Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Remedies For Sensorimotor Polyneuropathy
Question: My dad has just been diagnosed with diabetic sensory and motor neuropathy. What can we do to help him Doctors say there are no treatments. I am sure something must be out there. What is the prognosis please? The Neurologist doesn't want to see my Dad again I feel we have been left on the shelf
My dad is insulin dependent type II diabetic and had it for 20 years.
Can dad get any mobility back and if so how? He has seen Neurologist but I think I am better getting in touch with Endocrinology Team Dad was under as I think they may be able to help more do you agree?
Dad needs to lose a bit of weight and blood sugar is now under control averaging around 6.2
This isn't classed as a terminal illness like motor neurone disease is it?
My dad is insulin dependent type II diabetic and had it for 20 years.
Can dad get any mobility back and if so how? He has seen Neurologist but I think I am better getting in touch with Endocrinology Team Dad was under as I think they may be able to help more do you agree?
Dad needs to lose a bit of weight and blood sugar is now under control averaging around 6.2
This isn't classed as a terminal illness like motor neurone disease is it?
Brief Answer:
sensorimotor polyneuropathy
Detailed Answer:
Dear
Thanks for contacting with your health concern and before providing with result oriented management, do address the following concerns:
1. Since he is also in CKD stage 3 and at the same time Insulin dependent and in renal disease the dose of insulin has to be reduced [ is the same been done]?
2. Are the said syndrome [diabetes-CKD-high BP] of disease independent or cause and effect to one another?
3. any associated Autonomic neuropathy: orthostatic hypotension, gustatory sweating, erectile dysfunction.
4. Reports of other blood parameters: Blood urea/Serum Creatinine [please upload the investigations like nerve conduction test,biopsy report] if done
5. Any possible complication(s) arising from the said neuropathy: i.e. presently is there more of numbness [sensory] OR deformity OR weakness [motor]?
6. As far as prognosis is concerned:if the damage does not affect the entire nerve cell [which means blood glucose has to be controlled within normal limits] and if your attending physician can treat it successfully then one can recover from the same completely. [so only a neurologist can tell after relevant examination and investigation that whether it is terminal or not]
Do revert back with your concerns for further management.
Dr. Munish Sood
Consultant & Physician
Naimittika
sensorimotor polyneuropathy
Detailed Answer:
Dear
Thanks for contacting with your health concern and before providing with result oriented management, do address the following concerns:
1. Since he is also in CKD stage 3 and at the same time Insulin dependent and in renal disease the dose of insulin has to be reduced [ is the same been done]?
2. Are the said syndrome [diabetes-CKD-high BP] of disease independent or cause and effect to one another?
3. any associated Autonomic neuropathy: orthostatic hypotension, gustatory sweating, erectile dysfunction.
4. Reports of other blood parameters: Blood urea/Serum Creatinine [please upload the investigations like nerve conduction test,biopsy report] if done
5. Any possible complication(s) arising from the said neuropathy: i.e. presently is there more of numbness [sensory] OR deformity OR weakness [motor]?
6. As far as prognosis is concerned:if the damage does not affect the entire nerve cell [which means blood glucose has to be controlled within normal limits] and if your attending physician can treat it successfully then one can recover from the same completely. [so only a neurologist can tell after relevant examination and investigation that whether it is terminal or not]
Do revert back with your concerns for further management.
Dr. Munish Sood
Consultant & Physician
Naimittika
Above answer was peer-reviewed by :
Dr. Naveen Kumar
1. insulin has been reduced
2. not related to each other
3. no autonomic neuropathy
4. sorry have no reports awaiting nerve conduction studies
5. Dad has leg weakness and thigh weakness which is affecting mobility. Dad has some numbness in legs and feet
6. blood glucose been well controlled Hba1c I think that's what it is is 51
2. not related to each other
3. no autonomic neuropathy
4. sorry have no reports awaiting nerve conduction studies
5. Dad has leg weakness and thigh weakness which is affecting mobility. Dad has some numbness in legs and feet
6. blood glucose been well controlled Hba1c I think that's what it is is 51
Brief Answer:
other instruction and additional prescriptions
Detailed Answer:
Dear
Thanks for reverting back and symptom wise approach is as follow:
1. Since neuropathy is there thus remember:
a. Care of the feet is very very important:
. Wash the feet daily,dry them, inspect them & then sprinkle lot of talcum powder
. Avoid walking barefoot, even at home.
. Wear soft cotton socks and canvas shoes. Avoid tight fitting shoe & chappals. Use new footwear with care to avoid shoebites.
. Cut naila very carefully and always after bath when they are soft.
b. Oral Hypoglycemic drugs may bring down blood sugar levels to normal but neuropathy/ neuritis will not respond thus control with plain INSULIN 2-3 times a day.
Additional Prescription:
Give:
. Cap. B complex with zinc in diabetes which is long standing and associated with peripheral neuritis.
