role of ongoing medical testing for idiopathic peripheral neuropathy
Hello,
I am in my early 60s and was diagnosed with idiopathic peripheral neuropathy (IPN) in 2020. I am fortunate that I have very little pain associated with it. It exhibits as mostly numbness, weakness, and muscle twitching. It has progressed slowly, but I have noticed its progression more lately.
I have often wondered what role ongoing medical testing and tracking should play with a diagnosis of IPN. I have only seen one neurologist since 2020 (~2023). I got the impression from the neurologist (not Mayo) that I was wasting his time by being there given that I had IPN. He didn't seem to take my questions very seriously.
So I am interested in others views/thoughts. Here are some questions to get the discussion going.
Is there their value in regular appointments with a neurologist if one has IPN? If yes, what purpose do they serve? What is an appropriate frequency? What types of ongoing testing is appropriate (EMGs, other)?
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@brennankb55 Thanks so much for letting us know about this. I just emailed my doctor to request a discussion and possible rx for this. On my last visit, she prescribed Lyrica, but after reviewing the side effects, I never filled that rx. It appears that those doctors versed in functional medicine are the ones most tuned in to the “solutions” that aren’t just slapping big pharma meds on symptoms. But in so many areas - mine included - there just aren’t any of those doctors, so this forum is proving to be incredibly helpful. Thank you again!
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3 Reactions@megidigo 15 minutes? You are fortunate. My last neurologist appointment lasted all of six minutes. As soon as I mentioned "neuropathy", he couldn't get rid of me fast enough.
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2 Reactions@heisenberg34
He did tell me I may improve in 2 to 3 years but I have documentation where he put on paper that I will deterioriate. But to your point Ive noticed that doors close with other doctors Im sent to once I mention neuropathy. So ive decided no more doctors appointments unless Im sent to the hospital or just dealing with my primary as I need medication refills.
Ive been told it isnt a death sentence but due to circumstances for me it actually is. I just wander if someone out there will listen (not online but in real life) but not looking that way. Sorry I do realize my posts turn into vents but its all I got.
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1 Reaction@brennankb55
I can relate. My feet burn, and socks feel like I am being suffocated. For years Iattributed it to stuffing my big wide feet into affordable shoes (Size 13 4E). In 2015 an MRI revealed severe spinal stenosis in my Lumbar. dealt with the pain, but eventually had a laminectomy (L2-4) which helped a bit, but my foot pain was getting worse. Then had a stroke, and saw a neurologist. He was concerned that my pain and footdrop was not confined to just my left foot, but was polyneuropathy. So he ordered many tests, which revealed I have MGUS, which is an abnormal monoclonal antibody that is assocated with many conditions that exhibit polyneuropathy as a symptom. Thanks to this doctor's diligence and knowlege, I am being monitored for this slowly growing condition. My footdrop has severely limited my activity, and I have undergone another back surgery. I am a formerly very active 70 year old man, who is still finding pleasure each day, (sometimes with effort). Modesty helps- A cane, and recently a walker to get more than a block from home, as well as raised beds in my garden and being careful not to overdo it help, along with loving family and friends. I am grateful for the excellent medical care I recieve ( I am living in British Columbia, Canada) and open minded, well educated doctors like my neurologist. We all will face more and more pain or frustration as we age, so make sure we have something to rejoice in each day. Gratitude- to good doctors, especially to nurses, and others who share their journeys in dealing with deteriorating health. Peace and joy to you all.
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3 Reactions@megidigo I hear you loud and clear. Sometimes I think that the only way to get real care is to go to the ER and tell them that I am in severe pain and nothing helps. That way I should be able to get a team looking into my situation not just one, uninterested doc.
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2 Reactions@megidigo I know exactly how you feel, I basically had the same experience with my last neurologist. After all of the testing came back as "normal", I was down to only seeing him once a year. This lasted a couple of years before he admitted that there wasn't anything more that he could do for me. Believe it or not my regular doctor did more to help me than he ever did. He's the one who prescribed gabapentin for the pain, along with recommending that I take ALA, alpha lipoic acid.
And as far as I'm concerned this is a death sentence, it's never going to improve, let alone just go away. I've been living with chronic pain from osteoarthritis and neuropathy in my feet for over a decade, and I'm going to spend the rest of my life like this.
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2 Reactions@megidigo ~ No apology needed. We all need to vent rather than keep our frustration bottled up. I've had my idiopathic neuropathy going on 15 years. It's been a "trial and error" process to find what helps and mostly what doesn't. Different things help different people, so one really has to do their own sleuthing, but so many share what they have discovered. Gabapentin didn't help me at all, but it helps a great majority. Lyrica has helped for the past 3-4 years and others can't tolerate it. There are various topical creams and gels and even essential oils that are helpful. Some swear by CBD. I've spent so much on useless gimmicks and "cure" promises. So for myself, I trust in the God who sent His Son Jesus to die in my place, and that believing in Him, I can have eternal life - regardless of what this life becomes. But I find great hope, peace and encouragement in that, and I pray it for all who are likewise afflicted here. It's definitely a journey. I'm praying God will direct you to someone who will actually listen to you.
@brennankb55
Please let us know how the LDN works for you. Who prescribed it for you? I was on gabapentin (1800) and it was causing tremors so I weaned off. Recently, I asked about LDN when I had my neuromuscular neurology appointment; he would not prescribe because he only prescribes what is currently recommended and evidence based?! He prescribed Lyrica instead. I have been diagnosed with Small fiber neuropathy that came on very rapidly in 2024.
I have had idiopathic PN for about 10 years. I am 81. In the beginning I had the entire gamut of tests, including a positive skin biopsy. A few years later, my University neurologist contacted me to suggest a battery of new tests only offered by select institutions. They were all negative.
Personally, I don't really see the need for follow up. Unless there is a new treatment (unlikely in my lifetime) anything done will just be a confirmation of what I already know, perhaps with a little more information. Standard advice is to be seen periodically if the condition is progressing (mine is), particularly if a purely sensory condition is developing autonomic symptoms (I think mine is). Unfortunately, even with these new symptoms, there's still no treatment other than supportive (PT, devices like walkers, etc.). If these become necessary, then follow up is needed.
For me, it doesn't feel worth the time and energy, but opinions certainly vary. This is a particularly weird disease.