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Your peripheral nervous system connects the nerves from your brain and spinal cord, or central nervous system, to the rest of your body. This includes your:

The job of these nerves is to deliver signals about physical sensations back to your brain.

Peripheral neuropathy is a disorder that occurs when these nerves malfunction because theyre damaged or destroyed. This disrupts the nerves normal functioning. They might send signals of pain when theres nothing causing pain, or they might not send a pain signal even if something is harming you. This can be due to:

The disorder is uncomfortable, but treatments can be very helpful. The most important thing to determine is whether peripheral neuropathy is the result of a serious underlying condition.

More than 100 different types of peripheral neuropathy exist. Each type has unique symptoms and specific treatment options. Peripheral neuropathies are further classified by the type of nerve damage involved. Mononeuropathy occurs when only one nerve is damaged. Polyneuropathies, which are more common, occur when multiple nerves are damaged.

The three types of peripheral nerves are:

Peripheral neuropathy can affect one nerve group or all three.

The symptoms of peripheral neuropathy include:

These symptoms can also indicate other conditions. Make sure you tell your doctor about all of your symptoms.

People who have a family history of peripheral neuropathy are more likely to develop the disorder. However, a variety of factors and underlying conditions may also cause this condition.

Nerve damage caused by diabetes is one of the most common forms of neuropathy. This leads to numbness, pain, and a loss of sensation in the extremities. The risk of neuropathy increases for people who:

According to the University of Chicagos Center for Peripheral Neuropathy (UCCPN), nearly 60 percent of people with diabetes have some sort of nerve damage. This damage is often due to high blood sugar levels.

Other chronic diseases that may cause nerve damage include:

Physical trauma is the most common cause of injury to the nerves. This can include car accidents, falls, or fractures. Inactivity, or holding still too long in one position, can also cause neuropathy. Increased pressure on the median nerve, a nerve in the wrist that supplies feeling and movement to the hand, causes carpal tunnel syndrome. This is a common type of peripheral neuropathy.

Alcohol can have a toxic effect on nerve tissue, putting people with severe alcoholism at a higher risk of peripheral neuropathy.

Exposure to toxic chemicals like glue, solvents, or insecticides, either through chemical abuse or in the workplace, can also cause nerve damage. Additionally, exposure to heavy metals such as lead and mercury can also cause this condition.

Certain viruses and bacteria directly attack nerve tissue.

Viruses such as herpes simplex, varicella-zoster virus, which causes chickenpox and shingles, and Epstein-Barr virus damage sensory nerves and cause intense episodes of shooting pain.

Bacterial infections such as Lyme disease can also cause nerve damage and pain if they arent treated. People with HIV or AIDS can also develop peripheral neuropathy.

Autoimmune diseases like rheumatoid arthritis and lupus affect the peripheral nervous system in various ways. Chronic inflammation and damage to tissues throughout the body, as well as pressure caused by inflammation, can all lead to severe nerve pain in the extremities.

Certain medications may also cause nerve damage. These include:

Recent research in The Journal of Family Practice also suggests that statins, a class of drugs used to lower cholesterol and prevent cardiovascular disease, may also cause nerve damage and increase the risk for neuropathy.

First, your doctor will perform a physical exam and ask about your medical history. If they still cant tell whether your symptoms are due to peripheral neuropathy, other tests to perform include:

Electromyography can show problems with how your bodys nerve signals move to your muscles. For this test, your doctor will place a small needle into your muscle. Your doctor will then ask you to move your muscle gently. Probes in the needle will measure the amount of electricity moving through your muscle. This test may feel like youre receiving a shot. Sometimes the area becomes sore for a few days afterward.

In a nerve conduction study, your doctor places electrodes on your skin. They then pulse tiny amounts of electricity through your nerves to see if the nerves are transmitting signals properly. This procedure is slightly uncomfortable while its happening, but it shouldnt hurt afterward.

The treatment is based on treating the underlying disorder. If diabetes is the cause, making certain that the blood glucose is controlled is important. If a vitamin deficiency is causing the problem, then correcting the deficiency is the treatment. Many treatments can bring relief and help you return to your regular activities. Sometimes a combination of treatments works best.

Over-the-counter (OTC) pain medications like acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs, such as aspirin and ibuprofen, can be very helpful in controlling moderate pain. If you take them in excess, these drugs can affect your liver or stomach function. Its important to avoid using them for an extended period, especially if you drink alcohol regularly.

Many prescription pain medications can also help to control the pain of this condition. These include narcotics, some antiepileptic medicines, and some antidepressants. Other helpful prescription medicines include:

Prescription drugs for sexual dysfunction in men include:

Your doctor can use several medical treatments to control the symptoms of this condition. Plasmapheresis is a blood transfusion that removes potentially irritating antibodies from your bloodstream. If you get a nerve block, your doctor will inject an anesthetic directly into your nerves.

Transcutaneous electronic nerve stimulation (TENS) doesnt work for everyone, but many people like it because its a drug-free therapy. During TENS, electrodes placed on the skin send small amounts of electricity into the skin. The goal of this treatment is to disrupt nerves from transmitting pain signals to the brain.

Ergonomic casts or splints can help you if your neuropathy affects your:

These casts provide support for the part of your body thats uncomfortable. This can relieve pain. For example, a cast or splint that holds your wrists in a proper position while you sleep can relieve the discomfort of carpal tunnel syndrome.

In addition to OTC pain relievers, many people have found relief for peripheral neuropathy through:

Moderate, regular exercise can also help lessen discomfort.

If you drink alcohol or smoke, consider cutting back or stopping. Both alcohol and tobacco aggravate nerve pain and can cause nerve damage when used for long periods.

If you have peripheral neuropathy, youre potentially at greater risk for accidents in the home. You can do the following to improve your safety:

If your neuropathy is due to an underlying, treatable condition, you may be able to stop your peripheral neuropathy by treating the larger problem. However, if this isnt the case for you, you can successfully manage the symptoms of your peripheral neuropathy. Speak with your doctor to determine the best medical treatment for you, and explore alternative and self-care options that can supplement your medical care.

Even if you have a family history of this disorder, you can help prevent its onset by doing the following:

You can lower your risk of peripheral neuropathy by:

If you have diabetes, take special care of your feet. Wash and inspect your feet daily, and keep the skin moist with lotion.

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Peripheral Neuropathy: Causes, Symptoms and Treatments

What is peripheral neuropathy?

Peripheral neuropathy refers to the many conditions that involve damage to the peripheral nervous system, the vast communication network that sends signals between the central nervous system (the brain and spinal cord) and all other parts of the body. Peripheral nerves send many types of sensory information to the central nervous system (CNS), such as a message that the feet are cold. They also carry signals from the CNS to the rest of the body. Best known are the signals to the muscles that tell them to contract, which is how we move, but there are different types of signals that help control everything from our heart and blood vessels, digestion, urination, sexual function, to our bones and immune system. The peripheral nerves are like the cables that connect the different parts of a computer or connect the Internet. When they malfunction, complex functions can grind to a halt.

Nerve signaling in neuropathy is disrupted in three ways:

Symptoms can range from mild to disabling and are rarely life-threatening. The symptoms depend on the type of nerve fibers affected and the type and severity of damage. Symptoms may develop over days, weeks, or years. In some cases, the symptoms improve on their own and may not require advanced care. Unlike nerve cells in the central nervous system, peripheral nerve cells continue to grow throughout life.

Some forms of neuropathy involve damage to only one nerve (called mononeuropathy). Neuropathy affecting two or more nerves in different areas is called multiple mononeuropathy or mononeuropathy multiplex. More often, many or most of the nerves are affected (called polyneuropathy).

More than 20 million people in the United States have been estimated to have some form of peripheral neuropathy, but this figure may be significantly highernot all people with symptoms of neuropathy are tested for the disease and tests currently dont look for all forms of neuropathy. Neuropathy is often misdiagnosed due to its complex array of symptoms.

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More than 100 types of peripheral neuropathy have been identified, each with its own symptoms and prognosis. Symptoms vary depending on the type of nervesmotor, sensory, or autonomicthat are damaged.

Most neuropathies affect all three types of nerve fibers to varying degrees; others primarily affect one or two types. Doctors use terms such as predominantly motor neuropathy, predominantly sensory neuropathy, sensory-motor neuropathy, or autonomic neuropathy to describe different conditions.

About three-fourths of polyneuropathies are length-dependent, meaning the farthest nerve endings in the feet are where symptoms develop first or are worse. In severe cases, such neuropathies can spread upwards toward the central parts of the body. In non-length dependent polyneuropathies, the symptoms can start more toward the torso, or are patchy.

