Small fiber neuropathy question
 

Hi,

I am new to the group and have symptoms suggestive of small fiber neuropathy. I have had the big workup including Brain, neck MRI's etc. I saw an neurologist who specialty is neuropathy and muscle disorders. He felt I had history consistent with small fiber disease but not a classic neuropathy. Have other members noted flares of symptoms after stressful events? I had two foot procedures in October which was a big stress load.

Glenn

Hi
 

Yes, yes,and yes, my neuro and well all my Drs. have let me know,
as well as my very own body stress is bad...I for one have some
stress issues and I pay for it...Why because it makes the pain,worst
so what I do is meditate..Why I think stress kills,or makes you
feel like your going to die..Focus on something you love,or a beach,
or something you would like to be doing...Throw that stress away
if you can,or come here vent let it go,be free of it...Someone
may even make you laugh...Hugs to all Sue

i have found that stress definitely increases the pain and inflammation, which may be the reason the pain increases. I know that stress increases airway inflammation and airway reactivity in the lungs.

Hey Joe
 

Sorry your not feeling well,hope you feel better soon. :hug: Sue

Yes, other Glenn--
 

--stress can certainly induce neuropathy symptom "flares", and this is not only restricted to small-fiber syndromes, although those syndromes with small-fiber involvement often produce the most neural pain.

This seems at the very least to have something to do with the release of inflammatory substances that happen in stressful situations--part of the "fight or Flight" reaction of the sympathetic nervous systems.

BTW, have you seen the interesting artciles in the Useful Websites section about small-fiber syndromes? (Look for the long list under my name--there are other as well.) Small-fiber syndromes due to diabetes or impaired glucose tolerance and vasculitis are quite common, as are "idiopathic" syndromes involving small fibers in which it is suspected autoimmune factors play a role:

http://www.neuro.wustl.edu/NEUROMUSC...ory-small.html

Hi & welcome to this forum, i agree with all the others, stress definitely aggravates damaged small fibres.

Brian :)

Agreed. Stress often causes neuropathy symptoms to worsen. It certainly affects me.

Did you have a general anaesthetic for your foot procedure? If so do you know if nitrous oxide (N2O) was used? N2O oxidises vitamin B12, so if you are B12 deficient an anaesthetic could make things a whole lot worse. Most anaesthetists think it is a minor issue and don't hesitate to use N2O in any patient. A senior anaesthetist I know who has looked into this issue told me that 2 - 4 hours of N2O anaesthetic can destroy all the stored B12 in a normal adult.

Martin

According to other posts I've read about this
(I think Rose has mentioned it),
it can also be the cause of PN !

B12
 

Hi,

I am actually an anesthesiologist who does only neurosurgery cases. I did check my B12 levels , after the surgeries and they were low normal. I have started some oral B12 supplement just in case.

I have had these strange symptoms for about 20 years off and on, with the usual megaworkups. I recently saw an expert in PN. He felt that given my normal neurological exam the chance of having a true neuropathy was small though he agreed there are symptoms of small fiber dysfunction. All of this can be quite frustrating. All the drugs out there reduce symptoms at best 50% which is better than nothing.

I recently got a book entitled Coping with peripheral neuropathy(via amazon.com). The author is a psychiatrist with CIDP who is quite disabled. It's a short book but might help some of the group member.

Thanks.

Glenn, welcome!
 

It's so hard to know where to begin to learn about neuropathy, all the neuropathies and the language that we at times speak. We've all here fumbled thru the medical diagnosis aspects...some with good docs, some not -who have had to go thru many docs to just get a diagnosis, let alone treatment. Then there is the pain? For many, trying to ignore it is the only way to deal with it; for others, varied medications, supplements and therapies are the way to go...Coping is key to dealing with it all, learning about what is going on in the 'neuropathy' processes can help deal with it?
I encourage you to read a bunch of prior posts and learn what questions have been asked before...and if there are any answers or not. The one thing I have found in common to us all - is that the WHY this happens is usually not known, the treatments-the options and what you can do to help yourself be in a better position to help those nerves heal is what we talk about here and what docs can or should be doing.
I encourage you to read the 'stickies' at the top of the page. Any highlighted blue 'link' cited there, well...just click on it and you should get a new window of reading. They aren't as organized as one new to this all would like, but learning along the way is the norm?
For starters tho I recommend the following sites:
http://www.neuroexam.com/content.php?p=2 This is a good intro as to what the basic and subsequent neuro exams look for and why.
This next site is a bit more technical, but it can help you learn about all the different factors that come into play in any diagnosis.....
http://www.aafp.org/afp/980215ap/poncelet.html
Lastly, with those as introductions...check out: http://www.lizajane.org/
These were put together by a member here, with input from many PN folks dealing with the different kinds of neuropathies.... I view this as a 'roadmap' of tests to keep track of as you go down the road...when viewed with the other two mentioned web sites, you can find your way down the right roads for diagnoses and testing. Or, just re-assure your own self that your docs are on the right track..if not the only track... LizaJane's sheets can and DO help you keep track of things...as two years down the road? You mite not remember when you took what med that didn't work, or when your last blood test was! As time goes on, these things can smush together into a terrible mess of a history! Be sure to get copies of all test results tho!
Last of all? Most important tho...no question is too simple, silly or insignificant!
Remember that nerves can die-well, rapid-fire fast! They can take months to years to heal. Less is known now about the 'healing' part than the dying parts. When nerves heal they at times feel as bad as when dying! So, try and do the best to help them, and ask questions away! Have a small :hug: to let you know that others here do understand lots, much, but not all of your pains. So many here have helped me to think differently about my pain, and how best to deal with it...I am sure they will help you as well. - j

Oh about the stress? Who wouldn't be with such pain? DUH? I am not belittling you here, it's that the pain, and the worry about that can make things worse? Put yourself on an island beach, lite breezes and soft winds, warm sun and a cool beverage in hand. I find that feeling/picture always makes me feel better and calmer. Try your own good image?