Most Effective Peripheral Neuropathy Treatment

Peripheral Neuropathy Program By Dr. Randall Labrum

Neuropathy Solution is considered as a self- treatment program that supplies people with a proven, simple solution for peripheral neuropathy. Dr. Randall C. Labrum, the author of this program claims that his treatment works successfully for most cases without fail, no matter your peripheral neuropathy results from chemotherapy, diabetes, hypertensions, or aging process. This 6-step system is effective for most people regardless of their age, ethnicity, gender, background. As evaluation, it is recommended by, even used by a lot of the sharpest-thinking neuropathy treatment researchers and innovators. You can effectively heal your neuropathy and achieve optimal health. With the Neuropathy Solution Program, you do not need to squander more money and time on surgery and drugs, as well as other methods that do not function. Many people have benefited from this program. If you give it a try, you too can gain those benefits. Continue reading...

The Peripheral Neuropathy Solution Summary


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All of the information that the author discovered has been compiled into a downloadable book so that purchasers of The Peripheral Neuropathy Solution can begin putting the methods it teaches to use as soon as possible.

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The peripheral nervous system

The peripheral nervous system contains all the nerves outside of the central nervous system. It consists of cable-like nerves that link the central nervous system to the rest of the body. The peripheral nervous system can be subdivided into the somatic nervous system and the autonomic nervous system. The somatic nervous system contains

Injuries To The Peripheral Nerves

From 1963 to 2002, 85 cases of peripheral nerve injury were reported in Chinese acupuncture journals (see Table 16-2). When the peripheral nerves are needled, the patient often feels an electric Most peripheral nerve injuries are caused by wet needling a few, by dry needling. This type of injury is usually caused by three factors

What is diabetic neuropathy

Diabetic neuropathy is the term used to describe the usually chronic damage to nerves that occurs as a result of untreated, or inadequately treated, high blood sugar. It results from a complex sequence of events that leads to damage and destruction of the minute blood vessels that nourish nerves along their course to the region of the body they serve after leaving the spinal canal. Each such nerve is a single cell. The longest nerves, much like long chains, are the most susceptible to damage. If a peripheral nerve (i.e., a nerve cell not contained in the brain or spinal column) emerging from the spinal column and traveling to the toes were the thickness of a piece of string, it would be 3 miles in length At frequent intervals along its length, each peripheral nerve receives nourishment from tiny blood vessels. If any of these tiny blood vessels are irreversibly damaged, that part of the nerve dies and no signals are conducted in Peripheral nerve Diabetic neuropathy is most either...

Central and Peripheral Nervous System

Peripheral nervous system Vibratory perception in the peripheral extremities is the classical index of peripheral nervous decline with aging. Less well appreciated is the effect of aging on pain perception, in which there can be a numbing of sensation or, less commonly, an accentuation of perception. Pain perception from the visceral organs is often dulled, which can have adverse implications for the early detection of organic diseases. All of the peripheral nerve dysfunction can result from the compensatory sprouting of axonal limbs to compensate for the loss

Approach To Neuropathic Pain

There is a wide range of choices in the approach to treatment of neuropathic pain. Potential treatments range from noninvasive measures, such as transcutaneous electrical nerve stimulation (TENS), physical therapy, to pharmacotherapy, to neurosurgical interventions in refractory cases.28 Table 1. General Interventions for Neuropathic Pain Medication Level of evidence tricyclic antidepressants or gabapentin for other features of neuropathic pain such as burning, dysesthesias, or allodynia.29 Reviews of older trials provide estimates for the number needed to treat (NNT) for tricyclic antidepressants (NNT 2-3), opioids (NNT 2.5), and anticonvulsants such as gabapentin (NNT 3.8). Based upon this, one might consider topical lidocaine patches for patients with post-herpetic neuralgia, and then alternate trials of tricyclic antidepressants or serotonin reuptake inhibitors for patients with other neuropathic pain syndromes before proceeding to opioids.30 Most of the evidence cited is derived...

Homeostatic Acu Reflex Point System

Acupuncture Point

The anatomic configuration of ARPs, either homeostatic or symptomatic, varies in different parts of human body. As described in previous chapters, the common components of all ARPs are peripheral nerve fibers, which may include the sensory or postganglionic nerve fibers, or both, and motor nerve fibers such as muscle or tendon spindles. Secondary components include other soft tissues such as blood vessels, lymphatic vessels, and tendons or fasciae. The nerves at which the points form can be very different, according to their location some are made of nerve endings, some are associated with big nerve trunks, and some contain a variety of different nerve fibers. The anatomic depths at which the points are formed are also varied. Ten anatomic features of ARP formation were discussed in detail in Chapter 8. All these features affect the formation, development, and appearance According to both clinical evidence and anatomic research, the most frequently used and therapeutically effective...

Trigeminal Nerve Cranial Nerve V

The trigeminal nerve forms two primary ARPs on the face, and their locations are easily defined. Nevertheless, the trigeminal nerve is one of the most complicated peripheral nerves. A comprehensive description of its anatomic and functional physiologic features is helpful for understanding its relationship to facial pathologic processes.

Michael J Devlin Stephen A Wonderlich B Timothy Walsh and James E Mitchell

We know now that there are separate but interconnected systems in the central nervous system, the peripheral nervous system, and the gut, and the number of chemical transmitters involved, in particular peptidergic substances which have been found to play important roles, continues to multiply. Our knowledge of these factors and how to manipulate them will contribute to effective and, ideally, specific pharmacological approaches to the treatment of binge eating disorder and obesity. Additionally, there has been a growing interest in the genetics of obesity and of binge eating and, despite the complexity, progress is being made.

Shellfish poisoning paralytic 245

Treatment There is little that can be done either for the rash or the pain afterward, but prompt use of antiviral drugs such as acyclovir, famcyclovir, or valacyclovir can shorten the rash stage and lessen the chance of pain later. Therefore, patients should seek medical help at the first signs of shingles. Acyclovir slows reproduction of the virus and shortens the course of the infection, although it doesn't prevent the nerve pain following a shingles attack. Some experts maintain that steroid drugs such as prednisone can prevent this pain. Valacyclovir is a chemical cousin of the widely used acyclovir it received FDA approval in June 1995.

Anatomic Survey Of Homeostatic Acureflex Points

Dry Needling Homeostatic Points

The distribution of ARPs follows the same segmental scheme as do the peripheral nerves. After exiting from the spinal cord, many fibers of nerve roots, both sensory and motor, are mixed to form a mesh that is called the plexus (Fig. 8-3). In addition to the sensory and motor pathways, the peripheral nervous system includes some specialized neurons involved in controlling such auto-nomic functions as heart rate, peristalsis, sweating, and smooth muscle contraction in the walls of blood vessels, bronchi, sex organs, pupils, and other areas. These neurons are part of the autonomic nervous system.

A HSV Gene Transfer for Neuropathy and Pain

Gastrocnemius Muscle Transfer

Lication-defective vectors, such as wild-type HSV, target with high efficiency to dorsal root ganglion (DRG) neurons following subcutaneous inoculation, a process that benefits from high-level expression of the HveC HSV receptor on sensory nerve terminals in the skin (160) and specific interactions between capsid and tegument proteins and dynein to mediate retrograde axonal transport along microtubules (161), followed by injection of the DNA through a nuclear pore into the nucleus. We have used HSV-mediated gene transfer to the PNS in rodent models of peripheral neuropathy and in the treatment of pain. The underlying rationale for using HSVmediated gene transfer in these 2 conditions is similar. In both cases, peptides of proven efficacy have been identified. Peripheral neuropathy can be prevented in animal models by treatment with neurotrophic factors, and pain can be substantially ameliorated by the delivery of opioid peptides. However, it is difficult to deliver these short-lived...

Neuronal Tracing Using Lipophilic Membrane Dyes Fluorescent Dextrans and Horseradish Peroxidase HRP

The organization of neurons and their axons in the CNS and peripheral nervous system can be examined using anterograde and retrograde tracing techniques with fluorescent or nonfluorescent dyes. The lipophilic membrane dyes, such as DiI, have the advantage that they may be used on fixed as well as living 4. Micromanipulate the tip of the micropipet into the tissue, and use a pressure injector (e.g., a Picospritzer II) to deposit the dye. Injections are often made more easily if the pipette is fractionally withdrawn from the full depth of the penetration. If you want to label the cut end of a peripheral nerve, depositing the dye onto the cut surface will efficiently label the axons within. 4. To label axons within the CNS, push a micropin laden with dextran into the region of the axon tract. The dextran is taken up into the axons damaged by the pin, so you can regulate the number of axons labeled by controlling the size of the damage. To label axons in peripheral nerves, the author...

