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Screening and diagnosis: Small Fiber Neuropathy can be tested by
a skin biopsy.
Please read Dr Katzs opinion on skin biopsy
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Autonomic neuropathy
Small fiber neuropathy Treatment
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- system
- Autoimmune diseases, in which your
immune system attacks and damages parts of your body, including
your nerves
- Some tumors, which can press on nerves
and cause direct or remote damage (paraneoplastic syndrome)
- Multiple system atrophy, a degenerative
disorder that destroys the nervous system
- Surgical or traumatic injury to nerves,
injury can be from a car accident.
- Other chronic illnesses such as
Parkinson's disease and HIV/AIDS
- Celiac
disease more info
For treatment of small fiber Neuropathy continue to
page-2
Treatment
Treatment for autonomic neuropathy depends on the underlying
cause and the particular signs and symptoms you're experiencing. For
example, if the underlying cause is diabetes or an autoimmune
disease, treatment will focus on modulating your immune system and
decreasing inflammation. By using IVIg both autonomic and diabetic
neuropathy can be treated. You will first need to fix your vitamin
or nutrition deficiency.
The goal of treatment is to manage the underlying condition,
repair nerve damage, if possible, and provide symptom relief.
Medications The type of medication your doctor may prescribe depends on your
symptoms.
- Gastrointestinal symptoms.
Your doctor may prescribe metoclopramide (Reglan, Metoclopramide
HCL), which helps your stomach empty more rapidly by increasing
the contractions of the stomach and intestines. Possible side
effects include diarrhea when taken in high doses, drowsiness
and restlessness. Other medications include fiber supplements
such as psyllium (Metamucil) or methylcellulose (Citrucel) to
relieve constipation and tricyclic antidepressants such as
imipramine (Tofranil) and amitriptyline for diarrhea and
abdominal pain. Possible side effects of tricyclic
antidepressants include orthostatic hypotension, drowsiness,
urinary retention, constipation and dry mouth.
- Sexual dysfunction.
Your doctor may prescribe sildenafil (Viagra), vardenafil (Levitra)
or tadalafil (Cialis) for erectile dysfunction. Possible side
effects include flushing, indigestion and headache. Don't take
these medications if you've had a heart attack, stroke or
life-threatening heart rhythm in the previous six
months.Treatmentsfor vaginal dryness include vaginal estrogen
cream (Premarin, Estrace), which you insert into your vagina
with an applicator two or three times a week, and vaginal
estrogen rings (Estring), which releases estrogen for 90 days.
- Bladder problems.
Bethanechol (Urecholine) helps cause urination and emptying of
the bladder. Possible side effects include dizziness,
lightheadedness or fainting. Your doctor may prescribe an
antibiotic to clear up a urinary tract infection.
- Postural hypotension.
If you get dizzy or feel faint from a drop in blood pressure
when you get up, your doctor may prescribe medication, a
high-salt diet or support stockings. He or she may prescribe
fludrocortisone acetate (Florinef) to help your body retain salt
or recommend a blood pressure regulator such as midodrine (ProAmatine).
Possible side effects of midodrine include blurred vision,
headache and pounding in the ears. Recently, pyridostigmine
(Mestinon) has shown promising results for treating postural
hypotension without causing high blood pressure while lying down
(supine hypertension), a common problem with midodrine.
- Sweating. If autonomic
neuropathy affects sweating, it usually causes a decrease. But
if you experience excessive sweating, your doctor may prescribe
a drug that inhibits sweating, such as belladonna alkaloids
(scopolamine, glycopyrrolate) or botulinum toxin type A (Botox).
Possible side effects of belladonna alkaloids include blurred
vision, drowsiness, dizziness and dryness of the mouth, nose and
throat. Botox, given by injection, can cause a skin rash or
reaction at the injection site.
Therapies and procedures If you have trouble emptying your bladder fully, your doctor may
recommend intermittent urinary catheterization, a procedure in which
a tube is threaded through your urethra to empty your bladder.
Psychotherapy or counseling may be appropriate if you're depressed.
Sex therapy or couples counseling might be helpful if you're
experiencing relationship problems as a result of sexual
dysfunction.
Prevention
Taking good care of your health in general and managing any
medical condition that puts you at risk of autonomic neuropathy is
the best prevention. Unfortunately, however, there's no way to
prevent degenerative diseases, such as multiple system atrophy, that
increase the risk of developing autonomic neuropathy. Ways to help
prevent autonomic neuropathy may include:
- Control your blood sugar if you have
diabetes.
- Get help if you have a problem with
alcohol.
- Get appropriate treatment if you have an
autoimmune disease.
- Achieve and maintain a healthy weight.
- Exercise regularly.
Self-care
If you have trouble digesting food and your symptoms are mild,
your doctor might recommend eating small, frequent meals, avoiding
fats and reducing intake of dietary fiber. For a drop in blood
pressure when you stand up, wearing elastic stockings and sleeping
with your head elevated may help.
Coping skills
Living with a chronic illness or disability presents daily
challenges. Some of these suggestions may make it easier for you to
cope:
- Set priorities. Decide
which tasks you need to do on a given day, such as paying bills
or shopping for groceries, and which can wait until another
time. Stay active, but don't overdo.
- Seek and accept support.
Having a support system and a positive attitude can help you
cope with the challenges you face. Ask for or accept help when
you need it. Don't shut yourself off from family and friends.
- Prepare for challenging
situations. If something especially stressful is coming
up in your life, such as a move or a new job, knowing what you
have to do ahead of time can help you cope.
- Talk to a counselor or
therapist. Depression and impotence are possible
complications of autonomic neuropathy. If you experience either,
you may find it helpful to talk to a counselor or therapist in
addition to your primary care doctor. There are treatments that
can help.
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autoimmune treatment
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