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Symptoms are related to the type of nerves affected.

Motor nerve damage is most commonly associated with muscle weakness. Other symptoms include painful cramps, fasciculations (uncontrolled muscle twitching visible under the skin) and muscle shrinking.

Sensory nerve damage causes various symptoms because sensory nerves have a broad range of functions.

Autonomic nerve damage affects the axons in small-fiber neuropathies. Common symptoms include excess sweating, heat intolerance, inability to expand and contract the small blood vessels that regulate blood pressure, and gastrointestinal symptoms. Although rare, some people develop problems eating or swallowing if the nerves that control the esophagus are affected.

There are several types of peripheral neuropathies, the most common of which is linked to diabetes. Another serious polyneuropathy is Guillain-Barre syndrome, which occurs when the bodys immune system mistakenly attacks the nerves in the body. Common types of focal (located to just one part of the body) mononeuropathy include carpal tunnel syndrome, which affects the hand and the wrist, and meralgia paresthetica, which causes numbness and tingling on one thigh. Complex regional pain syndrome is a class of lingering neuropathies where small-fibers are mostly damaged.

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Most instances of neuropathy are either acquired, meaning the neuropathy or the inevitability of getting it isnt present from the beginning of life, or genetic. Acquired neuropathies are either symptomatic (the result of another disorder or condition; see below) or idiopathic (meaning it has no known cause).

Causes of symptomatic acquired peripheral neuropathy include:

Genetically-caused polyneuropathies are rare. Genetic mutations can either be inherited or arise de novo, meaning they are completely new mutations to an individual and are not present in either parent. Some genetic mutations lead to mild neuropathies with symptoms that begin in early adulthood and result in little, if any, significant impairment. More severe hereditary neuropathies often appear in infancy or childhood. Charcot-Marie-Tooth disease, also known as hereditary motor and sensory neuropathy, is one of the most common inherited neurological disorders.

The small-fiber neuropathies that present with pain, itch, and autonomic symptoms also can be genetic. As our understanding of genetic disorders increases, many new genes are being associated with peripheral neuropathy.

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The bewildering array and variability of symptoms that neuropathies can cause often makes diagnosis difficult. A diagnosis of neuropathy typically includes:

Additional tests may be ordered to help determine the nature and extent of the neuropathy.

Physiologic tests of nerve function

Neuropathology tests of nerve appearance

Autonomic testing

Radiology imaging tests

Muscle and nerve ultrasound is a noninvasive experimental technique for imaging nerves and muscles for injury such as a severed nerve or a compressed nerve. Ultrasound imaging of the muscles can detect abnormalities that may be related to a muscle or nerve disorder. Certain inherited muscle disorders have characteristic patterns on muscle ultrasound.

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Treatments depend entirely on the type of nerve damage, symptoms, and location. Your doctor will explain how nerve damage is causing specific symptoms and how to minimize and manage them. With proper education, some people may be able to reduce their medication dose or manage their neuropathy without medications. Definitive treatment can permit functional recovery over time, as long as the nerve cell itself has not died.

Addressing neuropathys causes. Correcting underlying causes can result in the neuropathy resolving on its own as the nerves recover or regenerate. Nerve health and resistance can be improved by healthy lifestyle habits such as maintaining optimal weight, avoiding toxic exposures, eating a balanced diet, and correcting vitamin deficiencies. Smoking cessation is particularly important because smoking constricts the blood vessels that supply nutrients to the peripheral nerves and can worsen neuropathic symptoms. Exercise can deliver more blood, oxygen, and nutrients to far-off nerve endings, improve muscle strength, and limit muscle atrophy. Self-care skills in people with diabetes and others who have an impaired ability to feel pain can alleviate symptoms and often create conditions that encourage nerve regeneration. Strict control of blood glucose levels has been shown to reduce neuropathic symptoms and help people with diabetic neuropathy avoid further nerve damage.

Inflammatory and autoimmune conditions leading to neuropathy can be controlled using immunosuppressive drugs such as prednisone, cyclosporine, or azathioprine. Plasmapheresisa procedure in which blood is removed, cleansed of immune system cells and antibodies, and then returned to the bodycan help reduce inflammation or suppress immune system activity. Agents such as rituximab that target specific inflammatory cells, large intravenously administered doses of immunoglobulins, and antibodies that alter the immune system, also can suppress abnormal immune system activity.

Specific symptoms can usually be improved

Medications recommended for chronic neuropathic pain are also used for other medical conditions. Among the most effective are a class of drugs first marketed to treat depression. Nortriptyline and newer serotonin-norepinephrine reuptake inhibitors such as duloxetine hydrochloride modulate pain by increasing the brains ability to inhibit incoming pain signals. Another class of medications that quiets nerve cell electrical signaling is also used for epilepsy. Common drugs include gabapentin, pregabalin, and less often topiramate and lamotrigine. Carbamazepine and oxcarbazepine are particularly effective for trigeminal neuralgia, a focal neuropathy of the face.

Local anesthetics and related drugs that block nerve conduction may help when other medications are ineffective or poorly tolerated. Medications put on the skin (topically administered) are generally appealing because they stay near the skin and have fewer unwanted side effects.

Lidocaine patches or creams applied to the skin can be helpful for small painful areas, such as localized chronic pain from mononeuropathies such as shingles. Another topical cream is capsaicin, a substance found in hot peppers that can desensitize peripheral pain nerve endings. Doctor-applied patches that contain higher concentrations of capsaicin offer longer term relief from neuropathic pain and itching, but they worsen small-fiber nerve damage. Weak over-the-counter formulations also are available. Lidocaine or longer acting bupivicaine are sometimes given using implanted pumps that deliver tiny quantities to the fluid that bathes the spinal cord, where they can quiet excess firing of pain cells without affecting the rest of the body. Other drugs treat chronic painful neuropathies by calming excess signaling.

Narcotics (opioids) can be used for pain that doesnt respond to other pain-control medications and if disease-improving treatments arent fully effective. Because pain relievers that contain opioids can lead to dependence and addiction, their use must be closely monitored by a physician. One of the newest drugs approved for treating diabetic neuropathy is tapentadol, which has both opioid activity and norepinephrine-reuptake inhibition activity of an antidepressant.

Surgery is the recommended treatment for some types of neuropathies. Protruding disks (pinched nerve) in the back or neck that compress nerve roots are commonly treated surgically to free the affected nerve root and allow it to heal. Trigeminal neuralgia on the face is also often treated with neurosurgical decompression. Injuries to a single nerve (mononeuropathy) caused by compression, entrapment, or rarely tumors or infections may require surgery to release the nerve compression. Polyneuropathies that involve more diffuse nerve damage, such as diabetic neuropathy, are not helped by surgical intervention. Surgeries or interventional procedures that attempt to reduce pain by cutting or injuring nerves are not often effective as they worsen nerve damage and the parts of the peripheral and central nervous system above the cut often continue to generate pain signals (phantom pain). More sophisticated and less damaging procedures such as electrically stimulating remaining peripheral nerve fibers or pain-processing areas of the spinal cord or brain have largely replaced these surgeries.

Transcutaneous electrical nerve stimulation (TENS) is a noninvasive intervention used for pain relief in a range of conditions. TENS involves attaching electrodes to the skin at the site of pain or near associated nerves and then administering a gentle electrical current. Although data from controlled clinical trials are not available to broadly establish its efficacy for peripheral neuropathies, in some studies TENS has been shown to improve neuropathic symptoms associated with diabetes.

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The best treatment is prevention, and strategies for reducing injuries are highly effective and well tested. Since medical procedures ranging from casting fractures to injuries from needles and surgery are another cause, unnecessary procedures should be avoided. The new adjuvanted vaccine against shingles prevents more than 95 percent of cases and is widely recommended for people over 50, including those who have had previous shingles or vaccination with the older, less effective vaccine. Diabetes and some other diseases are common preventable causes of neuropathy. People with neuropathy should ask their doctors to minimize use of medications that are known to cause or worsen neuropathy where alternatives exist. Some families with very severe genetic neuropathies use in vitro fertilization to prevent transmission to future generations.

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The mission of the National Institute of Neurological Disorders and Stroke (NINDS) is to seek knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. NINDS is a component of the National Institutes of Health (NIH), the leading supporter of biomedical research in the world.

NINDS-funded research ranges from clinical studies of the genetics and the natural history of hereditary neuropathies to discoveries of new cause and treatments for neuropathy, to basic science investigations of the biological mechanisms responsible for chronic neuropathic pain. Together, these diverse research areas will advance the development of new therapeutic and preventive strategies for peripheral neuropathies. Understanding the causes of neuropathy provides the foundation for finding effective prevention and treatment strategies.