Focal Central Nervous System Disorders

Sjogren Brain Mri

Primary Sjogren's syndrome can mimic or coexist with multiple sclerosis (MS),42'46'47 thereby presenting significant diagnostic and therapeutic dilemmas. Alexander and colleagues46 reported an unusual series of 20 pSS patients with multifocal neurologic disease in whom the clinical features, evoked potentials, and CSF fluid profiles met criteria for definite MS, although a high proportion of these patients had features of systemic disease (cutaneous vasculitis, peripheral neuropathy, and myositis) not found in MS patients. De Seze and colleagues48 studied 60 consecutive patients with the relatively rare primary progressive form of MS, 10 of whom (17 ) met criteria for pSS. Other studies of MS populations have not found unequivocally higher prevalence of pSS than that expected in the general population.49-51 Peripheral Nervous System Involvement As is the case with CNS involvement, neuropathy can be the presenting feature of pSS.4,9,54,55 Neuropathic symptoms preceded sicca symptoms in...

Subconscious Incubation

To directly test the hypothesis that norepinephrine modulates cognitive flexibility, we performed a study in our laboratories where we (Beversdorf, Hughes, Steinberg, Lewis, & Heilman, 1999) tested normal participants' ability to solve problems when treated with placebo, ephedrine, or propranolol. Ephedrine increases the levels of norepinephrine and propranolol a beta-noradrenergic blocker interferes with norepinephrine's influence on the brain. We used a test that relies heavily on cognitive flexibility solving anagrams. In this task, normal participants are presented with a series of words in which the letter order has been scrambled and their task in each trial is to recognize the word that uses these letters. We found that this anagram task was performed better after participants took propranolol than after they took ephedrine. To learn if the increase in cognitive flexibility induced by propranolol was produced by central or peripheral nervous system blockade, Broome, Cheever,...

Homeostatic Acureflex Points On The Upper Limb

As emphasized previously, each ARP contains a main peripheral nerve that is responsible for the dynamic physiology of the point. In addition, different nerves also innervate different tissues at different layers of the same point. Only the major nerves that affect the physiology of the primary homeo-static ARPs are discussed as follows.

The Biological Domain

There is a long history of speculation and theorizing about the relation between the body and the mind. Some of this speculation has led to dead ends. For example, less than a century ago, people believed that the bumps on a person' s head revealed his or her personality . This so-called science of phrenology has been discredited and abandoned. Nevertheless, many modern personality psychologists believe that differences between people in other bodily systems (such as activity in the brain and peripheral nervous system) are related to their personalities. People who like a lot of stimulation and thrills in their lives, for example, might differ from those who don' t in terms of certain blood chemicals that influence nerve transmis sion. Or shy people might have a more reactive sympathetic nervous system compared to socially confident people Another area in which biology and personality intersect is in the physiological systems, such as the brain or peripheral nervous system, where...

Paraneoplastic Syndromes

Uncut Men Black

Subacute Sensory Neuropathy Subacute sensory neuropathy is the most characteristic peripheral neuropathy associated with SCLC. The main complaints are asymmetric distribution of pain and paresthesias involving the arms more than the legs4. Later, numbness, limb ataxia, and pseudoathetotic movements of the hands replace pain4. The deep tendon reflexes are abolished and all modalities of sensation are involved, particularly joint position4. This may precede the diagnosis of SCLC by several months. Type 1 antineuronal nuclear antibody (ANNA-1), also known as anti-Hu, is a valuable serologic marker for SCLC in patients with peripheral neuropathy. These antibodies are occasionally detected in patients who have SCLC without neurologic symptoms but are not found in normal persons.

Pathogenic Autoantibodies

Sera positive for antibody to extractable nuclear antigens (ENA) based on enzyme immunoassay, despite negative antinuclear antibodies, were recently studied and the associated clinical characteristics reported by Davis and colleagues.81 Neurologic disorders, specifically peripheral neuropathy, were the predominant manifestation. The autoantibodies detected by ENA were anti-Ro SSA or anti-La SSB (in 33 out of Aquaporin (AQP) family proteins are differentially distributed in endovascular and neuronal tissue throughout the central and peripheral nervous system. Abnormal distribution of AQP in the salivary and lacrimal glands has been described in pSS.84,85 Increasing evidence also suggests that autoantibodies directed against AQPs mediate neurologic disease. A unique association of antibody directed against AQP4, a member of the family of water channel proteins, has been described in association with neuromyelitis optica. The histopathology of NMO is that of both necrotizing vasculitis...

Drugs Used to Treat Infectious Diseases

Side Effects Because long-term treatment may be associated with liver problems, isoniazid should not be used by patients with liver disease. High doses or prolonged treatment has been associated with problems with the peripheral nervous system (the motor and sensory nerves outside the brain and spinal cord). Other side effects that commonly occur are rash and fever occasionally, patients may experience dry mouth and digestive problems.

Sarah J Glastras MBBS Hons BSc Psychol Honsa Fauzia Mohsin Mbbs Fcpsa Kim C Donaghue MBBS PhD FRACPab

Microvascular complications of diabetes include retinopathy, nephropathy, and neuropathy. Such complications can have devastating long-term effects, including blindness caused by diabetic retinopathy, renal failure caused by diabetic nephropathy, and disabling pain caused by diabetic neuropathy. Although they uncommonly affect children and adolescents with diabetes, subclinical micro-vascular changes may be detected by sensitive testing methods during these early periods. Macrovascular complications that predispose to ischemic and peripheral vascular disease are rare under the age of 30 years. Childhood and adolescence are periods during which intensive education and treatment may prevent or delay the onset of complications.

Multiple Sclerosis Functional Composite

Nervous system Includes all of the neural structures in the body the central nervous system consists of the brain, optic nerves, and spinal cord the peripheral nervous system consists of the nerve roots, nerve plexi, and nerves throughout the body and the autonomic nervous system regulates the internal organs through a balance of the sympathetic and parasympathetic divisions.

Physiology of Acu Reflex Points

If this sensitization, especially when it is peripheral, is not neutralized, the sensitized reflex nerve will sensitize other peripheral nerves, possibly through both central sensitization and functional intercon-nectedness between different parts of the body. For example, when low back pain occurs at the L2-L5 level, it can be found that the superior cluneal, inferior gluteal, popliteal and sural nerves have already been sensitized. If the pain persists, the lateral and medial pectoral nerves also become sensitized. Why this happens in such an interconnected pattern is little understood, and what is currently known is just the tip of an iceberg. Nevertheless, the limited knowledge of this interconnectedness has already offered guidance in clinical practice a systemic approach to restoring homeostasis. For instance, when pathologic conditions of the core system (e.g., low back pain) are treated, the interconnected peripheral nerves of the lower limbs will be treated at the same time....

Vector Transgene Expression

When LAP2 was added to the LAPl-reporter cassette in the ectopic site within the genome, long-term expression was restored although the transcription start site was not determined (150). The LAP1-LAP2 complex was capable of driving long-term transgene expression when a lacZ reporter gene cassette was introduced into the LAT intron in the native LAT locus (151), Chen and Glorioso, unpublished data, 1995 or when a LAP2-lacZ expression cassette was present in an ec-topic locus within the viral genome (147). We have also shown that a LAP2-NGF cassette present either in the tk or Us3 loci of the vector expressed this gene product in latently infected rodent neurons both in culture and in vivo (111). Although, expression of p-galactosidase from the LAP-lacZ vectors could be detected in neurons of the mouse peripheral nervous system (PNS) for up to 300 days (147), Chen and Glorioso, unpublished data, 1995 , prolonged expression in the central nervous system (CNS) was at very low...

RLS and other neurologic disorders

Peripheral neuropathy has also been associated with RLS. A recent case-control study (Hattan E et al 2009) in a Quebec population examined 245 patients with a diagnosis of peripheral neuropathy and 245 age and gender matched controls. The authors considered a positive response to three of the four essential criteria to be 'screen-positive'. All 'screen-positive' patients were subsequently evaluated by a blinded movement disorders specialist. Of the 245 peripheral neuropathy patients, 26.5 were 'screen-positive', compared to 10.2 of controls. Confirmation by neurologist, however, revealed only 46 of the 'screen-positive' peripheral neuropathy patients were felt to truly have a diagnosis of RLS compared to 80 of the 'screen-positive' control patients. After this diagnostic confirmation, the overall prevalence of RLS did not differ between the peripheral neuropathy patients and the control group. The prevalence of RLS was evaluated in a cohort of 99 Italian patients with acquired...

