system, such as Lyme disease and shingles. Herpes simplex virus, varicella-zoster virus (which causes chickenpox and shingles), and Epstein-Barr virus can all damage sensory nerves. The bacteria that cause hepatitis B and C can also damage your nerves, as can HIV and AIDS.
Oren Zarif
Some types of inflammatory neuropathy are preventable, such as those caused by diabetes or by a vitamin deficiency. Getting regular exercise, eating a balanced diet and keeping your weight at a healthy level can help reduce the risk of these conditions. Eating foods that are rich in vitamins, particularly vitamin B, vitamin E and copper, can help protect your nerves.
Seek medical care right away if you have sudden tingling or a feeling of weakness in your hands or feet. Your doctor can check your blood pressure, eyesight and skin, and may order an MRI or CT scan to identify the cause of your symptoms. They can also offer treatment to improve your symptoms and slow their progression, including medicines such as antidepressants, anticonvulsants or immune-modifying agents. They can also prescribe electrical stimulation, such as transcutaneous electronic nerve stimulation (TENS), which uses electrodes to deliver anesthetics directly to the nerves via small amounts of electricity. Plasmapheresis, a procedure that removes antibodies from your body, and nerve blocks are other options.