Genetic mutations have been identified in more than 80 distinct hereditary neuropathies. NINDS supports studies to understand the disease mechanisms of these conditions and to identify other genetic defects that may play roles in causing or modifying the course of disease. The Inherited Neuropathies Consortium (INC)a group of academic medical centers, patient support organizations, and clinical research resources dedicated to conducting clinical research in Charcot-Marie-Tooth disease and improving the care of people with the diseaseseeks to better characterize the natural history of several different forms of neuropathy and to identify genes that modify clinical features in these disorders. Knowing which genes are mutated, and what their normal function is, permits precise diagnosis and leads to new therapies that prevent or reduce nerve damage. INC is also developing and testing biomarkers (signs that can indicate the diagnosis or progression of a disease) and clinical outcome measures that will be needed in future clinical trials to determine whether individuals respond to candidate treatments.

Rapid communication between the peripheral nervous system and the central nervous system often depends on myelination, a process through which special cells called Schwann cells create an insulating coating around axons. Several NINDS-funded studies focus on understanding how myelin protein and membrane production and maintenance in Schwann cells is regulated and how mutations in genes involved in these processes cause peripheral neuropathies. Schwann cells play a critical role in the regeneration of nerve cell axons in the peripheral nervous system. By better understanding myelination and Schwann cell function, researchers hope to find targets for new therapies to treat or prevent nerve damage associated with neuropathy.

Other efforts focus on immune system peripheral nerve damage. In inflammatory peripheral neuropathies such as Guillain-Barre Syndrome and chronic inflammatory demyelinating polyneuropathy (CIDP), the bodys immune system mistakenly attacks peripheral nerves, damaging myelin and weakening signaling along affected nerves. NINDS-supported researchers hope to better understand how antibodies to cell membrane components cause peripheral nerve damage and how the effects of these antibodies can be blocked. Researchers are also studying how mutations in the Autoimmune Regulator (AIRE) gene in a mouse model of CIDP cause the immune system to attack peripheral nerves. NINDS research has helped discover that some types of small-fiber polyneuropathy appear to be immune-caused, particularly in women and children.

NINDS-supported researchers are also exploring the use of tissue engineered from the cells of humans with peripheral neuropathy as models to identify specific defects in the transport of cellular components along axons and the interactions of nerves with muscles. Such tissue engineering approaches may eventually lead to new therapeutics for peripheral neuropathies.

In addition to efforts to treat or prevent underlying nerve damage, other NINDS-supported studies are informing new strategies for relieving neuropathic pain, fatigue, and other neuropathy symptoms. Researchers are investigating the pathways that carry pain signals to the brain and are working to identify substances that will block this signaling.

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For more information on neurological disorders or research programs funded by NINDS, contact the Institute's Brain Resources and Information Network (BRAIN) at:

BRAINP.O. Box 5801Bethesda, MD 20824800-352-9424http://www.ninds.nih.gov

Information also is available from the following organizations:

Foundation for Peripheral Neuropathy485 Half Day RoadSuite 200Buffalo Grove, IL 60089877-883-9942www.foundationforpn.org

Charcot-Marie-Tooth Association (CMTA)P.O. Box 105Glenolden, PA 19036610-499-9264800-606-2682www.cmtausa.org/

Muscular Dystrophy Association2200S. Riverside Plaza, Suite 1500Chicago, IL 60606520-529-2000800-572-1717www.mda.org

American Diabetes Association2451 Crystal Drive, Suite 900Arlington, VA 22202703-549-1500800-342-2383www.diabetes.org

National Diabetes Information Clearinghouse (NDIC)National Institute of Diabetes and Digestive and Kidney DiseasesNational Institutes of Health1 Information WayBethesda, MD 20892-3560800-860-8747www.niddk.nih.gov/health-information/diabetes

NeuropathyCommons.org(information for patients, professionals, and researchers hosted by Harvard University)https://neuropathycommons.org

"Peripheral Neuropathy Fact Sheet", NINDS, Publication date: August 2018.

NIH Publication No.18-NS-4853

Back toPeripheral Neuropathy Information Page

See a list of all NINDS disorders

Publicaciones en Espaol

Neuropata Perifrica

Prepared by:Office of Communications and Public LiaisonNational Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesda, MD 20892

NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient's medical history.

All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.

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Peripheral Neuropathy Fact Sheet | National Institute of ...

If you think youre having these symptoms, consult a physician. A variety of tests can be done to diagnose neuropathy. There are certain patterns of complaints that suggest neuropathy, says Dr. Williams, so taking down a patient history that includes a description of the complaints is an important first step.

After that, your doctor can do a physical examination, checking motor and sensory function, checking deep tendon reflexes, as well as looking for symptoms such as allodynia and hyperalgesia, Williams says. Then we can also perform electrodiagnostic testing; the most common being electromyography and nerve conduction testing, where we can stimulate nerves and record responses, calculate the speed at which signals are being transmitted and see if there are any areas where nerves are not transmitting signals normally, Williams continues.

With needle examinations, Williams says, We can put small needles into individual muscles, and, based on what we see and hear with the needle in the muscle, get information about how the nerves supplying that muscle are functioning. So there are a number of different tests that could be helpful to identifying neuropathy, as well as localizing where the abnormality is most likely to be coming from.

Frequently, blood tests can check for elevated blood sugar (to see if your symptoms may be related to type 2 diabetes), vitamin deficiencies, toxic elements, hereditary disorders, and evidence of an abnormal immune response. (11)

Your doctor may also do a nerve biopsy, which usually entails removing a small portion of a sensory nerve to look for abnormalities, or a skin biopsy to see if there is a reduction in nerve endings. (12)

To give yourself the best chance of an accurate diagnosis and relief of your symptoms be prepared to describe your symptoms in detail, when you experience them, how long an episode lasts, and the amount of discomfort, pain or loss of sensation or movement you experience. The more specific you can be about the symptoms you are experiencing, the easier it will be for your doctor to understand what is going on.

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Neuropathy Signs, Symptoms, and Diagnosis | Everyday Health

What is peripheral neuropathy?

Peripheral neuropathy is a disorder of nerve(s) apart from the brain and spinal cord. Patients with peripheral neuropathy may have tingling, numbness, unusual sensations, weakness, or burning pain in the affected area. Oftentimes, the symptoms are symmetrical and involve both hands and feet. Because the symptoms are often present in the areas covered by gloves or stockings, peripheral neuropathy is often described as having a "glove and stocking" distribution of symptoms.

Peripheral neuropathy can involve different nerve types, including motor, sensory, and autonomic nerves. Peripheral neuropathy can also be categorized by the size of the nerve fibers involved, large, or small.

Neuropathy can present with many differing symptoms, including numbness, pain of different types, weakness, or loss of balance, depending on the type of nerve involved. Because the autonomic nerves control bodily functions that we do not consciously think of, such as heart rate, digestion, and emptying of the bowel and bladder, autonomic neuropathy manifests with symptoms affecting the loss of control of these functions. Symptoms may include problems with blood pressure, voiding, passage of stools (diarrhea, or constipation), heart rate, or sweating.

Cranial neuropathy is similar to peripheral neuropathy, except that the cranial nerves are involved. Any of the cranial nerves can be involved. One of the more common causes of cranial neuropathy is loss of blood flow from the optic artery to the optic nerve, causing ischemic optic neuropathy. Amyloidosis is one of the more common causes of this rare disorder.

Specific nerves can be involved in neuropathy. When a specific nerve is involved, the symptoms are limited to the distribution of that nerve. The most commonly involved peripheral nerve is the median nerve at the wrist in carpal tunnel syndrome. Essentially any peripheral nerve can become entrapped and cause the signs and symptoms of neuropathy. The ulnar nerve is commonly entrapped at the elbow. The peroneal nerve is exposed at the outer part of the knee. The pudendal nerve can cause pain in the perineum and is relieved by sitting on a toilet seat or an inflatable donut. Entrapment of the lateral femoral cutaneous nerve at the waist, called meralgia paresthetica, causes numbness at the outer part of the thigh.

Read more here:
Peripheral Neuropathy Symptoms, Causes, Treatment & Prognosis

Editor's Note:The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.

A 40-year-old man is referred for neurologic evaluation after presenting with peripheral neuropathy. Three years ago, he noted numbness, burning pain, and reduced temperature sensation in his feet. For the past 2 years, he has had dry eyes and dry mouth; urinary retention that requires self-catheterization; gastrointestinal symptoms, including alternating diarrhea and constipation; and nausea. His weight has decreased by 40 lb (18.1 kg) over 12 months. He has noticed decreased sweating.