Pharmacological Uses and Toxicity of Vitamin B6 Supplements

Supplements have also been used empirically, with little or no rational basis, and little or no evidence of efficacy, in the treatment of a variety of conditions, including acute alcohol intoxication, atopic dermatitis, autism, carpal tunnel syndrome, dental caries, diabetic neuropathy, Down's syndrome, Huntington's chorea, schizophrenia, and steroid-dependent asthma. Animal studies have demonstrated the development of signs of peripheral neuropathy, with ataxia, muscle weakness, and loss of balance, in dogs given 200 mg pyridoxine per kilogram body weight for 40-75 days, and the development of a swaying gait and ataxia within 9 days at a dose of 300 mg per kilogram body weight. At a dose of 50mgper kilogram body weight, there are no clinical signs of toxicity, but histologically there is a loss of myelin in dorsal nerve roots. At higher doses there is more widespread neuronal damage, with loss of myelin and degeneration of sensory fibers in peripheral nerves, the dorsal columns of...

Sleepdisordered breathing disorders in neurological diseases

Generation of respiratory movements (neuromuscular disorders). Vascular damage to the respiratory center may lead to central respiratory disturbances. Neurodegenerative disease can damage the respiratory center (Cormican, 2004), as well as demyelinating lesions (Auer, 1996) located within the respiratory center. Damage of the axons projecting from respiratory center to spinal cord a-motoneurons (cervical spine trauma, demyelinating plaques in multiple sclerosis) can cause respiratory disorders. Damage to the a-motor neurons of the spinal cord (amyotrophic lateral sclerosis, post-polio syndrome) leads to respiratory failure (Aboussouan, 2005). Similarly, peripheral nerve conduction abnormalities (Guillian-Barre syndrome and congenital polyneuropathy) may lead to hypoventilation and respiratory failure. Disorders of the neuromuscular transmission (myasthenia gravis, botulinum toxin poisoning) and primary muscle disorders (myopathies, muscular dystrophy) can cause respiratory disorders....

The Effects Of Alcohol On Bodily Systems

The main adverse consequences of chronic alcohol consumption with respect to the nervous system are the following brain damage (manifested by dementia and alcohol amnestic syndrome) complications of the withdrawal syndrome (seizures, HALLUCINATIONS) and peripheral neuropathy. Chronic alcohol consumption results in tolerance, followed by an increased long-term consumption that likely leads to tissue damage. PHYSICAL DEPENDENCE may also develop (i.e., a withdrawal syndrome occurs on sudden cessation of drinking). The brain damage, when severe, is usually classified as one of two main disorders. The first is a type of global (general) dementia. It is estimated that 20 percent of admissions to state mental hospitals suffer from alcohol-induced dementia (Freund & Ballinger, 1988). The second is an alcohol-induced amnestic (memory-loss) syndrome, more commonly known as Wernicke-Korsakoff syndrome. This is related to thiamine (Vitamin B1) deficiency. The Wernicke component refers to the...

Biochemistry and Physiology of Galactose

Patients with classical galactosemia have markedly elevated levels of galactitol in plasma and urine, which remain above age-matched control levels after treatment with galactose-free diet, whereas high urinary galactose levels return to normal in all patients. Aldose reductase has been localized to the Schwann cells of peripheral nerves and to renal paptillae cells. Kinetic studies suggest that neither glucose nor galactose are preferred substrates. Only when tissue levels of galactose are much elevated would reduction be important. Aldose reductase activity of lens and other tissue is stimulated by sulfate ions and ATP and is inhibited by various keto acids, fatty acids, and ADP. Increased production of galactitol is felt to play an important role in the pathogenesis of cataracts in the infant with galactose-1-phosphate uridyltransfer-ase, galactokinase, and UDP-galactose epimerase deficiency. The toxicity of polyols in the ocular lens is probably related to their ability to act as...

Methodologies for the Detection of BSE Risk Material in Meat and Meat Products

Soon after the emergence of bovine spongiform encephalopathy (BSE), a fatal disease of the central nervous system (CNS) in cattle, so-called specified bovine offal were legally defined and banned (SBO-ban) in order to reduce the presumed potential BSE exposition risk for British consumers (UK, 1989). Later on the legal definition of risk material was frequently modified according to new scientific results on BSE tissue infectivity (Table 19.1). A European-wide ban on specified risk materials (SRM) was established in 2001 (EC, 2001). In effect, the SRM-ban is still the most important direct measure in reducing potential human BSE exposure risk (EC, 2005). Taking into account the overall and constant reduction of the frequency of BSE cases as well as the very high costs of preventive measures, the European Commission has envisioned a future lifting of the SRM-ban (EC, 2005). Scientific uncertainties and new insights into atypical BSE, however, do not argue in favour of a total lift of...

Peripheral organization of visceral afferent fibers

Differ significantly from somatic primary afferent fibers in both number and pattern of distribution. Visceroreceptive afferent fibers are diffusely organized into web-like plexuses rather than forming distinct peripheral nerve entities. Afferent fibers with endings in a specific visceral site may have cell bodies in the dorsal root ganglia of 10 or more spinal levels in a bilaterally distributed manner. In contrast, somatic pain afferent fibers arise from a limited number of unilateral dorsal root ganglia. Individual visceroreceptive afferent fibers have been demonstrated to branch within the spinal cord and to spread over multiple spinal segments. Quantitative examination has revealed that spinal dorsal horn neurons with visceral inputs have multiple, convergent inputs from other viscera, from joints, from muscles, and from cutaneous structures. Together, these results suggest that visceral primary inputs are imprecisely organized, which would be consistent with imprecise...

Energetic Relations of Teeth continued

Tooth 27 (lower right central incisor) gall bladder, biliary ducts right side, liver right side, posterior knee, lateral ankle joint, frontal sinus, sphenoidal sinus, eye anterior position, gonad Tooth 28 (lower right first bicuspid) esophagus stomach right side, pylorus pyloric antrum, pancreas, anterior hip, anterior knee, medial ankle joint, jaw, maxillary sinus, tongue, gonad Tooth 29 (lower right second bicuspid) lymph vessels, esophagus stomach right side, pylorus pyloric antrum, pancreas, anterior hip, anterior knee, medial ankle joint, jaw, maxillary sinus, tongue Tooth 30 (lower right first molar) veins, large intestine right side, lung right side, shoulder elbow right side, hand radial side, foot, big toe, ethmoid cells, nose Tooth 31 (lower right second molar) arteries, large intestine right side, shoulder elbow right side, hand radial side, foot, big toe, ethmoid cells, nose Tooth 32 (lower right third molar) peripheral nerves, terminal deum, heart right side, shoulder...

Why are pancreatic cancer cells attracted to nerves Molecular mechanisms of neural invasion in PCa

Neural Control Lymph Vessels

Researchers and clinicians have long puzzled about why PCa cells are frequently encountered around intrapancreatic nerves. Early reports had claimed that PCa cells enter nerves through the perineurium at its weakest points, i.e. along neural lymph vessels(di Mola&di Sebastiano, 2008), which, however, could not be confirmed in later studies. In later studies, investigators suggested that PCa cells grow along the path of least resistance after entering nerves, which was thought to be the perineural space (Rodin et al., 1967 Bockman et al., 1994 di Mola&di Sebastiano, 2008). Indeed, a higher proliferative index and decreased apoptosis in the perineural space could previously be shown for prostate cancer cells invading nerves (Ayala et al., 2004). However, newer studies could demonstrate that limiting PCa cells' presence around nerves to the local physical circumstances may be an oversimplification of the utmost frequent NI in Pca (Demir et al., 2010). In particular, the development of...

Blood Coagulation System And Immune Complement System

When the needle is removed, tissue repair processes are stimulated, the lesioned cells are digested, and protein synthesis is mobilized. The lesion-induced healing is directed by systemic neurohormonal mechanisms. The pituitary gland starts to increase the blood volume of adrenocorticotro-pic hormones (ACTH), which triggers the synthesis and secretion of physiologic corticosteroids and other hormones. This process protects the body from stress, including reduction of the inflammatory reaction. Descending neural control systems from the brain inhibit and desensitize the nocicep-tive nerves in both the spinal cord and the peripheral nervous system. These systems also balance the autonomic nervous system, which normalizes blood flow and energy metabolism. Finally, the body's homeostasis is improved or restored, and local tissue healing and pain relief are accelerated.

