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Suggest Treatment For Numbness And Neuropathy

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Posted on Mon, 16 Jan 2017
Question: I have pure motor CIDP. My biggest symptom is full body numbness. Could this be small fiber neuropathy? Can you have just numbness and no pain from small fiber neuopathy? How long does it take for ivig to treat small fiber neuropathy if it is immune related? I am 7 weeks into ivig and at times i feel as though i get sensation in my numb fingers.
doctor
Answered by Dr. Dr. Erion Spaho (1 hour later)
Brief Answer:
Pain may be absent. IVIG are to be used for six months.

Detailed Answer:
Hello again and thanks for being on HCM.

Since there are sensory symptoms present, it could not be pure motor CIDP. In the other hand, there are several variants of CIDP.

Pain is a symptom that is found less commonly in patients diagnosed with CIDP, so, it can be absent. As a demyelination polineuropathy, CIDP may affect small peripheral sensory nerve fibers too, resulting this way in numbness and tingling.

Intravenous immunoglobulins are one of the treatment ways (besides corticosteroids and plasmapheresis) in CIDP, but are used for six months with scheduled applications and result in full treatment in about 80% of patients. Since you refer for return of sensation in times, there is hope for improvement.

So, if the diagnosis is correct, IVIG is the correct treatment.

Hope you found the answer helpful.

Let me know if I can assist you further.

Greetings.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Dr. Erion Spaho (50 minutes later)
How long does it take ivig to treat immune related small fiber neuropathy?
doctor
Answered by Dr. Dr. Erion Spaho (8 hours later)
Brief Answer:
It takes months.

Detailed Answer:
Welcome back.

Treatment with intravenous immunoglobulins for small fiber neuropathy caused by CIDP, continues for six months with scheduled applications.

Results in improvement vary, improvement could be seen after few weeks to several months after start of this treatment.

A small part of patients don't improve at all.

Hope I helped you.

Kind regards.
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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Follow up: Dr. Dr. Erion Spaho (15 hours later)
I am able to feel temperature and a pin prick. I identify my feelings as numbness because i dont know what to call it. I feel as though i dont have body presence and that my arms and legs and face arent even there. Is this numbness? Is this something else? Can this be a pinched nerve or something? My feeling i dont think match the criteria of numbness so what do i make of this? What is going on?
doctor
Answered by Dr. Dr. Erion Spaho (11 hours later)
Brief Answer:
Loss of propriocepsion.

Detailed Answer:
Hello again.

Those symptoms indicate impaired propriocepsion, that is a modality of the sensory nervous system.

The problem may be at any level from peripheral sensory nerves to spinal cord, midbrain etc.so, a careful neurological examination and imaging studies ( MRI ) of brain and spinal cord are necessary to understand better your condition besides nerve conduction study that you had.

Hope this helps.

Wishing you good health.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4493 Questions

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Suggest Treatment For Numbness And Neuropathy

Brief Answer: Pain may be absent. IVIG are to be used for six months. Detailed Answer: Hello again and thanks for being on HCM. Since there are sensory symptoms present, it could not be pure motor CIDP. In the other hand, there are several variants of CIDP. Pain is a symptom that is found less commonly in patients diagnosed with CIDP, so, it can be absent. As a demyelination polineuropathy, CIDP may affect small peripheral sensory nerve fibers too, resulting this way in numbness and tingling. Intravenous immunoglobulins are one of the treatment ways (besides corticosteroids and plasmapheresis) in CIDP, but are used for six months with scheduled applications and result in full treatment in about 80% of patients. Since you refer for return of sensation in times, there is hope for improvement. So, if the diagnosis is correct, IVIG is the correct treatment. Hope you found the answer helpful. Let me know if I can assist you further. Greetings.