SF AIDS Fdn: BETA 3/97 -- Peripheral Neuropathy Peripheral neuropathy occurs frequently in people with diabetes mellitus. Treatment of neuropathy may be complex for people with both diabetes and HIV. http://www.sfaf.org/treatment/beta/b32/b32pn.html
Extractions: beta@sfaf.org by Mark Bowers The ancient Greeks were the first to enumerate the 5 senses: vision, hearing, taste, smell and touch. Aristotle further divided the sense of touch into hard-soft, hot-cold and rough-smooth components, quite similar to the findings of modern neurological research that supports the existence of different types of peripheral nerves in the body that carry the sensations of cold, warmth, touch and pain. HIV infection is associated with several kinds of peripheral neuropathy that affect primarily the sense of touch in the hands and feet, but may also cause more severe symptoms such as muscle weakness. HIV does not directly infect neurons (nerve cells). Instead, it may damage the cells that surround nerves, unraveling neural insulation and slowing, garbling or stopping the transmission of information to and from the brain. Abnormal macrophage activation is associated with the pathology. Some of the drugs that are used to treat HIV or associated opportunistic infections (OI) may damage axons, the long, narrow connecting processes of neurons that communicate with muscles, tissues and organs. Symptoms of peripheral neuropathy may arise at any time during HIV infection. Neuropathy is reported at a rate of 6-8% during the acute retroviral syndrome that often occurs shortly after infection. Neuropathy may affect people with asymptomatic HIV disease, manifesting in syndromes ranging from mononeuritis (inflammation of a single nerve) and mononeuropathy (disease of a single nerve), to polyneuropathies that affect multiple nerves and can lead to paralysis. Most commonly, peripheral neuropathy develops in people with symptomatic HIV disease or AIDS. For these individuals, the symptoms of painful, burning feet or numbness in the feet and/or hands are familiar and often disabling.
Pain Neuropathy or nerve damage due to diabetes can present as insensate neuropathy (sensoryloss) or painful neuropathy. The majority of people have the http://www.diabetes.usyd.edu.au/foot/Pain1.html
Extractions: Painful Diabetic Neuropathy Neuropathy or nerve damage due to diabetes can present as insensate neuropathy (sensory loss) or painful neuropathy. The majority of people have the insensate type and the consequences and management of this are discussed extensively in this web-site. However approximately 4-7% of patients with diabetes suffer chronic, often distressing symptoms of pain, pins and needles or numbness in their feet. Why do people get painful neuropathy? This question is yet to be fully answered and is the subject of ongoing research. People with poorly controlled diabetes for a long time are more likely to get chronic painful neuropathy. However, many patients with relatively well controlled diabetes also develop it. Painful symptoms can be transient, eg less than 12 months duration. These symptoms are often associated with periods of high blood glucose levels, or paradoxically, when the blood glucose level rapidly improves. In these acute situations, once the blood glucose has stabilised for a few months, the symptoms often spontaneously disappear. Once symptoms have persisted for more than 12 months, they are less likely to disappear on their own. Although good blood glucose control is important for many reasons, striving for very tight blood glucose control is less likely to make the painful symptoms get better when they have been present for this length of time.