Neurological Degeneration in Vitamin B2 Deficiency

Vitamin B12 deficiency is accompanied by neurological degeneration in about two-thirds of cases - either peripheral neuropathy or subacute combined degeneration of the spinal cord. Folic acid deficiency is only rarely associated with similar neurological damage. Subacute combined degeneration of the spinal cord is from demyelination of the corticospinal tracts and posterior columns of the spinal cord, leading to gait ataxia and loss of position sense and vibratory sense. Peripheral neuropathy leads to loss of cutaneous sensation and tendon reflexes (Savage and Lindenbaum, 1995).

Manifestations of Lead Toxicity

Neurologic Full-blown lead encephalopathy, including delirium, truncal ataxia, hyperirritability, altered vision, lethargy, vomiting, and coma, is not common. Although peripheral nerve damage and paralysis may still be reported in adults, the most common toxicity observed is learning disability and an associated high-frequency hearing loss occurring in children with blood lead levels previously assumed to be safe. At low blood levels of lead (less than 10 mgdl-1), children may lose IQ points, possibly due to the interference of lead in normal calcium signaling in neurons and possibly by blocking the recently reported learning-induced activation of calcium phospholipid-dependent protein kinase C in the hippocampus.

Protective Reflexes Through Sensory Feedback in the Musculoskeletal System

Reflexes Muscle Sensory Neuron

Any movement of the musculoskeletal system involves both acceleration and deceleration phases. If acceleration is not precisely controlled, or if deceleration is delayed or not strong enough, the resulting overacceleration of the body part can cause rupture of the muscles, tendons, and even bones. Two types of peripheral nerve cells are involved in this coordination to protect a muscle against unnecessary injury muscle spindles and tendon spindles. Muscle spindles prevent overstretching of the muscle fibers, and tendon spindles prevent overcontraction. Tendinitis, a common injury in athletes, is usually the result of ignoring warnings from these two spindles.

Physical Properties Of Muscle Tone Tension Contracture Thixotropy And Spasm

Muscle spasm is an involuntary contraction of a muscle or a segment within a muscle that can be caused by irritation of a nerve root, plexus, or peripheral nerve branch. Spasm caused by irritation of the nerve endings within a muscle may be limited to the muscle involved or may spread to other muscles because of reflex pain mechanisms.

Exploring brain systems

Despite many years of investment, giving up the work I had been doing in the peripheral nervous system was not that hard. I had gradually come to feel that working at that level would yield diminishing returns, similar to my sense in the 1970s about the future of invertebrate nervous systems as they were then being studied with electrophysiological and anatomical methods. By the mid-1980s, it was hard to ignore the fact that neuroscientists were shifting to what might be described as either a lower or a higher level of interests. The revolution in molecular biology and the powerful methods it provided were attracting many neuroscientists to pursue the organization of the nervous systems of worms, fruit flies, and mice at the molecular genetic level. At the same time, brain imaging techniques based on computer assisted tomography (CAT) and positron emission tomography (PET) were giving birth to a new field that had been dubbed cognitive neuroscience, defined as a wedding of psychology...

Asymmetrical distribution of auricular points and musculoskeletal pain


Some cases a stress reaction or a somatization disorder could contribute to a prevalent unilateral activation of the auricle (see next section). 4. Last but not least, a symptom could be represented on the contralateral side in specific disorders such as trigeminal neuralgia or other forms of neuropathic pain.

Interrelationships with other systems

Peripheral nervous system somatic nervous system cranial nerves olfactory optic The peripheral nervous system (PNS) consists of the somatic nervous system consisting of the cranial and spinal nerves and the autonomic (involuntary) nervous system. The peripheral nervous system contains all the nerves outside of the central nervous system and can be subdivided into the somatic nervous system and the autonomic nervous system.

Vitamin B6 Deficiency

In vitamin B6-deficient experimental animals there are more or less specific skin lesions (e.g., acrodynia in the rat) and fissures or ulceration at the corners of the mouth and over the tongue, as well as a number of endocrine abnormalities, defects in the metabolism of tryptophan, methionine, and other amino acids, hypochromic microcytic anemia (the first step of heme biosynthesis is a pyridoxal phosphate-dependent reaction), changes in leucocyte count and activity, a tendency to epileptiform convulsions, and peripheral nervous system damage resulting in ataxia and sensory neuropathy.

Medium Vessel Vasculitis

Polyarteritis nodosa (PAN) is observed in children and adolescents, but the peak age-of-onsetis around 50 years. Vasculitis of muscular medium sized vessels is characteristic, with aneurysm formation. Typically patients present with constitutional symptoms, abdominal pain, arthralgia, myalgia, livedo reticularis, peripheral neuropathy, hypertension and renal involvement (31). Angiography may demonstrate characteristic findings (32) but these are not specific to polyarteritis. Treatment is with corticosteroids, which are usually used in high dose to induce remission, and have reduced the five-year mortality from 90 to 50 (33). The addition of further immunosuppre-sion such as cyclophosphamide improves survival to 20 (34).

Clinical Manifestations

The majority of individuals ultimately diagnosed with SS initially present with dry eyes and or dry mouth. A few will present with the result of a secretory deficiency such as increased dental decay at incisal edges or exposed root surfaces of the teeth, oral mucosal burning secondary to a fungal infection, and corneal ulceration or corneal scarring. Dryness complaints may be accompanied by involvement of a diverse array of other organ systems Hashimoto's thyroiditis Graves' disease, severe fatigue, increased sedimentation rate, fever of unknown origin, myositis, peripheral neuropathy, leukocytoclastic vasculitis-purpura, renal tubular acidosis, atrophic gastritis, arthritis, and positive test for antinuclear antibodies or RF in asymptomatic patients (2,5,6).

Systemic Manifestations

Polyarteritis Chondtritis

Other systemic manifestations reported in RP patients include renal and neurologic diseases (30). Kidney disease occurs in 5 to 10 of patients and portends a worse prognosis. Up to 25 can have an abnormal urinalysis as evidenced by microscopic hematuria, proteinuria, or elevated creatinine. The most common renal biopsy findings are a mesangial glomerulonephritis with immune deposits and a segmental necrotizing glomerulo-nephritis with crescents. Tubulointerstitial disease and IgA nephropathy are also reported. Most renal disease in patients with RP is due to an associated vasculitis and not to RP itself. Similarly, neurologic manifestations in RP are usually due to a vasculitis. Neurologic disease may be acute or subacute and cause significant morbidity and mortality (31). The most common manifestation is a cranial neuropathy (cranial nerves II, VI, VII, VIII). Other manifestations include stroke syndromes, seizures, dementia, aseptic meningitis, and peripheral neuropathy.

Nonmalignant Complications of Celiac Disease

Usually the consequence of malnutrition or specific deficiencies. However, others such as neurological problems including ataxia, peripheral neuropathy, or dementia are of uncertain mechanism and perhaps autoimmune in nature. Other consequences of celiac disease have been discussed in the section on atypical or nongastrointestinal presentations (Table 1). Many, but not all, of these nonmalignant complications of celiac disease will respond to a gluten-free diet.

A systemic approach is necessary in dryneedling acupuncture

Central and peripheral nervous system and in the musculoskeletal system. Visceral physiology can be affected as well. For example, a sensitized trigger point on the iliotibial band, related to lower limb dysfunction, will increase the sensitivity of trigger points on the pectoralis major muscle. Both local symptoms and systemic dysfunction should therefore be treated at the same time to achieve restoration of homeostasis. This systemic approach is essential in the treatment of athletes to rehabilitate the current injury as well as to prevent injury in the future.

The Possible Essentiality of Inositol

People with untreated diabetes have high plasma concentrations of free inositol, and high urinary excretion of inositol, associated with relatively low intracellular concentrations of inositol, suggesting that elevated plasma glucose may inhibit the uptake of inositol. There is some evidence that impaired nerve conduction velocity in diabetic neuropathy is associated with low in-tracellular concentrations of inositol and that inositol supplements improve nerve conduction velocity. However, high intracellular concentrations of in-ositol also impair nerve conduction velocity, and supplements may have a deleterious effect.

Abnormal Neurotransmission Serotonin Norepinephrine and Dopamine

Serotonin is a neurotransmitter that regulates sleep patterns, mood, a feeling of well-being, and inhibition of pain. Since those with FM experience abnormal pain, it has been hypothesized that the pathophysiology underlying FM may be an impairment of serotonin metabolism. This hypothesis is supported by finding decreased serotonin metabolites in FM patient plasma and cerebrospinal fluid. However, medications such as selective serotonin reuptake inhibitors (SSRIs, a type of antidepressant that acts on serotonin levels such as Zoloft and Prozac) do not seem to alleviate the majority of FM pain, whereas drugs such as mixed serotonin norepinephrine reuptake inhibitors (SNRIs, a type of antidepressant that acts on both serotonin and norepinephrine levels) seem to be more successful. Examples of SNRIs include the drugs Cymbalta (duloxetine) and Savella (milnacipran) that also have been used to treat depression and the pain of diabetic neuropathy with some success.

