Common Testing Tools For Neuropathy

Today's post from painhq.org (see link below) is another article highlighting the commonest diagnosis/testing tools with regard to neuropathy. This is especially useful for people who have been told they probably have neuropathy but must undergo certain tests to establish that. Hopefully, your doctor will listen carefully to your story and conclude that there's enough evidence to diagnose nerve damage but many doctors (and insurance companies) require more than that - scientific proof. Unfortunately, even these tests can't prove neuropathy 100% but they are an accepted part of the process you go through. By the way, you're entitled to ask your doctor why you're having certain tests and not others. That may be perfectly reasonable but you deserve an explanation as to why.

How is neuropathic pain diagnosed?
Last updated August 5, 2014
 
Diagnosing neuropathy is often difficult because the symptoms are highly variable. A thorough neurological examination is usually required and involves taking an extensive patient history (including the patient’s symptoms, work environment, social habits, exposure to any toxins, history of alcoholism, risk of HIV or other infectious disease, and family history of neurological disease), performing tests that may identify the cause of the neuropathic disorder, and conducting tests to determine the extent and type of nerve damage.

A general physical examination and related tests may reveal the presence of a systemic disease causing nerve damage. Blood tests can detect diabetes, vitamin deficiencies, liver or kidney dysfunction, other metabolic disorders, and signs of abnormal immune system activity. An examination of cerebrospinal fluid that surrounds the brain and spinal cord can reveal abnormal antibodies associated with neuropathy. More specialized tests may reveal other blood or cardiovascular diseases, connective tissue disorders, or malignancies. Tests of muscle strength, as well as evidence of cramps or fasciculations, indicate motor fiber involvement. Evaluation of a patient’s ability to register vibration, light touch, body position, temperature, and pain reveals sensory nerve damage and may indicate whether small or large sensory nerve fibers are affected.

Based on the results of the neurological exam, physical exam, patient history, and any previous screening or testing, additional testing may be ordered to help determine the nature and extent of the neuropathy.

Computed tomography, or CT scan, is a noninvasive, painless process used to produce rapid, clear two-dimensional images of organs, bones, and tissues. X-rays are passed through the body at various angles and are detected by a computerized scanner. The data is processed and displayed as cross-sectional images, or "slices," of the internal structure of the body or organ. Neurological CT scans can detect bone and vascular irregularities, certain brain tumors and cysts, herniated disks, encephalitis, spinal stenosis (narrowing of the spinal canal), and other disorders.

Magnetic resonance imaging (MRI) can examine muscle quality and size, detect any fatty replacement of muscle tissue, and determine whether a nerve fiber has sustained compression damage. The MRI equipment creates a strong magnetic field around the body. Radio waves are then passed through the body to trigger a resonance signal that can be detected at different angles within the body. A computer processes this resonance into either a three-dimensional picture or a two-dimensional "slice" of the scanned area.

Electromyography (EMG) involves inserting a fine needle into a muscle to compare the amount of electrical activity present when muscles are at rest and when they contract. EMG tests can help differentiate between muscle and nerve disorders.

Nerve conduction velocity (NCV) tests can precisely measure the degree of damage in larger nerve fibers, revealing whether symptoms are being caused by degeneration of the myelin sheath or the axon. During this test, a probe electrically stimulates a nerve fiber, which responds by generating its own electrical impulse. An electrode placed further along the nerve’s pathway measures the speed of impulse transmission along the axon. Slow transmission rates and impulse blockage tend to indicate damage to the myelin sheath, while a reduction in the strength of impulses is a sign of axonal degeneration.

Nerve biopsy involves removing and examining a sample of nerve tissue, most often from the lower leg. Although this test can provide valuable information about the degree of nerve damage, it is an invasive procedure that is difficult to perform and may itself cause neuropathic side effects. Many experts do not believe that a biopsy is always needed for diagnosis.

Skin biopsy is a test in which doctors remove a thin skin sample and examine nerve fiber endings. This test offers some unique advantages over NCV tests and nerve biopsy. Unlike NCV, it can reveal damage present in smaller fibers; in contrast to conventional nerve biopsy, skin biopsy is less invasive, has fewer side effects, and is easier to perform.

https://www.painhq.org/learning/knowledge-base/category/clinical-assessment/neuropathic-pain-overview/how-is-neuropathic-pain-diagnosed

Common Signs That You May Have Nerve Damage

Today's post from prevention.com (see link below) is a good one to start the new year for people experiencing strange, new symptoms that they can't explain. It's a good reference to use before going to your doctor because if you're suffering from these physical symptoms, then at least you'll have a pretty good idea that they're nerve related and possibly evidence of nerve damage...or neuropathy. What's most useful about this list of symptoms is that it doesn't just concentrate on the most commonly known pain, tingling or numbness in the feet but also looks at a wide range of symptoms which indicate 'autonomic' neuropathy. Autonomic neuropathy is where nerve damage has affected some or all of the involuntary functions of the body we take for granted (such as breathing, digestion, sexual performance, and many others and can be a source of great confusion for both patients and doctors alike, who assume those symptoms indicate other conditions. With over 100 sorts of neuropathy and over 100 causes, it remains one of the most frustrating and life-changing ailments, so this list is a place from which to begin your questions and research, even before going to see the doctor. No reason to panic but a little knowledge goes a long way when faced with a new medical problem!

