Chief Causes of Neuropathy

Today's post is the second of three articles this week, from footpaincenter.com (see link below) the blog of Dr. Marc Spitz, who has been featured on this blog before and has extensive experience of neuropathic foot problems. He has his own Foot Pain Center in California and although advertising is strongly discouraged on this blog (in the interests of objectivity), there is no arguing with Dr Spitz's information which can be very helpful for many neuropathy sufferers. If you wish to follow up on his site or any of the products he mentions, please copy and paste the link below.
In this clearly explained article, he lists the most common causes of neuropathy (there are more than a hundred in total). It's important to realise that although you may be HIV positive, your neuropathy may come from another source. Doctors often find it very difficult to establish the true cause, although problems like diabetes, or post-chemotherapy side-effects can be strong indicators.

Causes of Neuropathy-Let Me Count the Ways

Posted on May 6, 2012 by admin

Peripheral neuropathy is due to damage to the nerve cells and nerve fibers. Nerve can be damaged in two ways: The cover of the nerve, the myelin sheath, can be stripped away or the “tail” of the nerve, the axon, can be destroyed. Peripheral neuropathy is usually an acquired condition but in some cases it may be inherited.

Diabetic Neuropathies
Diabetes is the most common cause of peripheral neuropathy. It is estimated that approximately 70 percent of all persons with diabetes develop some form of peripheral neuropathy.

Neuropathies Caused by Chemotherapy
The development of peripheral neuropathy following chemotherapy treatment is a fairly common occurrence. Chemotherapy agents that aggressively “attack” cancer cells often have a neurotoxic effect, damaging the nerve cells as well. The extent of nerve damage depends on the cumulative dose and the type of drugs used.

Neuropathy Caused by Spinal Problems
The nerves of the lower spinal column innervate the feet. Damage of the spinal column, causing spinal stenosis (narrowing of the spine) or protruding vertebral discs can “pinch” the nerves of the spinal cord causing pain, burning, numbness and tingling sensations in the feet

Neuropathy Caused by Excessive Alcohol Intake
Prolonged and excessive use of alcohol will invariably have a toxic effect on the nerve tissue. Studies have shown that the incidence of alcoholics who develop peripheral neuropathy ranges from 25 to 50 percent. Nutritional deficiencies often associated with alcohol abuse can exacerbate neuropathy symptoms.

Neuropathies Caused by Toxins and Drugs
As noted previously, exposure to certain toxins such as arsenic, lead, mercury, thallium, chemical solvents and nitrous oxide, can cause nerve damage. Some insecticides may also cause peripheral neuropathies symptoms. Certain anticonvulsant, antiviral and antibiotic drugs man result in pain, burning, tingling and numbness.

Neuropathies Caused by Nutritional Imbalance
Deficiencies of vitamins B12 (cobalamin), B1(thiamine), B6 (pyridoxine) or vitamin E can cause peripheral neuropathy symptoms. Vitamin B12 plays an important role in neurologic function. It should also be noted that overuse of some vitamins may actually cause peripheral. This includes taking mega-doses of B6 and B12. Caution should also be used when taking higher doses of vitamin E as well, since this is a fat-soluble vitamin and can accumulate in the body’s tissue.

Neuropathies Caused by Infection
It is estimated that nearly one-third of people with HIV/AIDS experience peripheral neuropathy. Nerve damage can be caused by the medication, the actual virus or a combination of both.

Neuropathies Caused by Autoimmune Diseases
An autoimmune disease is a condition in which the immune system destroys or attacks its own bodily tissues. Rheumatoid arthritis, Systemic lupus erthematosus and Guillian-Barre syndrome are autoimmune disease that is linked to peripheral neuropathy. Chronic inflammatory demyelinating polyneuropathy(CIDP) is thought to be another form of this syndrome.

Neuropathies Caused by Cancer
Different types of cancers can have varying effects on nerves. Multiple myeolma is type of cancer that affects the plasma cells in the bone marrow. It can cause destruction to the axon part of the nerve cell. Certain blood cancers—chronic lymphocytic leukemia and lymphoma—can also cause peripheral nerve damage.

Neuropathy Caused by Hereditary Conditions:
Charcot-Marie-Tooth is the most commonly inherited neurological disorder. Damage to the nerves is caused by gene mutation.