For several months, he has had frequent syncopal episodes triggered by positional change. In hindsight, he reports intermittent dizziness associated with a "daydreaming" feeling that began 8 years ago; however, these spells were not associated with loss of consciousness. He was also recently diagnosed with Sjgren syndrome.

He reports no chest pain, palpitations, shortness of breath, or edema. A review of systems is otherwise unremarkable. His past medical history is notable for hypothyroidism. His family history is notable for a grandfather who had gastrointestinal problems and a sister who has palpitations. His parents are alive and have no neurologic symptoms. He takes no medications or supplements.

Medscape2020WebMD, LLC

Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: Amanda Kennedy,Jeffrey Kaplan,Dianna Quan.A 40-Year-Old Man With Dizziness, Confusion, and Neuropathy-Medscape-Jan21,2020.

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A 40-Year-Old Man With Dizziness, Confusion, and Neuropathy - Medscape

By Zach Cavanagh

It started about a year ago.

San Juan Hills boys basketball coach Jason Efstathioustarted to notice some things in his body last January. By March of last year,he found himself barely able to walk, and then by the summer, he was in bed fornearly 12 hours a day.

I was like a burn victim on the inside, Efstathiou said.

From May until late December and his full return asStallions head coach on Jan. 3, Efstathiou was out battling an extremely rareform of neuropathy. Efstathiou, who is a type-one diabetic, said the diseaseattacks your nerves and affects 1% of diabetics.

Most neuropathies see the victim lose sensation in theirnerves, but Efstathious neuropathy was the opposite with a hypersensitivityand burning sensation.

For three months, they didnt know what I had, Efstathiousaid. I was going to MRIs and CT scans and all that kind of stuff.

Over those months, Efstathiou had been getting daily treatmentswith doctors and nerve therapists. Treatments consisted of machines that sentsignals to his nerves.

Efstathiou said he had lost 35 pounds at one point, and withbeing out of work officially since May, the San Juan Hills parents andcommunity held a fundraiser in September to support their sidelined coach.

It sounds dramatic, Efstathiou said, but I was really bad, like almost died, thats how bad I was. They all knew about it. People were being very supportive. Im very grateful to the coaches. The coaches and parents in the program had my back big time.

Over time, Efstathious condition improved, and he returnedto practices in September in a limited capacity. Efstathiou spends most ofpractice sitting on a stool near midcourt and relays instructions through hisassistant coaches.

I still limp around, Efstathiou said. I cant demonstatestuff. When I coach or teach I have to sit down. Ive given my bench guysassignments. I dont have a loud voice again yet. I use a whistle now. Idnever used a whistle before.

Efstathiou said hes still healing, and his doctors andnerve therapist feel that Efstathiou will keep getting better. The amount ofimprovement hes seen makes Efstathiou feel that it will go away, even if ittakes another year or two.

On coaching, Efstathiou said the experience has changed himand has given him a new perspective.

Im more focused on the big picture than living and dyingwith each game, Efstathiou said. I dont get as gnarly. (With the players,)Im trying to be more like understand the situation, understand when somethinggets taken away. I feel fortunate to be here and coaching you guys. You guysshould be grateful to be on a high school basketball team. Theres so many kidsthat never make it to their high school varsity team.

Efstathiou also said the ordeal has bettered his sidelinedemeanor.

Its keeping me calmer, Efstathiou said. The more intenseI get then I start to get more burning. In my mind, I just have to staycalmer.

With Efstathiou returning just before the start of Sea ViewLeague play, keeping calm is a taller task some nights more than others, but sofar, the Stallions have been good with those things for their coach.

San Juan Hills (9-14, 3-1) won its first three league gamesin strong fashion with victories over Laguna Hills by 29 points, Dana Hills byeight points and El Toro by five points.

I told them the way weve been starting games playing withintensity, Efstathiou said, were going to be tough. A lot of teams wesurprise them a little bit. I think if you come out and play intense, and Ithink our guys are a little inspired right now, as long as we execute, I thinktheres a good opportunity.

Efstathiou got more fired up in San Juan Hills Wednesdaymatch-up as the Stallions battled league-favorite Tesoro for the league lead.The Stallions gave the Titans all they could handle and held a five-point leadin the fourth quarter. However, San Juan Hills couldnt execute down thestretch, and Tesoro took advantage of a foul-filled physical game by making itsfinal 14 points on free throws in a 65-57 win.

San Juan Hills still sits in second place in the Sea ViewLeague, and the Stallions will get another shot at Tesoro.

In the broad perspective, Efstathiou and San Juan Hills are right where they want to be.

Zach Cavanagh

Zach Cavanagh is the sports editor for Picket Fence Media. Zach is aCalifornia Journalism Award winner and has covered sports in Orange County since 2013. Follow him on Twitter and Instagram @ZachCav and follow our sports coverage on Twitter @SouthOCSports. Email Zach at zcavanagh@picketfencemedia.com.

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Fighting the Fire: Battling Rare Neuropathy, San Juan Hills' Efstathiou Coaches with New Perspective - Capistrano Dispatch

WOBURN, Mass., Jan. 27, 2020 (GLOBE NEWSWIRE) -- NeuroMetrix, Inc., (Nasdaq: NURO) today reported financial and business highlights for the quarter and year ended December 31, 2019.

The Company develops and commercializes diagnostic and therapeutic neurostimulation-based medical devices. The Company has three commercial products. DPNCheck is a point-of-care diagnostic test for peripheral neuropathies including diabetic peripheral neuropathy (DPN). ADVANCE is a point-of-care diagnostic test primarily used for carpal tunnel syndrome. Quell is a wearable neurostimulation device that is available over-the-counter for symptomatic relief of chronic pain.

Q4 2019 Highlights:

"Although we were disappointed by the overall drop in revenue from the year-ago period, we expected this outcome given our large reduction in operating expenses, attention to improved gross margins and overall focus on long term growth and profitability. We believe we made important progress against these objectives. We experienced strong demand for DPNCheck during the fourth quarter which is typically our slowest period. This momentum should carry into 2020 as new Medicare Advantage accounts come on board and we expect a rebound in international sales. Our enthusiasm for the DPNCheck business is reflected in our investment in the next generation device to be launched in late 2020, said Shai N. Gozani, M.D., Ph.D., President and Chief Executive Officer of NeuroMetrix. Our Quell business is focused on cost-efficient advertising combined with an exclusively direct-to-consumer model via our QuellRelief.com website and exploration of new markets. We believe this technology is unique and represents an attractive long term opportunity for the Company. Finally, we are actively engaged with the Federal Trade Commission(FTC) to resolve the previously disclosed matter which is centered on earlier Quell advertising.

Financials:Regarding the fourth quarter 2019, total revenues were $1.7 million, down 54% from $3.7 million in the prior year period. Gross margin was $1.1 million versus $1.7 million in Q4 2018. The gross margin rate of 62.2% improved from 46.9% in Q4 2018. Operating expenses were $2.7 million, a reduction of $1.9 million from $4.6 million in Q4 2018. Collaboration income of $0.6 million was recognized in Q4 2019. Net loss was $1.1 million compared to $2.8 million in Q4 2018. Net cash usage from operations was $.7 million, a reduction from $2.7 million in Q4 2018. The Company ended the quarter with cash of $3.1 million.

Regarding the full year 2019, total revenues were $9.3 million, down from $16.1 million in 2018. Gross margin was $2.2 million after inventory-related write-downs of $2.6 million. 2018 gross margin was $7.4 million. Operating expenses were $13.8 million versus $19.7 million in 2018. Income from the GSK collaboration was $7.7 million in comparison with $12.3 million in 2018. Net loss was $3.8 million versus net income of $24 thousand in 2018.

Company to Host Live Conference Call and WebcastNeuroMetrix will host a conference call at 8:00 a.m. Eastern today, January 27, 2020. The call may be accessed in the United States at 844-787-0799, international at 661-378-9630 using confirmation code 6728609. A replay will be available starting two hours after the call at 855-859-2056 United States and 404-537-3406 international using confirmation code 6728609. It will remain available for one week. The call will also be webcast and accessible at http://www.NeuroMetrix.com under "Investor Relations".

About NeuroMetrixNeuroMetrix is a leading developer of diagnostic and therapeutic neurostimulation-based medical devices. DPNCheck is a point-of-care diagnostic test for diabetic neuropathy, which is the most common long-term complication of Type 2 diabetes. ADVANCE is a point-of-care nerve conduction study that evaluates multiple nerves including the median nerve, which is affected in carpal tunnel syndrome. Quell is a wearable neurostimulation device for symptomatic relief of chronic pain that is available over-the-counter. For more information, please visit NeuroMetrix.com.