8 Signs You Might Have Nerve Damage
By Crystal Harlan November 7, 2016
 


Sebastian Kaulitzki/Shutterstock

There are tens of thousands of nerves in your body. Most of them, your peripheral nerves, are like branches of a tree that spread out all over and transmit messages back to the "trunk"—your brain and spinal cord. When everything goes smoothly, your brain gets the info it needs so that you can move your muscles, recognize pain, and keep your internal organs working properly. But when peripheral nerves get damaged, it's another story: Walking could become challenging, you might experience unrelenting pain, or you could end up with a serious injury because you had no idea how hot that stove was.

An estimated 20 million Americans suffer from peripheral nerve damage, aka neuropathy, according to the National Institute of Neurological Disorders and Stroke. "Diabetes is the No. 1 cause. Bad luck [meaning you inherited an anatomical defect] is number two. Repetitive motion and Lyme disease follow," says Andrew Elkwood, MD, a surgeon who specializes in nerve reconstruction at The Institute for Advanced Reconstruction in New York and New Jersey.

Other causes include aging, vitamin deficiencies, exposure to toxins (including alcohol and cancer medications), and infections and autoimmune disorders like hepatitis C, diphtheria, HIV, Epstein-Barr, rheumatoid arthritis, and Guillain-Barré Syndrome. Meanwhile, about 30% of neuropathy cases are "idiopathic," meaning there's no known cause.

The good news is that nerve damage generally develops slowly, says Isha Gupta, MD, a neurologist at IGEA Brain and Spine in New York and New Jersey. That means you might be able to treat it before it worsens—but getting the right diagnosis isn't always easy. Your best shot? See a doctor right away if you have any of the following symptoms. (Make 2017 YOUR year by taking charge of your health and jump-starting your weight loss with the Prevention calendar and health planner!)


You have numbness, tingling, or burning.

1/8 memorisz/Shutterstock

You have numbness, tingling, or burning.


This sensation may radiate from your hands or feet into your arms or legs. "Compression of sensory nerves (often while sleeping) is relatively common, and symptoms such as numbness or tingling can be temporary," says Gupta. But if the pins-and-needles feeling doesn't go away, get it checked out.

It's difficult or impossible to move part of your body.

2/8 Mycteria/Shutterstock

It's difficult or impossible to move part of your body.


"If motor nerves are affected, then weakness or even paralysis may occur," says R. Glenn Smith, MD, PhD, a neurologist at Houston Methodist. These same symptoms could also indicate that there's an underlying issue that needs urgent attention, so it's best to head to the ER. If it turns out that you're actually having a stroke, you'll need medical attention ASAP.

You have pain running down just one leg.

3/8 Sebastian Kaulitzki/Shutterstock

You have pain running down just one leg.


A constant sharp pain, burning, or tingling that starts in the lower back and travels down the back of your leg could mean that you have sciatica—meaning that your sciatic nerve has become compressed, perhaps thanks to a slipped or worn down disc in your spine.

 You're way clumsier than usual.

4/8 jiw ingka/Shutterstock

You're way clumsier than usual.


Suddenly stumbling and falling a lot? "If large nerves affecting sensation are damaged, then lack of coordination and failure to sense position of the body can lead to falls," says Smith. It might also turn out that you have a condition like Parkinson's, in which the nerve cells in your brain have become damaged.

You're running to the bathroom all the time.

5/8 Momoforsale/Shutterstock

You're running to the bathroom all the time.


Damaged nerves can send your bladder faulty messages, so you feel like you have to pee a lot or have trouble making it to the restroom in time. You have a higher than average risk of this problem if you gave birth to a child vaginally or have diabetes.

You get brief, intense headaches that feel like electric shocks.

6/8 andrei simonenko/Shutterstock

You get brief, intense headaches that feel like electric shocks.


You may have something called occipital neuralgia, a condition that can occur when a nerve in your neck gets pinched. You may need a nerve block—an injection that temporarily blocks the troublesome nerve from transmitting pain signals.

You're sweating too much or too little.

7/8 werayuth tes/Shutterstock

You're sweating too much or too little.


It might be a sign that the nerves carrying info from your brain to your sweat glands have become compromised. Your doctor might order tests to measure your sweating and heart rate.


You got injured because you didn't feel something you should have.

8/8 Corbac40/Shutterstock

You got injured because you didn't feel something you should have.

Sensory nerves are supposed to tell your brain that a surface is dangerous in some way, and if they're not doing their job properly you could seem more accident-prone. If you have burns, cuts, or other trauma because you didn't realize that you were touching something hot, sharp, or otherwise uncomfortable, see your doc, says Smith.

http://www.prevention.com/health/8-signs-you-might-have-nerve-damage/slide/8

WEAR SUN GLASSES TO PREVENT COMMON EYE DISEASES

If your job leads to spending most of the time outdoors, do not forget to wear sunglasses as it can save you from developing a common eye disease.

According to a study, residential geography, time spent in the sun and whether or not sunglasses are worn may help explain why some people develop exfoliation syndrome (XFS), an eye condition that is a leading cause of secondary open-angle glaucoma and can lead to an increased risk of cataract.

“Lifetime outdoor activities may contribute to XFS so a more widespread use of UV-blocking eyewear can help prevent XFS,” said lead study author Louis Pasquale, as associate professor of ophthalmology at Harvard Medical School (HMS).

Researchers conducted a clinic-based, case-control study in the US and Israel, involving XFS cases and control individuals.

They measured weighted lifetime average latitude of residence and average number of hours per week spent outdoors as determined by validated questionnaires.

They found that genetic or environmental factors also contribute to XFS.

Previous studies have shown that residential (geographic) history and extent of solar exposure may be important risk factors for XFS.

The study appeared in the journal Ophthalmology.