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Peripheral Neuropathy Neurological Exam

Fluoroquinolones and Peripheral Neuropathy

Peripheral neuropathy, this is an often devastating condition in which people develop pain and numbness in their hands and feet. Basically they're told on the evening news that they should be taking this or that medication so that they can get through life. That's treating the smoke and ignoring the fire. Those medicines that you're seeing advertised don't treat the neuropathy, they only treat the symptoms. But what's causing peripheral neuropathy Well we know that in America, one of the biggest causes of peripheral neuropathy is being diabetic, which is clearly related to the foods that you eat by and large. Becoming.

A type 2 diabetic dramatically increases your risk for having peripheral neuropathy and in fact being devastated by it. This is a disease that effects 1 in 15 Americans. Let's take a look. So again this is 1 in 15 Americansthis is 20 million Americans afflicted by this disease, that aside from diabetes, we're told the cause is unknown. Well maybe that's not exactly true. Last month, in the journal Neurology, an incredible study was published describing a relationship between what are called fluoroquinolones, and the risk of developing a peripheral neuropathy.

You may not know what fluoroquinolones are, but chances are you may have actually been exposed to fluoroquinolone. These are antibiotics used for treating things like upper respiratory infections and even urinary tract infections. Things like Levaquin and Cipro are commonly used in walk in clinics. If you have a urinary tract infection, you may have received these mediations. Well, here's what the study showed us So this is a study published in September 2014 that looked at men between age 45 to 80 years of age followed for a 10 year period and in this group there were over 6,000 cases.

Of peripheral neuropathy. And they compared these individuals to about 25,000 aged match controls, and what they found was that risk for developing this devastating condition called peripheral neuropathy was doubled in those individuals exposed to this class of antibiotics called fluoroquinolones. And what the researchers also told us is that, and I quote, Fluoroquinolones have been shown to neurotoxic. Oral fluoroquinolones have also been associated with reported cases of psychosis and seizures, which similar to peripheral neuropathy have been shown to be acute events occurring within days of fluoroquinolone use.

In light of strong evidence of unnecessary prescribing of oral fluoroquinolones in the United States, clinicians must weigh the risk of PN against the benefits of prescribing FQ when prescribing these drugs to their patients. We've got to practice medicine under the dictum of above all do no harm. One of our most well respected peer review journals is now telling us that the use of these medicationsthese fluoroquinolone antibiotics is associated with doubling of the risk of peripheral neuropathy. A disease which often is not treatable. So keep that in mind the next time you think.

Peripheral Nervous System Disorders Diagnosis and Treatment

The peripheral nervous system is the part of the nervous system that excludes or is outside of the brain and the spinal cord. We take care of patients that have disorders that affect the motor neurons, which live in the spinal cord the peripheral nerves that extend out into the arms and legs as well as the muscles and the connection between the nerves and the muscles. Some of the disorders that a nerve and muscle a disease specialist will evaluate and develop care plans for include muscle disorders such as muscular dystrophy,.

Polymyositis, dermatomyositis, peripheral neuropathies such as Charcot Marie Tooth disease or hereditary neuropathy and as well as the neuromuscular junction disorders such as myasthenia gravis. Some symptoms that can be associated with the peripheral nervous system include generalized weakness, fatigue, numbness, tingling, sometimes pain can be caused by disorders of the peripheral nerve. The evaluation of a patient with a possible peripheral nervous system disorder first begins with the very careful history to understand how the symptoms started and how they affect the patient. From the history we extend to the physical exam,.

Dr. Ahmet Hoke

Hello, I'm Dr. Ahmet Hoke, a Professor of Neurology and Neuroscience and Director of the Neuromuscular Division at Johns Hopkins Hospital School of Medicine, Department of Neurology. The Neuromuscular Division at Johns Hopkins Hospital is a multidisciplinary group. It covers most aspects of neuromuscular diseases. Within this neuromuscular group, I specialize in disease of the peripheral nervous system, specifically focusing on peripheral neuropathies. These are disorders that affect peripheral nerves in the arms and legs, and can cause pain, weakness, numbness, and tingling. In addition to seeing patients in the Johns Hopkins outpatient.