Viral infections of the skin

Anatomy And Physiology Herpes Zoster

This is a painful infection along the sensory nerves due to the virus that causes chickenpox. Lesions resemble herpes simplex with erythema and blisters along the lines of the nerves. The areas affected are mostly on the back or upper chest wall. This condition is very painful due to acute inflammation of one or more of the peripheral nerves. Severe pain may persist at the site of shingles for months or even years after the apparent healing of the skin.

Psychosocial Influences On Painrelated Limitations In Cancer Survivors

Although pain has typically been considered the primary determinant of functional limitations in chronic pain sufferers, it has also been suggested that pain and disability are distinct and partially independent phenomena.99,103 Research suggests that, in chronic pain patients, pain intensity rarely accounts for more that 10 of the variance in the severity of functional limitations.97 Although the relation between pain and functional limitations has yet to be examined in cancer survivors, Sullivan et al9 reported that pain symptoms accounted for only 9 of the variance in self-rated functional limitations in a sample of mixed neuropathic pain patients. In recent years, increasing attention has been devoted to assessing the degree to which psychosocial factors might contribute to heightened risk for prolonged pain-related functional limitations. McGill Pain Questionnaire Neuropathic Pain Scale 18. Jung, B.F., Herrmann, D., Griggs, J., Oaklander, A.L., andDworkin, R.H. Neuropathic pain...

Toxicity of Vitamin B6

Animal studies have shown that vitamin B6 is neurotoxic, causing peripheral neuropathy, with ataxia, muscle weakness, and loss of balance in dogs given 200 mg ofpyridoxine per kg of body weight for 40 to 75 days, and the development of a swaying gait and ataxia within 9 days at a dose of300 mg per kg body weight (Phillips et al., 1978 Krinke et al., 1980). At the lower dose of 50 mg per kg of body weight, there are no clinical signs of toxicity, but histologically there is loss of myelin in dorsal nerve roots. At higher doses, there is widespread neuronal damage, with loss of myelin and degeneration of sensory fibers in peripheral nerves, the dorsal columns of the spinal cord, and the descending

Neurocutaneous syndromes

Neurocutaneous syndromes A group of genetic neurological skin disorders affecting the brain, spine, and peripheral nerves that can cause tumors to grow inside the brain, spinal cord, organs, skin, and skeletal bones. The most common syndromes involving children include neurofibromatosis, sturge-weber syndrome, tuberous sclerosis, ataxia-telangiectasia, and von hippel-lindau disease.

What can happen if my diabetes is not properly treated and controlled

Until they reach an advanced and irreversible stage, leading to blindness and the need for kidney dialysis or transplant. Diabetic neuropathy can cause very troublesome symptoms and lead to loss of sensation, mainly in the feet, which places the patient at high risk of trauma, infection, and amputations of the legs and feet.

Dry needling acupuncture is not the acupuncture of traditional chinese medicine tcm

Was invented by the ancient doctors and that many meridian phenomena are of unknown physiology, but do have some relation to physical tissue, especially to our nervous system. Many laboratory scientists claim that they have discovered or confirmed the existence of meridian channels from research such as infrared imaging or similar procedures. If these researchers understood the neuroanatomy of the peripheral nervous system, the neurology and pathophysiology of the human body, and if they knew clinical needling mechanisms and had experience with real patients, they would interpret their results differently and reach different conclusions.

Fate Mapping with Lipophilic Membrane Dyes

Human Meridian Imaging

Fig. 1. (A) Cells labeled with DiI and DiA in the chick embryo neural plate and viewed immediately after iontophoretic applications. About four cells are labeled with DiI (red) and one cell with DiA (green). Bar is 10 im. (B) After 48 h of development, the descendants of cells labeled as in (A) are still visible and their two colors distinct. Bar is 50 im. (C) Motor neurons retrogradely labeled from their peripheral nerves in fixed tissue. One nerve was labeled with DiI, and the adjacent nerve with DiA. Bar is 40 im. (See color plate 2 appearing after p. 368.) Fig. 1. (A) Cells labeled with DiI and DiA in the chick embryo neural plate and viewed immediately after iontophoretic applications. About four cells are labeled with DiI (red) and one cell with DiA (green). Bar is 10 im. (B) After 48 h of development, the descendants of cells labeled as in (A) are still visible and their two colors distinct. Bar is 50 im. (C) Motor neurons retrogradely labeled from their peripheral nerves in...

Needling Is Soft Tissue Therapy

Cortical Stimulation Pain

Soft tissue encompasses muscles, connective tissues, and nervous tissues. In this book, the term is used to include muscles, ligaments, tendons, bursae, capsules, fasciae, peripheral nerves, blood and lymphatic vessels, and viscera with their associated soft tissue such as pleura or ligaments and nerves. The CNS is also considered soft tissue by some authorities. Soft tissue is distributed all over the body and accounts for 50 of body mass. It plays a role in all human activity, including mental activity (which is aided by blood vessels, for example). Therefore all pathologic conditions understandably involve soft tissue, and in many cases, the soft tissue is itself the pathologic focus of the symptoms or disease for example, soft tissue pain in sport and daily activity.

Table 101 Potential Problems with Opioid Medications

Sometimes opioids are used in cancer treatment in conjunction with other medications. For example, if someone has a tumor that is pressing on a nerve, then a medication such as gabapentin, which is in the class of antiseizure drugs but is often used for nerve pain, might be a reasonable option. Other times opioids are used with antidepressant medications that affect serotonin levels or other substances (which help modulate pain) in the brain.

Consequences of Mg Deficit and Implications in Various Metabolic Diseases

Mg deficit causes neuromuscular manifestations, including positive Chvostek and Trousseau signs, muscular fasciculations, tremor, tetany, nausea, and vomiting. The pathogenesis of the neuromus-cular irritability is complex, and it implicates the central and peripheral nervous system, the neuromuscular junction, and muscle cells.

Pyridoxine Deficiency

Pyridoxine (vitamin B6) is required for transamination reactions, including the elimination of homo-cysteine. Pyridoxine deficiency in chronic alcoholism is caused by poor diet, whereas displacement of pyridoxal phosphate from circulating albumin by the alcohol metabolite acetaldehyde increases its urinary excretion. Low serum levels of pyridoxal phosphate are common in chronic alcoholics, and pyridoxine deficiency is manifest by peripheral neuropathy and sideroblastic anemia. In alcoholic hepatitis, the serum level of alanine transaminase (ALT) is disproportionately low compared to aspartate

The visual system Hubel and Wiesel redux

I don't think many neuroscientists would dispute the statement that the work David Hubel and Torsten Wiesel began in the late 1950s and continued for the next 25 years provided the greatest single influence on the ways neuroscientists thought about and prosecuted studies of the brain during much of the second half of the twentieth century. Certainly, what they were doing had never been very far from my own thinking, even while working on the formation and maintenance of synaptic connections in the peripheral nervous system. To explain the impact of their work and to set the stage for understanding the issues discussed in the remaining chapters, I need to fill in more information about the visual system, what Hubel and Wiesel actually did, and how they interpreted it.

The Enteric Nervous System and Gastrointestinal Motility

Peripheral Nervous System Lesions

The enteric nervous system (ENS) operates both in conjunction with and independent of the peripheral nervous system. As discussed previously, nerve plexi exist within the bowel wall, with Auerbach's plexus sandwiched between longitudinal and circular muscle layers, and Meissner's plexus located more medially in the submucosa. The ENS is the largest component of the autonomic nervous system, based on nerve cell number.

