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Neuropathy

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Notes

The 2007 Treatment Guidelines section will contain the 2007 published guidelines. To view Guidelines from previous years, view year 2006 Treatment Guidelines and 2005 InfoMedlinks (Articles section) or our Monthly Online Newsletter (under the Guidelines section).

Neuropathy

Daily Treatment Report

Cognitive Therapy-CBT-Psychotherapy

 

 

Device Therapy

 

Drug Side-Effects and Interactions

Use of Tricyclic Antidepressants in Older Patients With Diabetic Peripheral Neuropathy. (Clinical Journal of Pain 2007) "Conclusions: The high prevalence of contraindications, warnings, or precautions and the low level of TCA exposure suggest that many older patients with DPN who receive TCAs may be inappropriately treated."

Drugs

[Effects of administration of high dose steroids for complete idiopathic facial nerve palsy: propriety of a second course of steroid therapy] (Nippon Jibiinkoka Gakkai Kaiho. 2007) "RESULTS: The total cure rate of the patients was 77%. No significant differences were detected among the groups in terms of the cure rate, average time to achieve maximum recovery, or the side effects rate (P > 0.05). CONCLUSION: High-dose steroid therapy was considered to be somewhat effective in curing complete Bell's palsy. However, there were no correlations between the initial or total steroid dose and the prognosis if a prednisolone equivalent dose of more than 150 mg initially, or a total dose of more than 880 mg was used. These findings show no significant benefits of treating complete Bell's palsy with a second course of steroids."

Antidepressants for neuropathic pain. (Cochrane Database Syst Rev. 2007)

Early Treatment with Prednisolone or Acyclovir in Bell's Palsy (NEJM 2007) "Conclusions In patients with Bell's palsy, early treatment with prednisolone significantly improves the chances of complete recovery at 3 and 9 months. There is no evidence of a benefit of acyclovir given alone or an additional benefit of acyclovir in combination with prednisolone."

Antiepileptic Drugs in Treatment of Pain Caused by Diabetic Neuropathy (Journal of Pain and Symptom Management 2007)

An Evidence-Based Algorithm for the Treatment of Neuropathic Pain (Medscape General Medicine. 2007)

Exercise

Physiological improvement with moderate exercise in type II diabetic neuropathy. (Electromyogr Clin Neurophysiol. 2007) " CONCLUSIONS: This study supports the hypothesis that exercise can be performed safely in patients with type II diabetic neuropathies and can produce improvement in their nerve function. This study also supports the hypothesis that ischemia may have a meaningful role in the pathogenesis of neuropathies in patients with type II diabetes mellitus."

A prospective study of physiotherapist prescribed community based exercise in inflammatory peripheral neuropathy. (J Neurol. 2007) "These findings demonstrate that individually prescribed community based exercise is feasible and acceptable for people with stable motor neuropathy and participation in exercise may be successful in reducing chronic disablement."

General Information

Management of herpes zoster and postherpetic neuralgia. (J Am Acad Dermatol. 2007)

Steroids for traumatic optic neuropathy (Cochrane Database of Systematic Reviews 2007)

Overview on pathophysiology and newer approaches to treatment of peripheral neuropathies. (CNS Drugs. 2007)

Effects of treatments for symptoms of painful diabetic neuropathy: systematic review. (BMJ. 2007) "CONCLUSION: Anticonvulsants and antidepressants are still the most commonly used options to manage diabetic neuropathy. Oral tricyclic antidepressants and traditional anticonvulsants are better for short term pain relief than newer generation anticonvulsants. Evidence of the long term effects of oral antidepressants and anticonvulsants is still lacking. Further studies are needed on opioids, N-methyl-D-aspartate antagonists, and ion channel blockers."

Are opioids effective in the treatment of neuropathic pain? (Am Fam Physician. 2007) "Reviewers' Conclusions: Short-term studies provide only equivocal evidence about the efficacy of opioids in reducing the intensity of neuropathic pain, whereas intermediate-term studies demonstrate significant efficacy of opioids over placebo, which is likely to be clinically important. Reported adverse events of opioids are common but not life threatening. Further randomized controlled trials are needed to establish long-term efficacy, safety (including addiction potential), and effects on quality of life."

Painful Diabetic Neuropathy: A Management-Centered Review (Clinical Diabetes 2007)

A pilot study comparing two manual therapy interventions for carpal tunnel syndrome. (J Manipulative Physiol Ther. 2007) " CONCLUSIONS: Although the clinical improvements were not different between the 2 manual therapy techniques, which were compared prospectively, the data substantiated the clinical efficacy of conservative treatment options for mild to moderate CTS."

Guidelines

NGC - American Academy of Orthopaedic Surgeons clinical guideline on diagnosis of carpal tunnel syndrome. (2007)

NGC - EFNS guidelines on pharmacological treatment of neuropathic pain. (2006)

NGC - European Federation of Neurological Societies/Peripheral Nerve Society Guideline on management of paraproteinemic demyelinating neuropathies. Report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society. (2006)

NGC - European Federation of Neurological Societies/Peripheral Nerve Society Guideline on management of multifocal motor neuropathy. Report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society. (2006)

Immunotherapy

 

Internet Sites

Treatment Information

DrugBank (drug structure)

FDA - MedWatch (Drug Alerts)

Drug-Food-Supplement Information

Drug Information Online

Drug Interaction Checker

DrugDigest (drug interactions)

FDA - Drug Interactions: What You Should Know

NIH - Botanical Dietary Supplements: Background Information

NIH - Drug, Supplements, and Herbal Information

NIH - Herbal Supplements: Consider Safety, Too

NIH - Medicines

NIH - Vitamin and Mineral Supplement Fact Sheets

Nutrition

Other

Other Treatments

Experimental

Acetyl-L-carnitine in diabetic polyneuropathy: experimental and clinical data. (CNS Drugs. 2007)

Effects of resveratrol on nerve functions, oxidative stress and DNA fragmentation in experimental diabetic neuropathy. (Life Sci. 2007) "Results of the present study suggest the potential of resveratrol in treatment of diabetic neuropathy and its protective effect may be mediated through reduction in oxidative stress and DNA fragmentation."

Radiotherapy

 

Supplements-Vitamins-CAM

Protective effect of acetyl-l-carnitine on the apoptotic pathway of peripheral neuropathy. (Eur J Neurosci. 2007) "Peripheral neuropathies are widespread disorders induced by autoimmune diseases, drug or toxin exposure, infections, metabolic insults or trauma. Nerve damage may cause muscle weakness, altered functionalities and sensitivity, and a chronic pain syndrome characterized by allodynia and hyperalgesia."

The effect of alpha-lipoic acid on symptoms and skin blood flow in diabetic neuropathy. (Diabet Med. 2007)

Effects of resveratrol on nerve functions, oxidative stress and DNA fragmentation in experimental diabetic neuropathy. (ife Sci. 2007) " Results of the present study suggest the potential of resveratrol in treatment of diabetic neuropathy and its protective effect may be mediated through reduction in oxidative stress and DNA fragmentation."

Surgery

Power grip, pinch grip, manual muscle testing or thenar atrophy - which should be assessed as a motor outcome after carpal tunnel decompression? A systematic review. (BMC Musculoskelet Disord. 2007)

Surgical treatment options for carpal tunnel syndrome. (Cochrane Database Syst Rev. 2007)

Transplantation

 

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