Clinic, I also carry out EMG nerve conduction studies and read muscle and nerve biopsies. EMG nerve conduction studies and nerve and muscle biopsies help us diagnose diseases of the peripheral nervous system as well as neuromuscular disorders. In addition to my clinical work, I direct a research laboratory focusing on understanding mechanisms of peripheral neuropathies as well as trying to develop new therapies for peripheral neuropathies. We're also interested in improving peripheral nerve regeneration in patients with peripheral nerve injuries using nanotechnology and cellbased therapies with stem cells. What truly excites me about my work is that I can make.

A difference in patient's lives through their medical care. But also though my research, I can impact many more people's lives. Recently we identified a new compound to treat peripheral neuropathies and we're hoping to develop this as a new therapy to prevent peripheral neuropathies in patients who are undergoing chemotherapy for their cancer. At Johns Hopkins Hospital Peripheral Nerve Clinic, we offer multidisciplinary care for patients with challenging diseases of the peripheral nerve system. Our center is one of the largest in the country, focusing specifically on the disease of the peripheral nervous system.

Eva Feldman, MD Tutorial Profile

Gtgt Dr. Eva Feldman So when I completed college I had the dilemma whether I wanted to go straight into medical school or whether I also wanted to do research because when I was in college, I got very excited about the brain and had, again a professor who told me that he felt that in the next century all the major advances in medicine and in research we're going to be in the nervous system particularly in the brain. So when I finished college, I decided oh maybe I'll get a PhD and a M.D.

And so I started my graduate studies first and I began in a neuroscience program at the University of Michigan. Fell in love with the brain completely and when I started medical school there was no doubt from the very first day in medical school, I said I was going to be a neurologist and I loved every day of it. One of my passions as a neurologist is also to be a neuroscientist. So I'm very privileged to have a fairly large laboratory that I work in with about 30 young people who do research with me.

And we've become very interested over the last 5 years in using stem cells in regenerative medicine particularly in neurodegenerative diseases in neurology. Lou Gehrig's disease is one passion that we have. We're also interested in Alzheimer's disease, Parkinson's disease, and Huntington's disease. So from our basic findings in the laboratory of how stem cells can promote nerve regeneration and protect nerve cells from dying, we've actually begun a clinical trial using stem cells in patients with Lou Gehrig's disease. So it's very exciting because what I do in my basic science laboratory I can then transition.

Over to my clinical practice and ALS or Lou Gehrig's disease is one of the disorders that I am familiar with and I take care of hundreds of patients with that disorder. And so I'm able to serve as a bridge from the basic science to the clinic. I can go to the clinic and tell my patients what I've learned in my basic science laboratory. I can go back and tell my basic scientists what my patients have taught us and they teach us so much. And so stem cells is one of the major avenues I see translating in the near future.

Raynauds Syndrome Peripheral Neuropathy Care DavisClinic

We've been treating you for Raynaud's phenomena in both hands and small fiber neuropathy in both of your hands. What were your experiences before consulting the office with this condition and how have you been responding to the care program today Well the reason that I came in is the numbness in my hands, both hands. It kept getting worse and worse. I got to the point I couldn't feel the keyboard when I typed, I couldn't feel the mouse. Every time it got cold, it would get worse. My fingers were blue, and it would last almost all day.

It was really starting to affect my job. I couldn't hold on to things because I couldn't feel them, I was always dropping things. I came in to see Dr. Davis, we tried this program. I was excited about it because there really isn't a lot of treatment for this particular condition. So when we decided to try it I was excited, and didn't really expect a lot of results as fast as I have. I still have a little numbness in my hands, but at least I can feel the keyboard. The numbness doesn't last as long as it did before. It would last.