The Role of Pyridoxal Phosphate in Steroid Hormone Action and Gene Expression

In vitamin B6-deficient experimental animals, there are skin lesions (e.g., acrodynia in the rat) and fissures or ulceration at the corners of the mouth and over the tongue, as well as a number of endocrine abnormalities defects in the metabolism of tryptophan (Section 9.5.4), methionine (Section 9.5.5), and other amino acids hypochromic microcytic anemia (the first step of heme biosynthesis is pyridoxal phosphate dependent) changes in leukocyte count and activity a tendency to epileptiform convulsions and peripheral nervous system damage resulting in ataxia and sensory neuropathy. There is also impairment of immune responses, as a result of reduced activity of serine hydroxymethyltransferase and hence reduced availability of one-carbon substituted folate for nucleic acid synthesis (Section 10.3.3). Ithas been suggested

Requirements and Signs of Deficiency

The most characteristic clinical signs of severe niacin deficiency in humans are dermatosis (hyper-pigmentation, hyperkeratosis, desquamation - especially where exposed to the sun), anorexia, achlorhydria, diarrhea, angular stomatitis, cheilosis, magenta tongue, anemia, and neuropathy (headache, dizziness, tremor, neurosis, apathy). In addition to the pellagra caused by dietary deficiency or imbalance, there are also reports of disturbed niacin metabolism associated with phenylketonuria, acute intermittent porphyria, diabetes mellitus, some types of cancer (carcinoid syndrome), thyrotoxicosis, fever, stress, tissue repair, renal disease, iron overload, etc. The picture in other species is not radically different however, deficient dogs and cats typically exhibit 'black tongue' (pustules in the mouth, excessive salivation) and bloody diarrhea, pigs exhibit neurological lesions affecting the ganglion cells, rats exhibit damage to the peripheral nerves (cells and axons), and fowl exhibit...

Electrical Acupuncture

Electrical acupuncture stimulates specific peripheral nerves, which send strong impulses to the spinal cord and brain. With different stimulating frequencies, electrical acupuncture can induce different endorphins at different levels of the CNS. Endorphins have many physiologic functions, such as modulating pain mechanisms to relieve pain, relaxing cardiovascular systems, and improving immune activity by reducing physiologic stress. Electrical acupuncture stimulation, therefore, results in accelerated self-healing.

Peculiarities Of The Clinical Spectrum Of Ss

The clinical course of SS is relatively stable and benign in a majority of patients, and is largely characterized by sicca symptoms, fatigue, arthralgias, and myalgias. Sometimes, slowly progressive involvement of other epithelial tissues (quite frequently those of the upper airways, more rarely those of renal tubuli and the gastrointestinal tract) occurs. In about 20 of patients, more or less severe extraglandular systemic features dominate the clinical picture. Most frequent are Raynaud's phenomenon, arthritis, vasculitis leukopenia, and peripheral neuropathy. Glomerulonephritis and central nervous system manifestations are more rarely recorded.

Measures to Prevent Postmastectomy Pain

Post thoracotomy pain syndrome. In this syndrome, pain recurs or persists along a throracotomy scar at least 2 months following the surgical procedure.125 The prevalence varies. It has been estimated that 50 of patients who undergo thoracotomy will have mild to moderate pain and 5 of patients will have severe post thoracotomy pain.126 Pain at postoperative day 1 is predictive of pain 1 month and 1 year after thoracotomy.127 Physical exam usually shows sensory abnormalities such as absence of sensation or allodynia. Tumor recurrence should be excluded if the character of the pain changes, or becomes increasingly severe. Earlier reviews found little evidence for effective interventions.128 Capsaicin was effective in a trial for surgical neuropathic pain (see above),36 and topiramate was active in a small series of patients.129 This remains a difficult problem.130

Summary and conclusion

Neural invasion in PCa bears a unique importance in the biology of this disease due its impact on patient survival, local tumor reccurence and neuropathic pain sensation. Higher interest in NI has paved path for increased research on the biology of NI and accelarated the development of numerous experimental models. The discussed in vitro and in vivo models which shall help to eludicate the pathomechanisms of NI in PCa may provide novel tools to control and to reduce NI in this highly aggressive human malignancy. Considering the dismal average prognosis associated with PCa, one may wonder about the actual benefit of reducing the specific invasion of nerves in this tumor entity. Here, it should be underlined that reduction of NI can be regarded as one of several possibilities to control tumor growth, just as adjuvant therapy as an oncological therapy regimen aims at reaching microscopic tumor presence and reducing the systemic tumor burden. The control of NI, however, bears a further...

Biopsychosocial Perspective On The Pain Experience Of Cancer Survivors

Pain symptoms in cancer survivors can arise from multiple causes including adverse effects of cancer treatment, infection, and musculoskeletal problems (see Chapter 9).7-10 Research suggests that 30-60 of individuals with cancer will continue to experience pain symptoms that will persist in the posttreatment period.2,11-17 Neuropathic pain and somatic pain conditions are the most common pain diagnoses in cancer survivors.18-20

Idiopathic Diseases Sarcoidosis

Neurologic involvement can be central or peripheral. Diabetes insipidus, basal leptomeningitis, and peripheral neuropathy are frequent manifestations (76). An estimated 12 of all patients with sarcoidosis and 50 of patients with neurosarcoi-dosis have facial paralysis, which remains the most frequent neurological presentation of the disorder. The paralysis can be either unilateral or bilateral in up to 33

Injuries Of The Nervous System

When practiced without sufficient modern knowledge of anatomy, acupuncture needling may injure the central and peripheral nervous systems. It has been reported (see Table 16-2) that needle-induced injuries of the nervous system involve the cerebrum, cerebellum, brainstem, spinal cord, nerve trunks in the limbs and face, and visceral nerves. Of these injuries, subarachnoid-space bleeding is the most common. Peripheral nerves, cranial nerves, and spinal nerves are the targets of acupuncture needling. Among injuries of the cranial nerves, the most common are injury to the facial nerve and injury to the trigeminal nerves. Reported injuries of spinal nerves have involved the sciatic, common peroneal, radial, median, ulnar, and diaphragmatic nerves.

Claudio D Stern 1 Introduction

The somites are an intriguing invention of vertebrate embryos. They represent the most overtly segmented structures of the body plan, but they give rise to both obviously segmental (e.g., the axial skeleton) as well as not-so-obvi-ously metameric (dermis and skeletal muscle) elements. In addition, they play a key role in controlling several aspects of the organization of the central and peripheral nervous system of the trunk, and appear to participate in several different types of inductive interactions both within themselves and with neighboring tissues like the neural tube, the notochord, the metanephric and lateral plate mesoderm and the ectoderm and endoderm (see refs. 1 and 2 for reviews). Questions that can be addressed by manipulating somites range from investigations on the mechanisms by which metameric pattern is established, to their influence on the segmental outgrowth and differentiation of precursors of the peripheral nervous system (neural crest cells, motor axon growth...

Nicotine Tolerance And Dependence

Nicotine is the pharmacologic agent that acts on the central nervous system (CNS). Its actions are seen in the brain where it operates on cholin-ergic receptors. The cigarette is a very fast and effective delivery system and effects occur rapidly after a single inhalation of tobacco smoke. Nicotine quickly crosses the blood-brain barrier and, once in the brain, interacts with brain receptors. Nicotine alters moods and acts on pleasure-seeking receptors in the brain, including dopamine and serotonin. The nicotine alkaloid affects numerous body systems It raises blood pressure and the heart rate. It also affects the peripheral nervous system (PNS) and both stimulant and depressive effects are observed in cardiovascular, endocrine, gastrointestinal, and skeletal systems.

Steve Abel Dry Needling

(ACTH), 10-11 Adrenomedullary response, 10, 15-16 Adverse effects, and prevention, 256-258, 257t acupuncture induced, case analyses nervous system injuries, 260, 261 peripheral nerve injuries, 261 pneumothorax, 259 syncope, 262-263 visceral injuries, 262 body position in, 258 disposable needles in, 258 of, 181-189, 181 , 182t Lower leg and foot injuries, 229-233 Achilles tendinitis, 230 ankle fracture, 232 ankle sprain, 231-232 anterior compartment syndrome, 231 in basketball players, 238-239 calf strain, 230 in cyclists, 237-238 fibular (peroneal) tendinitis, 232 foot fracture, 232 foot stress fracture, 232-233 in football players, 242-243 heel spur, 233 in hockey players, 247 medial tibial pain syndrome, 230 plantar fasciitis, 233 posterior tibial tendinitis, 231 in runners, 235-236 in soccer players, 244-245 stress fracture, 230-231 in swimmers, 248-249 tibial and fibular fractures, 229-230 in volleyball players, 252-253 Lower limb. See also Lower limb acu-reflex points Lower limb...