Safe Harbor StatementThe statements contained in this press release include forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, including, without limitation, statements regarding the companys or managements expectations regarding the business, as well as events that could have a meaningful impact on the companys revenues and cash resources. While the company believes the forward-looking statements contained in this press release are accurate, there are a number of factors that could cause actual events or results to differ materially from those indicated by such forward-looking statements, including, without limitation, estimates of future performance, the ability to successfully develop, receive regulatory clearance, commercialize and achieve market acceptance for any products, and the final outcome of the ongoing Federal Trade Commission civil investigative demand enforcement action involving Quell. There can be no assurance that future developments will be those that the company has anticipated. Such forward-looking statements involve known and unknown risks, uncertainties and other factors including those risks, uncertainties and factors referred to in the companys most recent Annual Report on Form 10-K, Quarterly Reports on Form 10-Q, as well as other documents that may be filed from time to time with the Securities and Exchange Commission or otherwise made public. The company is providing the information in this press release only as of the date hereof, and expressly disclaims any intent or obligation to update the information included in this press release or revise any forward-looking statements.

Source: NeuroMetrix, Inc.

Thomas T. HigginsSVP and Chief Financial Officer781-314-2761neurometrix.ir@neurometrix.com

NeuroMetrix, Inc.Statements of Operations(Unaudited)

Condensed Balance Sheets(Unaudited)

See the article here:
NeuroMetrix Reports Q4 and Full Year 2019 Financial Results - BioSpace

(KPRC)Many people drink lemon water because they think it tastes good, or they think it has some health benefits.

Heres a look at what makes it so great.

The majority of women are walking around dehydrated. Adding lemon to your water might be the motivation you need to drink more.

In doing so, you can reduce sugar cravings and get good antioxidants. And that citrus fruit is packing the potential to decrease your risk of kidney stones or reduce diabetic neuropathy.

Dietitian Erin Gussler with the Whole Health Center in Houston, Texas, says she knows this because of studies done in mice.

And in humans, she says it can relieve morning sickness.

"There was a study that showed that drinking lemon water during pregnancy actually can decrease nausea and vomiting so the study showed that consuming lemon water for 4 days actually decrease nausea and vomiting by 33%, Gussler says.

But there's a catch. To get these benefits you might need lots and we mean lots of lemon. Think one-half to two whole lemons a day!

"Some of the studies were like an obscene amount of lemon. Like, like cups of lemon, Gussler says.

While the amount matters more than anything, the temperature only slightly matters. Warm lemon water can help with constipation more than cold water but be careful not to get essential oils too hot.

"There are some studies that show heating those oils to high can break down so thinking about getting a mix of hot and cold and playing with that just to get maximum benefit of both, Gussler says.

Dentists warn patients not to drink too much lemon since the acidity can damage enamel.

They say to lessen that potential damage, you can try drinking through a straw.

Read the original here:
The health benefits of lemon water | News - WPSD Local 6

New York City, NY: Jan 2020 Published via (Wired Release) MarketResearch.Biz adds Diabetic Neuropathy Market report to its research report database. It is a thorough study of vital elements of the markets such as drivers, growth opportunities, challenges, restraints, current and upcoming trends, SWOT analysis, and many more among other market influencers and strategic information. After comprehensively analyzing these market parameters, the information is presented in a very organized manner that clearly mentions the growth prospects of the Diabetic Neuropathy market during the forecast period.

Making you aware of the latest innovations, market developments, challenges, and opportunities those are estimated to propel Diabetic Neuropathy market growth, this research report puts you in a top position and gives a chance to make use of every opportunity and upcoming trend which can be changed into significant revenues. Diabetic Neuropathy market analysis is extensive into given categories and segmentation and the report is presented in a chapter-wise section for easy finding of required details.

For competitor study, it covers all key players and their respective business information for the pervasive understanding of the competitive scenario. It also makes insertion of their business strategies and reveals the recent developments among major players along with the data of any known collaborations between them. In brief, the well-presented competitive landscape makes you understand the degree of competition.

Being a worldwide report, distinct regions have been studied with detail regional analysis of North America, Europe, Asia Pacific, Middle East & Africa, and Latin America. The regional study helps gain insights on the growth of the market in terms of market size, share, and revenue(USD), thereby revealing the market value, volume, and penetration.

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Our FREE SAMPLE COPY of the report gives a brief introduction to the research report outlook, TOC, list of tables and figures, an outlook to key players of the market and comprising key regions.

Competitive Landscape

Global Diabetic Neuropathy market is highly cleft and the key players have used numerous plans such as new product launches, acquisitions, mergers, collaborations, innovation in products, expansions, agreements, joint ventures, and others to increase their footmarks in this market.

Key players profiled in the report include: Actavis Pharma Inc, NeuroMetrix Inc, Astellas Pharma Inc, Meda Pharma GmbH, Eli Lilly and Company, GlaxoSmithKline plc, Pfizer Inc, Cephalon Inc, Johnson & Johnson Inc and Boehringer Ingelheim GmbH

Market Segmentation:

Segmentation on the basis of disorder type: Peripheral neuropathy, Autonomic neuropathy, Proximal neuropathy, Focal neuropathy, Segmentation on the basis of treatment: Radiotherapy, Physiotherapy

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There Are 13 Chapters To Extensively Display The Diabetic Neuropathy Market:

Chapter 1: Global Diabetic Neuropathy Market Outlook, Product Introduction, Market Segmentation, Market Study of Regions, Market Dynamics, Constraints, Opportunities and Industry News and Policies.

Chapter 2: Global Diabetic Neuropathy Market Chain Study, Upstream Raw Material Suppliers, Key Players, Production Process Study, Cost Analysis, Market Channels, and Key Downstream Buyers.

Chapter 3: Value Study, Production, Price Analysis and Growth Rate Of Diabetic Neuropathy Market by Type.

Chapter 4: Downstream Features, Consumption and Diabetic Neuropathy Market Share by Application.

Chapter 5: Production Volume, Gross Margin, Price, and Revenue (USD) of Diabetic Neuropathy by Regions.

Chapter 6: Diabetic Neuropathy Production, Consumption, Import/Export by Regions.

Chapter 7: Diabetic Neuropathy Market Regional Status and SWOT Analysis.

Chapter 8: Global Competitive Landscape, Product Description, Company Profiles, Diabetic Neuropathy Market Distribution Status by Major Players.

Chapter 9: Diabetic Neuropathy Market Study and Projection by Type and Application (2020-2029).

Chapter 10: Worldwide Market Analysis and Forecast by Regions (2020-2029).

Chapter 11: Global Industry Features, Key Growth Factors, New Entrants SWOT Study, Study of Investment Feasibility.

Chapter 12: Market Conclusion of the Complete Report.

Chapter 13: Appendix Such as Research Methodology and Information Resources.

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Diabetic Neuropathy Market Innovations, And Top Companies Forecast To 2029| Pfizer Inc, Eli Lilly and Company, Actavis Pharma Inc - Neptune Pine

DUBLIN--(BUSINESS WIRE)--The "Leber's Hereditary Optic Neuropathy (Leber optic atrophy) - Pipeline Review, H2 2019" drug pipelines has been added to ResearchAndMarkets.com's offering.

The Publisher's Pharmaceutical and Healthcare latest pipeline guide Leber's Hereditary Optic Neuropathy (Leber Optic Atrophy) - Pipeline Review, H2 2019, provides comprehensive information on the therapeutics under development for Leber's Hereditary Optic Neuropathy (Leber Optic Atrophy) (Ophthalmology), complete with analysis by stage of development, drug target, mechanism of action (MoA), route of administration (RoA) and molecule type. The guide covers the descriptive pharmacological action of the therapeutics, its complete research and development history and latest news and press releases.

The Leber's Hereditary Optic Neuropathy (Leber Optic Atrophy) (Ophthalmology) pipeline guide also reviews of key players involved in therapeutic development for Leber's Hereditary Optic Neuropathy (Leber Optic Atrophy) and features dormant and discontinued projects. The guide covers therapeutics under Development by Companies /Universities /Institutes, the molecules developed by Companies in Pre-Registration, Phase III, Phase II, Phase I, Preclinical, Discovery and Unknown stages are 1, 1, 3, 2, 7, 2 and 2 respectively. Similarly, the Universities portfolio in Phase III and Phase I stages comprises 1 and 1 molecules, respectively.