Neuropathy Caused by Injury
Injury or excessive pressure on a particular nerve can result in nerve damage causing peripheral neuropathy symptoms. Carpal Tunnel and tarsal tunnel are common neuropathies as a result of injury or repetitive motion.

Idiopathic Neuropathies
Neuropathies in which no specific cause can be identified are called idiopathic neuropathies.

http://www.footpaincenter.com/blog/?m=201205

Symptoms And Causes Of Neuropathy

Today's post from mayoclinic.org (see link below) is a no frills, simple neuropathy 123 description of the disease, its symptoms and its causes. You can use it to educate yourself, or friends, family and co-workers and to build up enough basic knowledge to at least have a sensible discussion with your doctor or neurologist. It's amazing how much more respect you get from doctors if you've done a little homework and it enables them to get down to the nitty gritty of treatment without spending too much time on explanation.

Peripheral neuropathy Symptoms and causes
By Mayo Clinic Staff 2016

Symptoms

Every nerve in your peripheral system has a specific function, so symptoms depend on the type of nerves affected. Nerves are classified into:
 
Sensory nerves that receive sensation, such as temperature, pain, vibration or touch, from the skin
Motor nerves that control muscle movement
Autonomic nerves that control functions such as blood pressure, heart rate, digestion and bladder

Signs and symptoms of peripheral neuropathy might include:
 
Gradual onset of numbness, prickling or tingling in your feet or hands, which can spread upward into your legs and arms
Sharp, jabbing, throbbing, freezing or burning pain
Extreme sensitivity to touch
Lack of coordination and falling
Muscle weakness or paralysis if motor nerves are affected

If autonomic nerves are affected, signs and symptoms might include: 
 
Heat intolerance and altered sweating
Bowel, bladder or digestive problems
Changes in blood pressure, causing dizziness or lightheadedness

Peripheral neuropathy can affect one nerve (mononeuropathy), two or more nerves in different areas (multiple mononeuropathy) or many nerves (polyneuropathy). Carpal tunnel syndrome is an example of mononeuropathy. Most people with peripheral neuropathy have polyneuropathy.
When to see a doctor

Seek medical care right away if you notice unusual tingling, weakness or pain in your hands or feet. Early diagnosis and treatment offer the best chance for controlling your symptoms and preventing further damage to your peripheral nerves.

Causes

Not a single disease, peripheral neuropathy is nerve damage caused by a number of conditions. Causes of neuropathies include: 

Alcoholism. Poor dietary choices made by people with alcoholism can lead to vitamin deficiencies. 

Autoimmune diseases. These include Sjogren's syndrome, lupus, rheumatoid arthritis, Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy and necrotizing vasculitis. 

Diabetes. More than half the people with diabetes develop some type of neuropathy.

Exposure to poisons. Toxic substances include heavy metals or chemicals.
Medications. Certain medications, especially those used to treat cancer (chemotherapy), can cause peripheral neuropathy.

Infections. These include certain viral or bacterial infections, including Lyme disease, shingles, Epstein-Barr virus, hepatitis C, leprosy, diphtheria and HIV.
Inherited disorders. Disorders such as Charcot-Marie-Tooth disease are hereditary types of neuropathy.

Trauma or pressure on the nerve. Traumas, such as from motor vehicle accidents, falls or sports injuries, can sever or damage peripheral nerves. Nerve pressure can result from having a cast or using crutches or repeating a motion such as typing many times.

Tumors. Growths, cancerous (malignant) and noncancerous (benign), can develop on the nerves or press nerves. Also, polyneuropathy can arise as a result of some cancers related to the body's immune response. These are a form of paraneoplastic syndrome.

Vitamin deficiencies. B vitamins — including B-1, B-6 and B-12 — vitamin E and niacin are crucial to nerve health.

Bone marrow disorders. These include abnormal protein in the blood (monoclonal gammopathies), a form of bone cancer (osteosclerotic myeloma), lymphoma and amyloidosis.

Other diseases. These include kidney disease, liver disease, connective tissue disorders and an underactive thyroid (hypothyroidism).

In a number of cases, no cause can be identified (idiopathic).