. Vitamin E capsules for diabetics with atherosclerosis,and HYPERTENSION.
. Omega 3 fatty acids + alphalipoic acid tablet to delay microvascular complications: nephropathy & retinopathy.
. If a diabetic patient needs an anti hypertensive, prefer ACE inhibitor (enalapril)
Perform following investigation(s)
. Nerve conduction velocity
.Nerve biopsy
. EMG (to differentiate neuropathy from myopathy)
. Blood for routine examination of: sugar, urea, creatinine, VDRL, autoantibodies, serum folate and B12, and thyroid and liver function test.
Approach in Ayurveda:
I usually manage my patient after careful examination on the line of " SNAYUGATA SHOTHA" (Neuritis) and prescribe adopt following line of treatment:
. XXXXXXX ghansatwa (in capsule form): 500 mg twice daily for 3 months
. Massage with Maha prasarani tailam
. Capsule Diabacol (result oriented): 1 capsule twice daily for 3 months (HbA1c test is done in the beginning and repeated after 3 months)... If interested I can courier you the said medicine since not exported.
Dr. Munish
Naimittika
other instruction and additional prescriptions
Detailed Answer:
Dear
Thanks for reverting back and symptom wise approach is as follow:
1. Since neuropathy is there thus remember:
a. Care of the feet is very very important:
. Wash the feet daily,dry them, inspect them & then sprinkle lot of talcum powder
. Avoid walking barefoot, even at home.
. Wear soft cotton socks and canvas shoes. Avoid tight fitting shoe & chappals. Use new footwear with care to avoid shoebites.
. Cut naila very carefully and always after bath when they are soft.
b. Oral Hypoglycemic drugs may bring down blood sugar levels to normal but neuropathy/ neuritis will not respond thus control with plain INSULIN 2-3 times a day.
Additional Prescription:
Give:
. Cap. B complex with zinc in diabetes which is long standing and associated with peripheral neuritis.
. Vitamin E capsules for diabetics with atherosclerosis,and HYPERTENSION.
. Omega 3 fatty acids + alphalipoic acid tablet to delay microvascular complications: nephropathy & retinopathy.
. If a diabetic patient needs an anti hypertensive, prefer ACE inhibitor (enalapril)
Perform following investigation(s)
. Nerve conduction velocity
.Nerve biopsy
. EMG (to differentiate neuropathy from myopathy)
. Blood for routine examination of: sugar, urea, creatinine, VDRL, autoantibodies, serum folate and B12, and thyroid and liver function test.
Approach in Ayurveda:
I usually manage my patient after careful examination on the line of " SNAYUGATA SHOTHA" (Neuritis) and prescribe adopt following line of treatment:
. XXXXXXX ghansatwa (in capsule form): 500 mg twice daily for 3 months
. Massage with Maha prasarani tailam
. Capsule Diabacol (result oriented): 1 capsule twice daily for 3 months (HbA1c test is done in the beginning and repeated after 3 months)... If interested I can courier you the said medicine since not exported.
Dr. Munish
Naimittika
Above answer was peer-reviewed by :
Dr. Prasad
Brief Answer:
Management of back
Detailed Answer:
Dear
Thanks for reverting back.
1. It is important first to consult the doctor before any treatment is started, since progression of spinal OM to cervical/thoracic vertebrae can result in paraplegia/quadriplegia, and if involves lumbar spine it might result in cauda equina syndrome [bladder/bowel incontinence, lower extremity weakness, saddle anesthesia]
PS. Research published in The Journal of Bone and Joint Surgery (1997) notes that most patients do not experience symptoms of the infection following surgical intervention and therefore, patients with an advanced case of vertebral OM who undergo a surgical approach often experience better outcome.
2. Since MRI report is awaited it gives information about the size of the bony canal and any other abnormalities [if present], thus do let me know about the MRI scan report first so that further management of the back can be discussed.
3. The price of the tablet is 2100/- [INR] for 30 capsules to be taken once daily for 3 months which means: 90 capsules for 6300/- [INR]
PS. do let me know whether you want to proceed further so that further arrangement with courier services can be made.
Dr. Munish
Naimittika
Management of back
Detailed Answer:
Dear
Thanks for reverting back.
1. It is important first to consult the doctor before any treatment is started, since progression of spinal OM to cervical/thoracic vertebrae can result in paraplegia/quadriplegia, and if involves lumbar spine it might result in cauda equina syndrome [bladder/bowel incontinence, lower extremity weakness, saddle anesthesia]
PS. Research published in The Journal of Bone and Joint Surgery (1997) notes that most patients do not experience symptoms of the infection following surgical intervention and therefore, patients with an advanced case of vertebral OM who undergo a surgical approach often experience better outcome.
2. Since MRI report is awaited it gives information about the size of the bony canal and any other abnormalities [if present], thus do let me know about the MRI scan report first so that further management of the back can be discussed.