Indications Milk Thistle

Acne (f MCK) Ague (f GMH) Allergy (f1 MCK ACT9 251) Amenorrhea (f MCK NP9(2) 6) Anorexia (2 FAD PHR) Anthrax (f BIB) Arthrosis (f ACT9 251) Asthma (f1 BIB ACT9 251) Atherosis (1 X15617879) Biliousness (f GMH WOI) Bleeding (f BIB HHB NP9(2) 6) Bron-chosis (f BIB BOU EB49 406) Calculus (f BIB WOI) Cancer (f JLH WOI NP9(2) 6) Cancer, bladder (f1 NP9(2) 6) Cancer, breast (f1 HHB JLH MAB) Cancer, cervix (f1 HC020444-262) Cancer, colon (f1 FNF JN133 3861S) Cancer, lung (f1 X15224346) Cancer, nose (f HHB JLH) Cancer, ovary (f1 HC020444-262) Cancer, prostate (f1 X15899838) Cancer, skin (f1 HC020444-262 NP9(2) 6 X15586237) Cancer, tongue (f1 HC020444-262) Cardiopathy (1 X15617879) Catarrh (f BIB GMH) Cerebrosis (f ACT9 251) Childbirth (f HHB) Cholecocystosis (2 APA BIB PHR PH2) Cholelithiasis (f MCK) Cirrhosis (2 BGB KOM PH2 SHT) Colic (f HH3 PH2) Colitis (f ACT9 251) Congestion (f MCK) Constipation (f MCK) Cough (f BIB) Cramp (f BIB) CTS (f1 ACT9 251 HC020444-262) Cystosis (f HH3) Depression...

And Other Medical Systems

Findings from basic research have begun to elucidate the mechanisms of action of acupuncture, including the release of opioids and other chemicals in the brain and peripheral nervous system. Although much needs to be accomplished, the emergence of plausible mechanisms for the therapeutic effects of acupuncture is encouraging.

Therapeutic Approaches

Ein Fall Doktor Abel

Patients with sensory complaints should be followed and a trial of immunomodulatory treatment considered if the extent of involvement and rate of progression suggest active inflammation. In the majority of pSS patients in whom sensory deficits remain stable, management is symptomatic and principles of neuropathic pain management are recommended. Treatments with documented efficacy in other neuropathic pain states include tricyclics, gabapentin, pregabalin, duloxetine, high-dose venlaxifene, tramadol, opioids, and topical local anesthetic agents.141 Lidocaine patches are effective without systemic side effects.142

Sequential compression devices

There is a hypothesis that reduced blood flow to the extremities may play a role in RLS symptoms. Research has been undertaken to ascertain whether sequential (pneumatic) compression devices may alleviate RLS symptomatology. In a small preliminary study from 2005, researchers from New Jersey evaluated 6 patients using enhanced external counter pulsation (EECP) devices on the legs for one hour daily Monday to Friday for 7 weeks (Rajaram SS, 2004). All 6 patients met the 2003 IRLSSG criteria and were assessed with the IRLS rating scale (IRLSSS) before and after the intervention. It should be noted that 3 subjects did not complete the IRLSSS until 4-5 months after EECP treatment. Further complicating the results, 4 of the 6 patients suffered from diabetic peripheral neuropathy and no electromyography or nerve conduction studies were done before or after EECP treatment to assess any potential neuropathy changes. Nevertheless, the research team found that the IRLS rating scale was...

L Carnitine Infusion Versus Oral Supplementation Mitochondrial Myopathy

Acetyl-L-carnitine (levace car nine) in the treatment of diabetic neuropathy. A long-term, randomised, double-blind, placebo-controlled study. Drugs RD 3(4) (2002) 223-31. Maestri A, De Pasquale Ceratti A, Cundari S, Zanna C, Cortesi E, Crino L. A pilot study on the effect of acetyl-L-carnitine in paclitaxel- and cisplatin-induced peripheral neuropathy. Tumori 91(2) (2005) 135-8.

FIGURE 2 Wegeners granulomatosis saddle nose deformity

Nervous system disease in WG is less common and may result from diffuse, small-vessel involvement or mass lesions. Both may be seen in the CNS, leading to cranial neuropathies, stroke, aseptic meningitis, and intracerebral bleeds. The peripheral nervous system is most often affected by small-vessel vasculitis causing sensory neuropathies or mononeuritis multiplex (7).

Preventing Diabetic Complications

Preliminary evidence suggests a possible antinociceptive activity of quercetin, probably through modulation of opioidergic mechanism, suggesting a potential for the treatment of diabetic neuropathic pain (Anjaneyulu & Chopra 2003). Topical application of quercetin in combination with ascorbyl palmitate and vitamin D3 has been tested in a randomised, placebo-controlled, double-blind trial of 34 men and women (age 21-71 years) with diabetic neuropathy. The QR-333 preparation or placebo was applied three times daily for 4 weeks to each foot experiencing symptoms. QR-333 was well tolerated and reduced the severity of numbness, jolting pain, and irritation from baseline values and improved QOL scores (Valensi et al 2005).

Polyarteritis Nodosum

Polyarteritis nodosum is a vasculitis involving medium-sized arteries, most commonly at their bifurcations. Presentation usually involves the gastrointestinal tract as postprandial abdominal pain with nausea. Patients may also demonstrate kidney dysfunction, subcutaneous palpable nodules, fevers, livedo reticularis, and mononeuritis multiplex. Unlike Wegener's granulomatosis, lung involvement is not typically seen. Nervous system involvement is most often a peripheral neuropathy. Although cranial nerve palsies are uncommon, the facial nerve is the most frequently involved nerve and has been reported by several investigators (100-102). Diagnosis is confirmed with biopsy demonstrating granulomatous vasculitis as well as an elevated serum perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) and an elevated ESR with anemia. Without treatment, the overall prognosis is dismal. Treatment involves high-dose corticosteroids. Dudley and Goodman performed decompression surgery on a patient...

Floyd Bloom Neurotransmission Neurons nerve

Cells) communicate chemically by releasing and responding to a wide range of chemical substances, referred to in the aggregate as NEUROTRANSMITTERS. The process of neurotransmission refers to this form of chemical communication between cells of the central and peripheral nervous system at the anatomically specialized point of transmission, the SYNAPSE (synaptic junctions). Thus, it is convenient to conceive of ''the'' neurotransmitter for a specific instance of synaptic connections between neurons in one brain location (the source neurons) and their synaptic partner cells (the target neurons) in another neuronal location. For example, the phrase ''dopaminergic neurons of the nigro-accum-bens circuit'' refers to the DOPAMINE-transmitting synaptic connections between the brain neurons of the substantia nigra and their targets in the NUCLEUS ACCUMBENS. Current concepts of neurotransmission, however, require a broader view they would consider as neurotransmitters all the chemical...

AIDSHuman Immunodeficiency Virus

Central nervous system disease is present in 69 of cases, with the peripheral nervous system affected in 8 of HIV cases. Of the peripheral nervous system dysfunctions, the facial nerve is most common, found in approximately 5 of patients (61). A similar study of 170 AIDS patients found a 4.1 incidence of facial paralysis (62). Facial paralysis is abrupt in onset and usually unilateral (63). The mechanism of facial nerve injury may be a direct effect of the neurotropic virus, secondary involvement due to parotid or other neoplastic processes, or immunosuppression leading to reactivation of herpes zoster or other viruses. Multidrug therapy is the current standard therapy for HIV infection. Reverse transcriptase and protease inhibitors are effective and block HIV replication fusion inhibitors are also used and block HIV entry into the cell. The prognosis for facial paralysis is good, with the majority of patients having complete or near-complete recovery of facial function (64).

Why is PD called a movement disorder

Movement disorder is the term given to a broad category of problems that includes disorders of increased and decreased movement. Movement disorders can involve all parts of the nervous system the majority originate in the brain, although injuries or disorders of the spinal cord and peripheral nerves may also cause problems with movement. Diagnosing these disorders requires specialized training. Knowledge about the causes and mechanisms of movement disorders is growing rapidly, as are advances in treatment. Recent developments have added to the understanding of genetic abnormalities and are also revealing some of the causes of specific movement

Dietary and other sources

Selenides. sclenates and various other inorganic Se compounds have significant toxic potential (at chronic intake levels of 1000pig or more), mainly by causing dermatitis. hair loss, nail deformities, nausea, diarrhea, and peripheral neuropathy through unknown mechanisms.

Specific Nutritional Issues

Fat-soluble vitamins Deficiencies of fat-soluble vitamins are common in liver disease associated with steatorrhea due to the concomitant malabsorption of fat. Vitamin A deficiency can result in anorexia, growth failure, decreased resistance to infections, and night blindness. Vitamin D deficiency results in osteopenia or osteoporosis as well as rickets. The prevalence of fractures is increased in women being treated for alcohol abuse and also following sobriety deficiencies of vitamin D as well as calcium, phosphorus, and fluoride may play a role. The deficiency of vitamin E results in neur-axonal dystrophy, clinically manifesting as peripheral neuropathy and cerebellar disturbances. Vitamin K deficiency results in hemorrhage because of reduced synthesis of clotting factors.

