Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Persistent Peripheral Neuropathy And RLS
Question: I have had peripheral neuropathy for about 26 years and also very bad restless legs. My legs often look like I have cellulites but don`t have a fever or other signs of an infection. Can I safely assume I don`t have cellulitis? I also have insomnia due to severe restless legs. I have been on sinimet 50/200 q6h for many years. and am tapering off. I had been up to 1 1/2 q6h and 2 hs. I am now down to 1 q8hr. I have tried Mirapex, Cymbalta,?sp, Lyrica, Topamax and neuronton etc. with no luck. I am also on nortriptyline 10mg q6h and tramadol for pain 100mg q8h. I am now on requip 4mg long acting in the evening and 0.5mg short acting up to twice a day as needed. I am diabetic, have asthma, lymphedema, HTN. My brothers also have peripheral neuropathy. I don`t have any reports in my computer, but can tell you I had vascular tests done that were normal, and EMG`s getting worse. I have never smoked, don`t drink and don`t take recreational drugs. I am on Bystolic for BP, Lasix, puffers for asthma and magnesium, cod liver oil, Vit. D, Daily vits, I had both carpal tunnel, and tarsal tunnel repairs done. I have charcot feet, and had my foot broken and screws put in, and my ankle rebuilt last July. I have a gait problem, and need crutches to walk short distances, and a wheelchair longer distances. I was hoping the surgery would correct the balance problem, but it continues. I was looking into deep brain stimulation for the restless legs, but it seems pretty extreme and not even sure it is used for extreme restless legs.
Brief Answer:
You should be examined by your doctor
Detailed Answer:
Hello and welcome in HCM
I am sorry for your situation and i can understand your concern.
Cellulitis is usually a superficial bacterial infection of the skin.
Patients especially with chronic diseases like you are (diabetes), which means with conditions that weaken the immune system are more predispose to do cellulitis.
Usually we suspect cellulitis if there are some signs and symptoms present like:
the skin is red ,tenderness,swelling (inflammation signs),painful,warm and when you have fever (you exclude it).
But there are some blood tests which should be done to evaluate the infection diseases as follows:
Hemogram
ESR
CRP
A wound culture (if it is present)
If all of these are negative (i mean the blood tests combined with clinical picture) than the diagnosis of cellulitis is excluded.
Given the fact that your immune system is compromised due to diabetes better to consult with your doctor for the above to be sure for the situation and first he/she will examine your leg and order further the above tests (if it will be needed).
Unfortunately diabetic patients do not respond with temperature against various infective agents and for this better for you to be examined by your doctor.
You should be very careful in controlling diabetes too,with diet,physical activity,no smoking,no alcohol and vaccinations.
I fully agree with your treatment of restless legs syndrome too.
So take care and feel free to ask me again
Dr.Jolanda
You should be examined by your doctor
Detailed Answer:
Hello and welcome in HCM
I am sorry for your situation and i can understand your concern.
Cellulitis is usually a superficial bacterial infection of the skin.
Patients especially with chronic diseases like you are (diabetes), which means with conditions that weaken the immune system are more predispose to do cellulitis.
Usually we suspect cellulitis if there are some signs and symptoms present like:
the skin is red ,tenderness,swelling (inflammation signs),painful,warm and when you have fever (you exclude it).
But there are some blood tests which should be done to evaluate the infection diseases as follows:
Hemogram
ESR
CRP
A wound culture (if it is present)
If all of these are negative (i mean the blood tests combined with clinical picture) than the diagnosis of cellulitis is excluded.
Given the fact that your immune system is compromised due to diabetes better to consult with your doctor for the above to be sure for the situation and first he/she will examine your leg and order further the above tests (if it will be needed).
Unfortunately diabetic patients do not respond with temperature against various infective agents and for this better for you to be examined by your doctor.
You should be very careful in controlling diabetes too,with diet,physical activity,no smoking,no alcohol and vaccinations.
I fully agree with your treatment of restless legs syndrome too.
So take care and feel free to ask me again
Dr.Jolanda
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