3. The price of the tablet is 2100/- [INR] for 30 capsules to be taken once daily for 3 months which means: 90 capsules for 6300/- [INR]
PS. do let me know whether you want to proceed further so that further arrangement with courier services can be made.
Dr. Munish
Naimittika
Above answer was peer-reviewed by :
Dr. Yogesh D
Please find below the letter received from hospital. Is there really nothing we can do I would like your opinion please as I feel my Dad has been written off;
Diagnosis: likely diabetic motor sensory neuropathy
Thank you for referring this 68 year old right handed gentleman to the Neurology clinic. He has had diabetes since 2000. His control was previosuly poor though has improved in the last 9 months. Mr Bridge has a previous history of osteomyelitis for which he was treated long term antibiotics. He now describes a 3 month history of progressive weakness of both legs. Although he can stand he feels unsteady and his legs quite often give way. He also described numbness in the legs. His arms bowel bladder speech and swallowing is unaffected.
On examination today his cranial nerves were unremarkable. Examination of limbs revealed normal tone. Power was normal in both arms and legs. Hip flexion was reduced to 3/5 bilaterally. Reflexes were absent in the legs but present in the arms. Sensation to pinprick was reduced distally in the legs but was present in the arms. Vibration sense was absent up to the hips. There were no fasiculations visible.
I suspect this gentleman has quite a severe axonal motor sensory neuropathy secondary to his diabetes. I have explained that this is not a treatable condition but we need to do some further investigations to exclude any more treatable causes. I am areanging MRI scan of lumbar spine to make sure there is no cord pathology or nerve root compression and some nerve conduction studies to quantify the extent of his nerve damage. I will write with the results once they are available.
Please help me there must be something I can do to help my dad I am really upset
Diagnosis: likely diabetic motor sensory neuropathy
Thank you for referring this 68 year old right handed gentleman to the Neurology clinic. He has had diabetes since 2000. His control was previosuly poor though has improved in the last 9 months. Mr Bridge has a previous history of osteomyelitis for which he was treated long term antibiotics. He now describes a 3 month history of progressive weakness of both legs. Although he can stand he feels unsteady and his legs quite often give way. He also described numbness in the legs. His arms bowel bladder speech and swallowing is unaffected.
On examination today his cranial nerves were unremarkable. Examination of limbs revealed normal tone. Power was normal in both arms and legs. Hip flexion was reduced to 3/5 bilaterally. Reflexes were absent in the legs but present in the arms. Sensation to pinprick was reduced distally in the legs but was present in the arms. Vibration sense was absent up to the hips. There were no fasiculations visible.
I suspect this gentleman has quite a severe axonal motor sensory neuropathy secondary to his diabetes. I have explained that this is not a treatable condition but we need to do some further investigations to exclude any more treatable causes. I am areanging MRI scan of lumbar spine to make sure there is no cord pathology or nerve root compression and some nerve conduction studies to quantify the extent of his nerve damage. I will write with the results once they are available.
Please help me there must be something I can do to help my dad I am really upset
Brief Answer:
Clinical Evaluation & Investigation
Detailed Answer:
Dear
Thanks for reverting back
Dear
Thanks for contacting with your health concern and after reviewing the letter received from hospital:
1. Acute motor and sensory axonal neuropathy [AMSAN]: which is recently described as subtype of GBS [guilliane barre syndrome] should be excluded which is characterized by distal weakness, loss of deep tendon reflexes and sensory symptoms [present in history].
PS. recently campylobacter jejuni enteritis and Zika virus pathogen has been linked with the disease [AMsAN]
2. recently one case has been published where a serious case of AMSAN was due to acute hepatitis A infection [thus one should go for immunoglobulin M antibodies against hepatitis A in blood and cerebrospinal fluid]
3. the best you can do for the improvement is: treatment with intravenous immunoglobulins, high-dose methylprednisolone, and a combination of gabapentin, antidepressants, and an oral Morphine under strict medical Supervision.
Dr. Munish
Naimittika
Clinical Evaluation & Investigation
Detailed Answer:
Dear
Thanks for reverting back
Dear
Thanks for contacting with your health concern and after reviewing the letter received from hospital:
1. Acute motor and sensory axonal neuropathy [AMSAN]: which is recently described as subtype of GBS [guilliane barre syndrome] should be excluded which is characterized by distal weakness, loss of deep tendon reflexes and sensory symptoms [present in history].
PS. recently campylobacter jejuni enteritis and Zika virus pathogen has been linked with the disease [AMsAN]
2. recently one case has been published where a serious case of AMSAN was due to acute hepatitis A infection [thus one should go for immunoglobulin M antibodies against hepatitis A in blood and cerebrospinal fluid]
3. the best you can do for the improvement is: treatment with intravenous immunoglobulins, high-dose methylprednisolone, and a combination of gabapentin, antidepressants, and an oral Morphine under strict medical Supervision.
Dr. Munish
Naimittika
Note: For further inquiries, we recommend seeking guidance from an expert homeopath. Click here to consult now
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