How A Neurologist Can Help If You Think You Have Nerve Damage From Your Surgery

Hello. I am Maryland Medical Malpractice Attorney Marcus Boston and I would like to Talk with you today about An issue which came up about A potential client who Contacted my office last week Regarding an issue of possible Nerve damage Now in a lot of These cases individuals who Think that they have some type Of nerve damage as a result of A surgery are really not sure What is the next step of the Process If you are watching This tutorial right now you may Have these same questions, what.

I would ask you to do is speak with you doctor and see if your Doctor will give you a referral To see a neurologist and the Reason why this is important is Because a neurologist will be Able to help you understand Whether you have nerve damage The extent of the nerve damage And things of that nature In Addition to that, your neurologist Can give you specific test to help Determine what is going on in your Case so why have I taken this quick Moment today to educate you on this.

And to explain this well the reason Why is because chances are if you are Watching this tutorial right now you have QUestions you are wondering whether Your nerve damage as a result of your Surgery is possible medical malpractice Here in Maryland here is what I invite You to do pick up the phone and give us A call I can be reached at 3018504832 Or if you would prefer to send me an Email first initially go ahead and send Me an email to medicalinjurybostonlawllc We answer questions like yours all of.

The time and we would be glad to hear Your story also if you are watching This tutorial right now on take a Quick moment to like the tutorial and Subscribe to our channel by Liking the tutorial what you do is you Help other people who are on the internet Just like you find the answers to the questions That they have and if you subscribe to our channel you will be alerted as soon As we upload helpful content just like what You are watching today we have over 250 tutorials.

Diabetes Foot Exam

We know that one in four people with diabetes will develop foot complications. These complications can be serious and can limit you and what you want to do with your life the Joslin clinical guidelines recommend that you have a thorough foot exam by your physician at least once a year one of the things that can cause foot problems in people with diabetes they result from two major problems. The first is neuropathy. diabetes can affect the nerves over time and as the nerves are affected you may lose the sensation in your feet.

This may not cause you any discomfort, your feet may feel fine, but not being able to sense problems in your feet puts them at risk. A second problem is circulation diabetes can affect circulation in the head in the heart but also affects circulation in your feet. With the circulation decreased, any problem that occurs in your feet will resolve more slowly infections heal more slowly and you are prone to more complications. this combination of neuropathy and circulation problems are why your physician needs to carefully examine you feet at least once a year.

When he or she examines your foot they're going to look at three different things they'll visually inspect your foot to see if there's any deformities, they'll look carefully the skin to see if there's any cuts, any sore spots, any lesions that should need attention between your toes as well as the top of the bottom of your feet the physician will also take a look at your circulation by feeling for pulses at certain spots in your feet where we know the the pulses should be strong and last, they'll check for signs of neuropathy.

By using either tuning fork or something called a ten gram fiber small wis you should be able to sense and if you can't it means you're especially high risk for problems with your diabetes smoking is obviously a problem for anyone's health if you have diabetes smoking is especially damaging so he can affect the circulation in particular the circulation to your feet we know that the majority of our patients with diabetes who have foot problems have had smoking in their past so what can you do to keep your feet healthy.

Gluten Sensitivity and the Brain

It seems to surprise a lot of people that gluten sensitivity can actually affect the brain in many different ways. Let's take a look at that in depth. There's a very intense researcher in England named Doctor Marios Hadjivassiliou, intense in that he's all over this idea that gluten sensitivity can be a neurological problem. And as he published in the journal Lancet Neurology, his quote, most patients who present with neurological manifestations of gluten sensitivity may have no gastrointestinal symptoms, which means that just because a person doesn't have a bowl problemupset stomach, diarrhea,.

Constipation, abdominal paindoesn't necessarily mean they couldn't have gluten sensitivity as an explanation for their brain troubles. And what sorts of brain troubles can be associated with gluten sensitivity Let's take a look. We now know that cognitive impairment, including dementia, can be associated with being sensitive to gluten, a protein found in wheat, barely and rye. As can be depression, headaches, even movement disorders, ADHD and even pain. It's important to consider that gluten sensitivity may explain things that don't have anything to do with the gut. You've got to keep an open mind. Consider gluten sensitivity. As.

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