Small fiber neuropathy is really an interesting condition because it consists typically of just burning, numbness, pain of the feet, sometimes the hands later on without necessarily having any abnormalities on your EMG or nerve conduction study. So what I tell patients and actually residents or students who train under us is that a normal nerve conduction study does not exclude a neuropathy. And we will confirm this by doing additional testing, specifically the nervous the the examination at the bedside asking patients about their.
Symptoms, for example, loss of sensation to cool or or hot temperatures, loss of pain sensation and also doing skin biopsies where we look at nerve densities in the skin both from the calf and the thigh as well as doing a special test that looks at sweat function both in your foot in in the legs as well as the feet to gauge the level of small fiber nerve damage. Small fiber neuropathy typically will progress unless the underlying cause is identified and reversed. Diabetes of course being the most common cause is always screened.
For. but once the more common causes are excluded and the focus becomes on excluding any underlying secondary disease process but also controlling pain because if patients’ symptoms of pain are generally controlled they tend to do pretty well and really have no other major functional deficits. I’ve really become interested over the years is how interconnected neurology and rheumatology are and one thing I often do on patients who have unexplained small fiber even autonomic neuropathy is have them see rheumatology or get evaluated for connective.
Why Cant We Reverse Nerve Damage
Every year, tens of millions of americans suffer from nerve damage, some irreparably so. Science can heal bones, grow new organs and even restore our microbiomes, but why is it so hard to fix our nerves? Hey guys Lissette here for DNews The human body posses a remarkable ability to heal. Bones refuse, skin wounds mend, and the immune system adapts to infection, after infection. But theres one area of.
The body that struggles to recover after an injury: the nervous system. nerve damage can be some of the most debilitating and permanent type of injury. The nervous system is an incredibly complex network used to send electrical information throughout your body. It can basically be divided into two sections. With the brain and spinal cord making up the central nervous system or CNS. and the nerves made up of fibers of sensory and motor neurons comprising the peripheral nervous system.
Each cell in the nervous system from the tip of your finger up your arm, up your spinal column, into your brain, is very specialized. And each has a unique function on the pathway, like a circuit. If one these gets cut or injured, its hard for an exact replacement cell to be put in in the right spot. Think about when you get a cut on your skin. If the cut goes deep enough, exact replicas of cells won’t cover the wound, instead fibrous tissues form. which we call scars. And scars are part of the problem in regrowing nerves, they.
Often get in the way especially in the case of spinal cord injuries. as part of the cns, spinal cord injuries are notoriously difficult to heal; partially because of the way nerve cells in the CNS are made. According to the book, Results and Problems in Cell Differentiation, the CNS also has certain proteins that weirdly, inhibit cell regeneration. While this might sound like a bad idea, its hugely beneficial overall to the formation of the CNS. These cells need.
To grow exactly where they are supposed to, just one out of place could be bad. like. think of an electrical circuit, each unit has to be in a specific order in specific place to work. If one is out of place, the integrity of the CNS is compromised. Neurons in the CNS also lack certain cleaning cells. Nerve cells are made up of many parts, but they send signals through threads covered in a protective sheet of myelin. These threads are called axons. Axons are the long part of the cell that reaches out to the cell next.
To it to send information down the line. like arms handing the bucket down the line in a bucket brigade. So these are obviously super important and need protecting. Thats where the Schwann cells come in. which are only found in the Peripheral nervous system. Schwann cells, which arent neurons but GLEEL cells, produce the myelin that help protect the axons. But, a study published in The Journal of Cell Biology found they also clean up damaged nerves making way for the healing process to take place and.
New nerves to be formed. but the problem is. these schwann cells are missing from the cns. What they have instead are myelin producing cells called oligodendrocytes. But these cells dont clean up damaged nerve cells at all. Which is part of the problem. So unfortunately, according to Richard G. Fessler professor at Rush University Medical Center There are currently no therapies which successfully reverse the damage from injuries to the spinal cord. But research is currently underway to examine the potential success.
Of stem cell treatment, where stem cells are injected directly at the injury site. still, it will take a few years to see the results of such trials. But there are times your body can regenerate nerves. The peripheral nervous system doesnt have the same blocking proteins that the CNS has, and Schwann cells help heal the damage. So its able to regrow nerves, albeit slowly. For instance, if you cut a nerve into your shoulder, it could take a year to regrow. By that time.the muscles in your arms could.