Risk factors
Peripheral neuropathy risk factors include:
Diabetes mellitus, especially if your sugar levels are poorly controlled
Alcohol abuse
Vitamin deficiencies, particularly B vitamins
Infections, such as Lyme disease, shingles, Epstein-Barr virus, hepatitis C and HIV
Autoimmune diseases, such as rheumatoid arthritis and lupus, in which your immune system attacks your own tissues
Kidney, liver or thyroid disorders
Exposure to toxins
Repetitive motion, such as those performed for certain jobs
Family history of neuropathy
Complications

Complications of peripheral neuropathy can include: 
 
Burns and skin trauma. You might not feel temperature changes or pain on parts of your body that are numb.
Infection. Your feet and other areas lacking sensation can become injured without your knowing. Check these areas regularly and treat minor injuries before they become infected, especially if you have diabetes mellitus.
Falls. Weakness and loss of sensation may be associated with lack of balance and falling.

http://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/dxc-20204947

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ER Stress Causes Neuropathic Pain

Today's post from sciencedaily.com (see link below) has an optimistic title and an even more optimistic introduction but in the end we're still a long way from putting the findings here into practise. Scientists have found that the biological process called endoplasmic reticulum stress, or ER stress, is a significant cause of nerve pain and the conclusion is that finding drugs to block this stress from happening will provide a breakthrough in the treatment of neuropathy. So what is endoplasmic reticulum stress? Well, it's a highly complex process at cellular level which maintains cellular health. When it's disturbed, all sorts of things can go wrong, including nerve pain. I know, that's not an explanation by anyone's standards but you try Googling it and making sense of your findings! You really have to be a molecular scientist to understand how it works, so in the meantime, we have to trust in this article and believe that what they've found is important and maybe revolutionary for people suffering from neuropathic pain. If anyone can provide a simple explanation regarding ER stress, that everyone will understand, please let us know.
 

Key mechanism that causes neuropathic pain found 
Date:July 7, 2015 Source:University of California - Davis

Scientists at the University of California, Davis, have identified a key mechanism in neuropathic pain. The discovery could eventually benefit millions of patients with chronic pain from trauma, diabetes, shingles, multiple sclerosis or other conditions that cause nerve damage.

A biological process called endoplasmic reticulum stress, or ER stress, is the significant driver of neuropathic pain, said lead researchers Bora Inceoglu of the UC Davis Department of Entomology and Nematology and UC Davis Comprehensive Cancer Center, and Ahmed Bettaieb, Department of Nutrition. The work is published July 6 in the journal Proceedings of the National Academy of Sciences.

"This is a fundamental discovery that opens new ways to control chronic pain," said co-author Bruce Hammock, distinguished professor at the UC Davis Department of Entomology and Nematology and the UC Davis Comprehensive Cancer Center.

"We can now specifically search for agents to control ER stress and its downstream pathways," Hammock said. "This search is already underway in a number of laboratories working on cancer and other diseases."

Working with Professor Fawaz Haj of the UC Davis nutrition department, Bettaieb found that key molecular signatures associated with diabetes and diabetic pain were linked to ER stress. Neuropathic pain is a common consequence of both Type 1 and Type 2 diabetes, affecting up to 70 percent of patients.

Inceoglu, working in Hammock's laboratory, showed that neuropathic pain could be initiated by compounds that cause ER stress and reversed by agents that block it.

The researchers had previously shown that a class of natural bioactive lipids has powerful analgesic effects in the body. These analgesic lipids are broken down in the body by an enzyme, soluble epoxide hydrolase. The team was able to show that blocking soluble epoxide hydrolase blocks ER stress and associated neuropathic pain.

The work sheds new light onto at least one biological process that mediates neuropathic pain, Inceoglu said. With this knowledge, researchers can now test ER-stress blocking drugs in the clinic, and carry out fundamental research on how different types of pain grouped under the name "neuropathic" differ from each other and respond to new drugs.

The study provides convincing evidence for a novel concept as to what causes neuropathic pain said John Imig, professor of pharmacology and toxicology at the Medical College of Wisconsin, Milwaukee, who was not involved in the study. The work provides new opportunities for drugs or drug combinations to treat chronic pain, he said.

Story Source:

The above post is reprinted from materials provided by University of California - Davis. Note: Materials may be edited for content and length.

Journal Reference:
Bora Inceoglu, Ahmed Bettaieb, Carlos A. Trindade da Silva, Kin Sing Stephen Lee, Fawaz G. Haj, Bruce D. Hammock. Endoplasmic reticulum stress in the peripheral nervous system is a significant driver of neuropathic pain. Proceedings of the National Academy of Sciences, 2015; 201510137 DOI: 10.1073/pnas.1510137112

http://www.sciencedaily.com/releases/2015/07/150707093353.htm