Is this typical PN?
 

Hi all, I joined the forums a while back and managed to post hello, but I've not really had time to post since then.
Our Dr had diagnosed my hubby with peripheral neuropathy some months ago and has referred him to the Neurosurgeon.
He has been waiting to see the neurosurgeon for 4 months and things are getting much worse.
He started getting pins and needles in his left foot, which then progressed to both feet. Then the pins and needles were replaced by pain again in the left foot, progressing to the right foot. He describes the pain like walking on pins or razor blades. He can't put his feet on the cold floor as it's to intense, but it's the same if his feet get warm they feel like they are on fire.
A few weeks ago his feet and ankles started swelling, even when he is resting they swell.
He is also getting what he describes at electric shocks in his legs and they have also started in his arms. He said the pain from them is very strong and I have seen him in tears from this pain.
Can anyone tell me if this is all typical of PN symptoms as our Dr told us last week that it may not be PN, it could be a rare condition?
Thanks in advance for any help.
Buttercup x

Welcome to our forum.

Can you provide more information? AGE, when this started, what medications have been used? Smoking? etc?

There are many many causes of PN... and without some detective background, it will be difficult to say.

Some spinal damage may be at fault. Slow onset diabetes, use of drugs (some very common) can cause PN. Low thyroid, some bacterial infections, exposure to toxins/metals or solvents. Autoimmune reactions esp after a vaccine. Many Many causes.

Thank you for the quick response Mrs D :)
My hubby is 44. We think his symptoms started around xmas time last year.
He is a recovering alcoholic and has been abstinent for 14 months. This is why we are unsure of when the symptoms first started, as they may have been masked by the alcohol and his initial recovery.
Our Dr did think that it was alcoholic PN.
Mark has had blood tests (a few over the last couple of years). At one point his liver function was affected, but it now normal. He was also tested for B12 deficiency, thyroid etc and all came back ok.
He is also being treated for depression and psychosis. His depression seems to be getting worse again, which I put down to his constant pain and feeling his every day life has ended, as there is very little he can do any more.
His current meds are:
Mirtazapine for depression.
Quetiapine for psychosis.
Pregabalin for PN.
Tramadol to help with pain.

Hope this helps.
Can I please ask, is it normal to get this very painful electric shocks with PN?
Thank you once again
Buttercup x

I have had the painful electric shocks quite often, more often the milder ones. Has he had an EMG lately? My electrical shocks are horrible for the first few weeks after an EMG. It seems to stir things up.
They did settle down somewhat when I went up to 1800 mg of neurontin.
I have hereditary neuropathy, CMT.

I would agree that after EMG or even exam with tuning forks etc my nerves were stirred up. I also suffer from painful electric shocks.
The frustrating part for him will be the snails pace of the NHS, the stress from sitting on waiting lists can also add to the symptoms. I wish him well.

The Quetiapine (Seroquel) is capable of altering blood sugar and raising it. I'd get that checked out ASAP.

I would also get the actual test result from the B12 test. Doctors are still using the old outdated lab ranges, and his "ok" may in fact be low.

Once people who were heavy drinkers, stop, and restore nutrition, any PN present typically can resolve. Benfotiamine (or regular thiamine) may also be helpful for him.

http://neurotalk.psychcentral.com/post653193-4.html

It is possible that all the sedative medications he is taking, are producing a "sedated, or depressed" constellation of side effects. Please keep that in mind.

And--
 

--it would be unusual for there to have been a referral to a neurosurgeon, as opposed to a neuromuscular specialist, unless there was a suspicion of spinal problems (even in the UK I think this would be true).

So, has there been any imaging done to see if there are problems with the spine or adjacent nerve roots?

Thank you all so much for your responses!
He has had no other tests done, only bloods which I've outlined above.
What the specialist will do, we don't know.

I'm really starting to doubt that this is a problem related to when he was drinking, as he has not touch a drop of alcohol for 14 mths. I do have to add I and our children are very, very proud of him!

Mrs D, I will telephone the Dr's tomorrow and ask for the B12 results figures. Is it ok if I come back to you with them?
I have to be honest, I don't really understand the terminology that is used in the forums and the names of treatments and meds means very little to me :o

He has had an on going back problem, which always seemed related to lifting heavy loads. Since stopping work last year his back has been fine.

Thanks again you lovely people for your help.
With kindest regards
Buttercup x

Yes, come back with the numbers and concentration. I believe UK reports a different concentration... pmol/l instead of pg/ml.

I have a conversion factor to change to U.S. concentrations.

Hi Mrs D, I have two of my hubby's Vit B12 results:
October 2010 202
April 2011 264

I hope you can make sense of this, as I don't have a clue.
Thank you once again
Buttercup x