Leber's Hereditary Optic Neuropathy (Leber Optic Atrophy) (Ophthalmology) pipeline guide helps in identifying and tracking emerging players in the market and their portfolios, enhances decision making capabilities and helps to create effective counter strategies to gain competitive advantage. The guide is built using data and information sourced from The Publisher's proprietary databases, company/university websites, clinical trial registries, conferences, SEC filings, investor presentations and featured press releases from company/university sites and industry-specific third party sources. Additionally, various dynamic tracking processes ensure that the most recent developments are captured on a real time basis.

Scope

Reasons to buy

Key Topics Covered:

Introduction

Leber's Hereditary Optic Neuropathy (Leber Optic Atrophy) - Overview

Leber's Hereditary Optic Neuropathy (Leber Optic Atrophy) - Therapeutics Development

Leber's Hereditary Optic Neuropathy (Leber Optic Atrophy) - Therapeutics Assessment

Leber's Hereditary Optic Neuropathy (Leber Optic Atrophy) - Companies Involved in Therapeutics Development

Leber's Hereditary Optic Neuropathy (Leber Optic Atrophy) - Drug Profiles

Leber's Hereditary Optic Neuropathy (Leber Optic Atrophy) - Dormant Projects

Leber's Hereditary Optic Neuropathy (Leber Optic Atrophy) - Product Development Milestones

Appendix

Companies Mentioned

For more information about this drug pipelines report visit https://www.researchandmarkets.com/r/hp1wmj

Originally posted here:

Leber's Hereditary Optic Neuropathy, 2019 - Pipeline Review, H2 - ResearchAndMarkets.com - Business Wire

Diabetic Neuropathy Market Report 2018-2026includes a comprehensive analysis of the present Market. The report starts with the basic Diabetic Neuropathy industry overview and then goes into each and every detail.

Diabetic Neuropathy Market Report contains in depth information major manufacturers, opportunities, challenges, and industry trends and their impact on the market forecast. Diabetic Neuropathy also provides data about the company and its operations. This report also provides information on the Pricing Strategy, Brand Strategy, Target Client, Distributors/Traders List offered by the company.

Description:

Diabetic Neuropathy is the damage caused to the nerve due to diabetes which often leads to pain and numbness in feet or lower legs. The pain can be experienced in other parts of the body such as hips, wrist and back depending upon the effect of neuropathy. There are different types of neuropathy such as focal neuropathy, proximal neuropathy, peripheral neuropathy and autonomic neuropathy. An estimated 50% of diabetic population suffers from diabetic neuropathy across the globe. Further, as per CDC estimates, 6-7 people per 1000 diabetic population suffer from diabetic neuropathy in the U.S. Rise in aging population coupled with rise in prevalence of diabetes, the patient pool for diabetic neuropathy will increase significantly, in turn fueling growth of the diabetic neuropathy market.

Diabetic Neuropathy Market competition by top manufacturers/players, with Diabetic Neuropathy sales volume, Price (USD/Unit), Revenue (Million USD) and Market Share for each manufacturer/player; the top players including: Eli Lilly and Company, GlaxoSmithKline, Pfizer, Johnson & Johnson and Janssen Pharmaceuticals

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Important Features that are under offer & key highlights of the report:

What all regional segmentation covered? Can the specific country of interest be added?Currently, the research report gives special attention and focus on the following regions:North America (U.S., Canada, Mexico), Europe (Germany, U.K., France, Italy, Russia, Spain etc), South America (Brazil, Argentina etc) & Middle East & Africa (Saudi Arabia, South Africa etc)** One country of specific interest can be included at no added cost. For inclusion of more regional segment quote may vary.

What all companies are currently profiled in the report?The report Contain the Major Key Players currently profiled in this market.** List of companies mentioned may vary in the final report subject to Name Change / Merger etc.

Can we add or profiled new company as per our need?Yes, we can add or profile new company as per client need in the report. Final confirmation to be provided by the research team depending upon the difficulty of the survey.** Data availability will be confirmed by research in case of a privately held company. Up to 3 players can be added at no added cost.

Can the inclusion of additional Segmentation / Market breakdown is possible?Yes, the inclusion of additional segmentation / Market breakdown is possible to subject to data availability and difficulty of the survey. However, a detailed requirement needs to be shared with our research before giving final confirmation to the client.** Depending upon the requirement the deliverable time and quote will vary.

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Diabetic Neuropathy Market Dynamics in the world mainly, the worldwide 2018-2026 Diabetic Neuropathy Market is analyzed across major global regions. CMI also provides customized specific regional and country-level reports for the following areas:

Region Segmentation:

North America (USA, Canada and Mexico)Europe (Germany, France, UK, Russia and Italy)Asia-Pacific (China, Japan, Korea, India and Southeast Asia)South America (Brazil, Argentina, Columbia etc.)Middle East and Africa (Saudi Arabia, UAE, Egypt, Nigeria and South Africa)

Further in the report, the Diabetic Neuropathy market is examined for Sales, Revenue, Price and Gross Margin. These points are analyzed for companies, types, and regions. In continuation with this data, the sale price is for various types, applications and region is also included. The Diabetic Neuropathy industry consumption for major regions is given. Additionally, type wise and application wise figures are also provided in this report.

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In this study, the years considered to estimate the market size of 2018-2026 Diabetic Neuropathy Market are as follows:History Year: 2015-2017Base Year: 2017Estimated Year: 2018Forecast Year 2018 to 2026

This post was originally published on Market Research Sheets

Read more:

Diabetic Neuropathy Market Poised to Take Off by 2026 - Market Research Sheets

Nerve pain is a crucial problem that occurs in people who have diabetes or are experiencing the after-effects of chemotherapy. It can be stressful and discomforting if not treated and taken care of by a professional physician. Neuropathy treatment is rather conventional, whereby the physician has to come up with a better way to relieve pain through supplements, vitamins, and herbs. This medication helps in avoiding any treatment that may result in negative side effects on ones nervous system. Consultation is the key approach method once you realize that you have neuropathy. This way, the doctor can guide you on ways that you can avoid nerve pain. Neuropathy mostly affects the hands and feet, making movement challenging to most patients. It also induces muscle weakness and lack of sensation. Nevertheless, there are easy treatments that you can rely on to ensure that your lifestyle does not change. Here are three affordable herbs and vitamins that you should try for nerve pain relief:

1) B Vitamins

Neuropathy is a critical condition that requires you to be keen on the mode of treatment you are taking. Lack of vitamins in the body has been linked with nerve pain, which can develop permanent damage. These vitamins include B1, B6, and B12. You can get these essential vitamins through the consultation of the doctor. You can also check out Neuropathy Relief Guide to understand different ways of handling your condition with good vitamins and herbs. Benfotiamine, which is also vitamin B1, is said to reduce nerve pain by a high percentage. It is also used in getting rid of inflammation in the legs and hands.

On the other hand, vitamin B6 is recommended since it helps in covering nerve ends to avoid any further damages that may occur to the nervous system. However, it is advised that you do not take any extra dosage since it can interfere with the nerves leading permanent damage. Vitamin B6 has proven to improve the immune system, which is linked with healing any nerve damage present in the body.

2) Fish Oil

Nerve pain is a progressive condition that can lead to serious damage to the body organs. This is because it causes numbness and weakness to the body muscles. This way, you have a better approach method on how you can ensure your nerves are healthy. If you are undergoing chemotherapy or suffering from diabetes, it is easy to have complications like neuropathy. Therefore, you are advised to take fish oil, which is a natural medication. Through research, it was proven that fish oil is beneficial since it has an anti-inflammatory effect that has posed a positive impact on healing the nerves.

Moreover, it has shown to help in reducing pain and decreasing muscle soreness, which is a great challenge for most patients. Fish oil contains omega-3 fatty acids, which are the main acting agents in stimulating the growth of nerves instead of damaging. This is similar to vitamin B6, which is used in covering the ends of nerves to prevent further complications. Fish oil has been encouraged by most physicians since it is highly available and can help in healing other diseases that may be chronic. Moreover, it is a cheap product, yet it can have significant benefits in preventing any nerve pain.

3) Capsaicin

Herbal treatment has been there for decades, making it the best method of treating any disease due to its natural effect on the body. This is unlike other medications that come with side effects that may lead to permanent damage. Neuropathy is a manageable condition that requires a patients attention and effort to avoid pain. Capsaicin is a component found in pepper, which makes your mouth hot once you consume it. Despite its hotness, it has proved to be beneficial in the treatment of peripheral neuropathy. Here, you are required to apply it on the skin where it blocks any transmission of pain. It also comes into two forms, capsaicin cream, and capsaicin patches. These two have helped patients to avoid inflammation on the joints and muscles, making you relieve any pain present on the body. This is has been considered the most affordable herb for treating neuropathy since it is highly available and easy to use. The bottom line in this is that capsaicin makes the nerves numb and insensitive. Therefore, you cannot experience any pain. You are also recommended to use ginger or turmeric if you experience any allergic reactions with capsaicin. This way, it will be comfortable to ease pain rather than inducing any further problems.