Experimental Thiamin Deficiency in Man and Measurement of Thiamin Status

The clinical symptoms resulting from experimental thiamin deficiency in man have usually responded rapidly to treatment with thiamin. In one feeding study, however, two mental patients were kept for 110 days on a diet providing 200 mg thiamin daily and 1 mg of thiamin by injection 1 day each week thus, their overall weekly average was 350 mg day. They developed a polyneuropathy characterised by defects in the sensory nervous pathways, loss of tendon reflexes, and paralysis of the legs, which took many weeks to respond to large doses of thiamin, and in one case response was still incomplete after 4 months of treatment. The slow cure suggested that degeneration of peripheral nerves had occurred, as is indicated in the dry form of beriberi, in which the neurological lesions are irreversible.

Physiological Actions

Ephedrine and the other alkaloids are sympathomimetic amines that have both direct and indirect actions at a- and h-adrenergic receptors in the brain and peripheral nervous system (12). The physiological actions of the ephedra alkaloids depend on their relative affinities for these receptors, which provide a molecular basis to explain their different profiles of action and adverse effects. For example, ( )-ephedrine appears to have relatively more direct agonist effects and greater central nervous system affinity than either pseu-doephedrine or norephedrine (22-24). Figure 2 Schematic of molecular mechanisms of action of ephedra alkaloids. (a) Indirect release of stored neurotransmitters, primarily norepinephrine. (b) Direct action at postsynaptic a1-adrenergic receptors in the brain and peripheral nervous system. (c) Direct action at postsynaptic h1-, h2-, and h3-adrenergic receptors in the heart, smooth muscle, liver, and adipose tissue. NT neurotransmitter, including...

Treating cervical cancer

Neurotoxicity and cognitive effects (chemo-brain) can be profoundly debilitating in patients who are already cognitively impaired (demented, disoriented, confused, etc.). Elderly patients with a history of falling, hearing loss, or peripheral neuropathy (nerve damage from, for example, diabetes) have decreased energy and are highly vulnerable to neurotoxic chemotherapy like the taxanes or platinum compounds. Many of the medicines used to control nausea (antiemetics) or decrease the side effects of certain chemo-therapeutic agents are also potential neurotoxins. These medicines include dexamethasone (psychosis and agitation),

Low output hypokinetic beriberi

The chronic alcoholic with severe nutritional deficiency for at least 3 months usually enters hospital with severe reversible congestive heart failure after being on minimal food intake for about 1 week. After a few weeks in hospital with abstention from alcohol and with good nutrition, especially with thiamine supplementation, the heart usually returns to normal size and the congestive heart failure disappears without the need for further drug therapy 16,18 , The symptoms of such patients may be a peripheral neuropathy or Wernicke's encephalopathy 23 ,

Pharmacological Options for Nonmalignant Pain

Neuropathic pain, there may be direct or indirect trauma to nerves. For example, some chemotherapeutic agents are toxic to nerves in the hands and feet and can cause a peripheral neuropathy that may be quite painful. Pharmacological options usually come in one of three forms topical medications such as creams or patches, oral medications (pills or liquid preparations), and injections. Most doctors have experience treating pain with oral medications and sometimes topical drugs, and a pain specialist is usually knowledgeable about prescribing oral and topical drugs and skilled at performing injections. Nociceptive pain is usually treated with oral anti-inflammatory medications and with analgesics (drugs that alleviate pain, such as acetaminophen or in some cases opioids). If there is associated muscle spasm, muscle relaxants may be helpful. The use of opioids for non-malignant pain, particularly if it is relatively protracted and not due to an acute injury, is controversial and beyond...

The Neurologist

A neurologist may be called to rule out other conditions that worry patients. For example, many young women with FM become concerned they actually have multiple sclerosis (MS). A neurologist is adroit at identifying this kind of neu-rodegenerative disease. The more common problem encountered by people with FM that is treatable by a neurologist is chronic headache. Many neurologists have extensive experience diagnosing and managing a variety of headaches. Decreasing the frequency and severity of headaches may not only improve the patient's quality of life but may in turn help reduce the central pain of fibromyal-gia. Some argue that because the brain, spinal cord, and peripheral nerves are adversely affected in FM, neurologists should be the primary providers for people with FM. In reality, there are currently too few neurologists to accept the additional patient load. Primary care is therefore argued to be the best home for fibromyalgia, with continued referral to neurologists to rule...


Hexane is a volatile solvent that contains six carbons in a straight chain and has the chemical formula C6H14. It can cause severe damage to the peripheral nervous system, producing death of the long myelinated nerves (distal axonopathy). This condition results in an inability to walk, loss of


Eribulin mesylate (E7389 is a synthetic analog of the marine macrolide halichondrin B, which acts as a novel microtubule modulator with a distinct mechanism of action (different from tax-anes) 60 . An open-label, multicenter, single-arm, phase II study was conducted in patients with CRPC stratified by prior taxane therapy 62 . Primary efficacy endpoint was PSA response rate defined as two consecutive 50 decreases in PSA levels from baseline. The secondary endpoints were duration of PSA response rate and objective response rate by RECIST criteria. One hundred and eight patients were available for analyses. Of these 50 were taxane pretreated. Eribulin showed activity in patients with metastatic CRPR, especially in those with taxane nai've disease. Side effects, mainly hematological toxicity (grade 3 and 4 leucopenia and neutropenia), fatigue, and peripheral neuropathy were manageable 62 .

Systemic Sclerosis

While 84 had classical focal sialadenitis with focus score of 1 or more, only 18 had concomitant fibrosis. In terms of complications, primary Sjogren's syndrome showed a somewhat increased prevalence of cryoglobulinemia, while Sjogren's syndrome associated with systemic sclerosis more often was complicated by peripheral neuropathy and additional autoimmune disease or autoantibodies, not typical for either primary Sjogren's syndrome or systemic sclerosis. On the other hand, Sjogren's syndrome may be protective against systemic sclerosis-associated pulmonary fibrosis, a finding in two recent French studies.11,29 Limited systemic sclerosis was predominantly associated with Sjogren's syndrome in these studies (81 and 95 respectively).11,29 In summary, the restricted data on Sjogren's syndrome in systemic sclerosis indicate that symptoms of dryness are due mainly to fibrosis of the glands and thus due to scleroderma itself, while a limited number of patients...


Although SJW is sometimes used for nerve pain, a randomised, double-blind, crossover study of 54 patients identified a trend toward lower total pain score with SJW treatment, although none of the individual pain ratings were significantly changed (Sindrup et al 2000). The dose of SJW used provided 2.7 mg day total hypericin and was taken over 5 weeks.

Adverse Events

In the Berlow trial, dose-dependent hemolytic anemia occurred in nine patients and theophylline toxicity in four. Other toxic reactions including malaise, rash, and thrombocytopenia were observed. Based upon experience in other disorders, side effects of dapsone include dose-related hemolysis with nearly all patients experiencing a loss of 1-2 g of hemoglobin (with a greater risk in G6PD deficiency). Less common or rare side effects include agranulocytosis and aplastic anemia, peripheral neuropathy that is usually reversible, rash, a fatal mononucleosis-like syndrome,


Neurologic involvement is usually of the peripheral nerves, the spinal nerve roots, and the autonomic ganglia, with the brain usually spared (116). Peripheral neuropathy in amyloidosis is found in 17 of patients. Cranial nerve involvement is rare in amyloidosis. Although cranial neuropathies are more common in familial amyloidosis, recent reviews


Excessive intake All As compounds are toxic in more than miniscule amounts, causing gastrointestinal distress, skin pigmentation, and keratosis (arsenicism), cancer of skin, lung, bladder, and other sites, gangrene of extremities (blackfool disease), anemia, symmetric peripheral neuropathy, and damage lo brain and liver. It is genoloxic and mutagenic at low concentrations. No As-containing supplements should be used and the arsenic content of public water supplies has been limited by the US Environmental Protection Agency to less than K)p.g 1 due to concerns about the potential of arsenic to cause cancer of the skin, bladder, lung, and other organs, even al very low levels of intake.


These vitamins have been isolated in foods and their chemical structures identified as part of the B group, although the activity of para amino benzoic acid (PABA) is quite different from other B vitamins. Biotin acts as a coenzyme in the metabolism of fats, carbohydrates, and protein. Prolonged use of antibiotics and antiseizure medicines interfere with its production. It is destroyed by raw egg white. The vitamin strengthens brittle nails and lowers blood glucose levels preventing diabetic neuropathy. Deficiency symptoms include fatigue, lack of appetite, dermatitis, hair loss, anemia, nausea, and depression.

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