Go here to read the rest:

3 Affordable Herbs & Vitamins that you should try for nerve pain relief - Explosion

The Food and Drug Administrations accelerated approval of Padcev offers patients with advanced bladder cancer a potential standard of care.

BY Kristie L. Kahl

The agency granted accelerated approval to the application for Padcev (enfortumab vedotin-ejfv) for this patient population, who had no standard of care prior.

Typically, for this patient population, there really wasn't anything that was active (in treating patients), and what weve seen is about 12% of patients have a complete tumor disappearance. Overall, about 40% of patients have whats called a partial response and 84% of patients have some form of tumor reduction, explained Dr. Daniel Petrylak, professor of medicine, medical oncology and urology, and co-leader of Cancer Signaling Networks, at Yale Cancer Center. So this is really a remarkable finding. To my knowledge, this is the most active single agent (in treating advanced bladder cancer). It is even more active than drugs they've been using in the earlier setting.

The agency based its decision on data from the multicenter, single-arm, phase 2 pivotal EV-201 trial designed to evaluate Padcev, which is directed against Nectin-4, a protein located on the surface of cells and highly expressed in bladder cancer, in 125 patients with locally advanced or metastatic urothelial cancer who received prior treatment with a PD-1 or PD-L1 inhibitor and a platinum-based chemotherapy.

The first-in-class antibody-drug conjugate is approved under the FDAs Accelerated Approval Program, which allows approval of a medicine based on a surrogate endpoint if the medicine fills an unmet medical need for a serious condition. In this instance, the accelerated approval was based on tumor response rate, the studys primary endpoint.

We had a certain goal that we had to meet, which was 30%, and we exceeded that, Petrylak said. Patients demonstrated an objective response rate of 44%, including 15 complete responses (12%) and 40 partial responses (32%).

Moreover, duration of response, a secondary endpoint of the study, was 7.6 months.

The most common serious side effects were urinary tract infection (6%), cellulitis (5%), febrile neutropenia (4%), diarrhea (4%), sepsis (3%), acute kidney injury (3%), dyspnea (3%) and rash (3%). Peripheral neuropathy led to treatment discontinuation in 6% of patients. Common side effects of any grade included fatigue (56%), peripheral neuropathy (56%), decreased appetite (52%), rash (52%), alopecia (50%), nausea (45%), dysgeusia (42%), diarrhea (42%), dry eye (40%), pruritus (26%) and dry skin (26%).

Continued approval of Padcev will be contingent upon further evaluation to verify and describe the clinical benefit of the drug in a confirmatory trial.

There are a lot of next steps. This is an exciting drug, and it has a tremendous amount of activity, Petrylak said. Were looking to move this up earlier, in the course of disease. There's a trial being done in patients who've had frontline chemotherapy, and we're looking to (add Padcev) in the neoadjuvant setting prior to somebody having their bladder taken out. And so the thought is that perhaps we'll have more activity earlier.

Petrylak added that researchers are also looking to add the agent to other combinations, like checkpoint inhibitors.

Read CUREs original coverage of the approval.

Read more:

What You Need to Know About the FDA - Curetoday.com

D'Angelo Russell is rapidly approaching a date some NBA observers have circled since the Warriors acquired him this summer.

Golden State can trade Russell as soon as Sunday, Dec. 15, and the 23-year-old has been the source of trade speculation during his time in the Bay Area. The Athletic's Jon Krawczynski reported Wednesday, citing sourcesthat the Minnesota Timberwolves "remain interested in Russell" and that the guard "seems to be realistic in understanding that he may not be long for the Warriors once Steph Curry and Klay Thompson return to full health."

Russell is averaging a career-high 22.4 points per game this season to go with 6.1 assists and 3.1 rebounds, serving as the top offensive option in the absence of his All-Star teammates. He knew he wouldn't play much with Thompson this season as he recovers from a torn ACL, but Curry's broken hand threw a wrench into the Warriors' -- and thus Russell's -- prospects this season. Warriors coach Steve Kerr praised how Russell has handled the rumors surrounding him.

"Money doesn't buy peace of mind," Kerr said Friday morning (H/T San Francisco Chronicle's Connor Letourneau)."It doesn't buy a sense of belonging, a sense of, 'Alright, this is my team.' If there's speculation that you're going to be traded all the time, I don't care how much money you make, I don't care who you are. That's tough. That's no fun to deal with, and this season has been nowhere close to what D'Angelo thought it would be when he first signed with us.

"There's no Steph. We're struggling to win games. He's had his own injuries, and we're throwing all kinds of different lineups out there based on the other injuries we've faced."

Russell has played in just 15 of the Warriors' 27 games this season, playing on a team that looksfar more like the Los Angeles Lakers of his first two seasons than the playoff-contending Brooklyn Nets a year ago -- let alone the reigning Western Conference champion Warriors.

[RELATED:How Warriors' Chriss earning chance to start at center]

Kerr, who entered this season with the highest winning percentage in NBA history (.785), is as aware of Golden State's dramatically different reality as anyone. He said it has only brought out the best in Russell.

"So given all that, he's played really well, and he's been a great teammate and he's doing everything he needs to do to solidify his position here," Kerr continued."But this is the NBA here, and we never know what's coming, what's happening. So, it's a difficult position to be in in general, but for him in particular it's strange set of circumstances and he's handling it really well."

Whether or not the Warriors trade Russell, it's clear Kerr holds him in high regard.

Excerpt from:

Looney gives up two aspects of diet to combat neuropathy - NBCSports.com

First oral taxane to demonstrate superior response rate and overall survival compared to IV paclitaxel in a Phase III clinical trial

Data to be presented today in an oral presentation at the 2019 San Antonio Breast Cancer Symposium (SABCS)

BUFFALO, N.Y., Dec. 13, 2019 (GLOBE NEWSWIRE) -- Athenex, Inc. (Nasdaq: ATNX), a global biopharmaceutical company dedicated to the discovery, development, and commercialization of novel therapies for the treatment of cancer, today announced results from a pivotal Phase III clinical trial showed oral paclitaxel and encequidar had superior response and survival with much lower incidence and severity of neuropathy compared to IV paclitaxel in the treatment of metastatic breast cancer. For additional details on the study results, please refer to the abstract GS6-01, which can be found online here.

Dr. Rudolf Kwan, Chief Medical Officer of Athenex, commented, Oral paclitaxel and encequidar is the first oral taxane to demonstrate in a Phase III study statistically significant improvement in response rate and median overall survival compared to IV paclitaxel, in the treatment of metastatic breast cancer while associated with a much lower incidence and severity of neuropathy. We believe these data suggest the potential for oral paclitaxel and encequidar to provide an important advance in the management of patients with metastatic breast cancer.

These results will be presented in an oral presentation today at the 2019 San Antonio Breast Cancer Symposium (SABCS) at 3:15 p.m. CT in General Session 6 in Hall 3 of the Henry B. Gonzalez Convention Center in San Antonio, Texas, and were selected for the official SABCS press program at 7:30 a.m. CT.

The Orascovery platform was initially developed by Hanmi Pharmaceuticals and licensed exclusively to Athenex for all major worldwide territories except Korea, which is retained by Hanmi.

About Athenex, Inc.

Founded in 2003, Athenex, Inc. is a global clinical stage biopharmaceutical company dedicated to becoming a leader in the discovery, development, and commercialization of next-generation drugs for the treatment of cancer. Athenex is organized around three platforms, including an Oncology Innovation Platform, a Commercial Platform, and a Global Supply Chain Platform. The Companys current clinical pipeline is derived from four different platform technologies: (1) Orascovery, based on nonabsorbed P-glycoprotein inhibition, (2) Src kinase inhibition, (3) T-cell receptor-engineered T-cells (TCR-T), and (4) arginine deprivation therapy. Athenexs employees worldwide are dedicated to improving the lives of cancer patients by creating more active and tolerable treatments. Athenex has offices in Buffalo and Clarence, New York; Cranford, New Jersey; Houston, Texas; Chicago, Illinois; Hong Kong; Taipei, Taiwan; multiple locations in Chongqing, China; Manchester, UK; Guatemala City, Guatemala and Buenos Aires, Argentina. For more information, please visit http://www.athenex.com.

Forward-Looking Statements

Except for historical information, all of the statements, expectations, and assumptions contained in this press release are forward-looking statements. These forward-looking statements are typically identified by terms such as anticipate, believe, continue, could, estimate, evaluate, expect, foresee, guidance, intend, investigate, likely, may, plan, potential, predict, preliminary, prepare, potential, probable, project, promising, seek, should, will, would, and similar expressions. Actual results might differ materially from those explicit or implicit in the forward-looking statements. Important factors that could cause actual results to differ materially include: the development stage of our primary clinical candidates and related risks involved in drug development, clinical trials, regulation, manufacturing and commercialization; our reliance on third partiesfor success in certain areas of Athenexs business; our history of operating losses and need to raise additional capital to continue as a going concern; our ability to integrate CIDALs assets into our existing operations; competition; intellectual property risks; risks relating to doing business inChina; the uncertainty of when, if at all, we will be able to resume producing API in ourChongqingplant; and the other risk factors set forth from time to time in ourSECfilings, copies of which are available for free in the Investor Relations section of our website athttp://ir.athenex.com/phoenix.zhtml?c=254495&p=irol-secor upon request from our Investor Relations Department. All information provided in this release is as of the date hereof and we assume no obligation and do not intend to update these forward-looking statements, except as required by law.

CONTACTSAthenex, Inc.:Jacqueline LiCorporate Development and Investor RelationsEmail: JacquelineLi@athenex.com

Investor Relations:Tim McCarthyManaging Director, LifeSci Advisors, LLCDirect: 212-915-2564

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Athenex Announces Superior Response and Survival with Lower Neuropathy of a Novel Oral Paclitaxel versus IV Paclitaxel in Treatment of Metastatic...

Assessment of the Chemotherapy Induced Peripheral Neuropathy Market

The latest report on the Chemotherapy Induced Peripheral Neuropathy Market published by Persistence Market Research (PMR) is a valuable tool for established and upcoming market players to solidify their presence in Chemotherapy Induced Peripheral Neuropathy Market landscape. Further, by leveraging the real-time and result-driven insights included in the report, readers can formulate effective business strategies to gain an advantage in the competitive nature of the market.

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Chemotherapy Induced Peripheral Neuropathy Market to Witness a Sluggish Growth Owing to Stringent Government Policies in 2019 - 2029 - Markets Gazette...

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Global Chemotherapy Induced Peripheral Neuropathy Treatment Market 2019 by Manufacturers, Regions, Type and Application, Forecast to 2025 - Industry...

Latest market research report On Neuropathy Pain Treatment Market from Ample Market Research covers market overview- defines characteristics, size and growth, segmentation, regional breakdowns, competitive landscape, market shares, trends and strategies for the Neuropathy Pain Treatment industry. The market size section gives the market revenues, covering both the historic data of the market and forecasting the future. Drivers and restraints are studied with respect to external factors influencing the growth of the market. Industry segmentations breaks down the key sub-sectors which make up the market. Additionally, the report also highlights market entry strategies for various companies across the globe. Some of the key players operating in this market include Pfizer, Depomed, Eli Lilly, Endo, Grnenthal Group, Arbor Pharmaceuticals.

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Neuropathy Pain Treatment Market 2019 Share, Growth, Region Wise Analysis of Top Players, Application, Driver, Existing Trends and Forecasts 2026 -...

The research report Neuropathy Pain Treatment Market Global Industry Analysis 2019 2025 offers precise analytical information about the Neuropathy Pain Treatment market. The report identifies top players in the global market and divides the market into several parameters such as major drivers market strategies and imposing growth of the key players. Worldwide Neuropathy Pain Treatment Industry also offers a granular study of the market dynamics, segmentation, revenue, share forecasts and allows you to make superior business decisions. The report serves imperative statistics on the market stature of the prominent manufacturers and is an important source of guidance and advice for companies and individuals involved in the Neuropathy Pain Treatment industry.

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Neuropathy Pain Treatment Market report segmentation on Major Product Type:Calcium Channel Alpha 2-delta Ligands, Serotonin-norepinephrine Reuptake Inhibitors, Others

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Global Neuropathy Pain Treatment Market 2019 by Manufacturers, Countries, Type and Application, Forecast to 2025 - World Industry Reports

New medicines and treatments can often help patients better tolerate the sometimes harsh side effects of chemo

Chemotherapy, or chemical treatment, is often recommended as a treatment for a variety of cancers as it uses powerful chemicals to kill fast-growing cells, such as cancer cells, in ones body. Particularly for cancer that has spread to different parts of the body beyond the original tumor, chemotherapy can be effective as it can work throughout the whole body. According to the American Cancer Society, the three main goals for using chemotherapy in cancer treatment are to cure cancer, to control the disease if a cure isnt possible and palliation, to ease symptoms.

Dr. Lindsey Prochaska, DO, a medical oncologist with NHRMC Physician Group - Cape Fear Cancer Specialists, and Katie Evans, an oncology clinical pharmacist at NHRMC, have shared some information about this common cancer-fighting treatment, often called chemo. Prochaska treats patients at Cape Fear Cancer Specialists office in Leland and at New Hanover Regional Medical Centers Zimmer Cancer Center, and Evans collaborates with the oncology teams and patients at the Zimmer Cancer Center.

1) Chemotherapy can be used alone or along with other treatments

Sometimes chemotherapy is the only treatment a patient may need to treat a cancer, other times it may be used along with other forms of treatment.

"Chemotherapy can be used after surgery, before surgery, or even in the metastatic non-curable setting for control of cancer, said Prochaska. In the setting in which surgery removes a cancer, chemotherapy is often used before or after the surgery to rid the bloodstream of cells to reduce recurrence.

Some cancers respond to chemotherapy better than others, and Prochaska said chemotherapy may not be recommended in some circumstances.

More aggressive cancers sometimes respond better to chemotherapy than slow growing ones, she said. Very few cancers have no role for chemotherapy, but if a cancer is caught at a very early stage chemo may not be recommended.

As for if chemotherapy can sometimes provide a complete cure, Prochaska said, Absolutely. When given before or after surgery cure is commonly the goal, she said.

2) Chemotherapy drugs can be taken orally or received through ones veins

Chemotherapy is most often administered intravenously (IV), although, there are some oral chemotherapy treatment options, Evans said. Chemotherapy is administered by chemotherapy certified nurses in the infusion center, whereas, the oral options patients can self-administer following safety precautions for hazardous medications.

3) Chemotherapy can also treat other conditions

Chemotherapy is mostly only used for cancer, but there are some targeted therapies and conventional chemotherapies that treat autoimmune diseases, like lupus and rheumatoid arthritis, Prochaska said.

4) Chemotherapy can reduce chances of a cancer returning

The side effects of chemo can be harsh, but many times when recommended, its to increase the chances of cure, Prochaska said. Chemo can reduce the chances of recurrence 25-50% -- sometimes higher.

5) Side effects are common with chemotherapy

It is true that most systemic chemotherapy can affect both healthy and cancer cells in causing cell death, Evans said. Chemotherapy targets fast growing cells inside of the body which can be both cancer cells and healthy cells. Herein lies the potential for side effects. With newer, more targeted therapy and immunotherapy coming into use, we have seen the potential for side effects to lessen as compared to traditional, systemic chemotherapy.

Evans said these targeted therapies still have side effects that are manageable by an oncologist.

As clinical oncology pharmacists we counsel patients on the side effects they may experience, timeline, and management of the particular side effects with the chemotherapy regimen, she said.

Evans said some common side effects of chemotherapy include lowering blood counts, nausea, vomiting, gastrointestinal disturbances, peripheral neuropathy, hair loss, appetite and taste changes.

Side effects from chemotherapy are common, but can be managed with supportive care medications, Evans said. Once chemotherapy is completed, many side effects will resolve, though we know that some side effects like hair loss and neuropathy will take months to resolve.

Evans said side effects with chemotherapy treatment also differ in the time of onset. The effects on blood cell counts are relatively soon after chemotherapy has begun, hair loss is usually between 2-3 weeks after chemotherapy, and neuropathy may take several weeks before noticing.

Contrary to what some may think, Evans said not all types of chemotherapy cause hair loss.

Prochaska said medications have made a difference regarding some side effects.

Chemotherapy premedications and postmeds have come a long way, Prochaska said. Many people tolerate chemotherapy much better than expected now that we have medications that can help control nausea and vomiting.

Contact the newsroom at 910-343-2384 or Breakingnews@StarNewsOnline.com.

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Health watch: 5 things to know about chemotherapy - StarNewsOnline.com