NEUROPATHY
What is Neuropathy?
Neuropathy refers to any condition that results from damage to nerves. This can occur from injury, toxins, medications or diseases, such as diabetes. A large percentage of the time the cause for a person’s neuropathy cannot be determined. Neuropathy often causes numbness and pain in the limbs. Sometimes there is weakness or loss of balance.
Other conditions can resemble neuropathy so correct diagnosis is key. Testing options include nerve conduction studies, electromyography (EMG), ultrasound, nerve biopsy and, in some cases, skin biopsy to look at the small nerve fibers in the epidermis.
It is important to determine the cause of someone’s neuropathy so the right treatment can be administered. Unfortunately, many neuropathies cannot be fixed and management involves treating symptoms, such as pain. It is especially important to identify cases were a person’s own immune system is attacking their nerves because there are therapies to treat to this (see CIDP).
Dr. David Saperstein is a nationally known neuropathy specialist
David Saperstein, MD
I have been taking care of patients with peripheral neuropathy for over 20 years. Unfortunately, rather often the previous care of their neuropathy has not been ideal. Often patients with neuropathy are not given adequate information about their condition and are told not much can be done. Sometimes patients do not have neuropathy or they do not have the type with which they have been diagnosed. Some patients are not treated when they should be and others are treated with therapies that will not help their neuropathy.
In response, I have harnessed my experience in diagnosing, treating, and researching peripheral neuropathy. Here at the Center, my team and I employ state-of-the-art techniques to implement the most effective and creative treatments. Better answers. Better solutions.
- Established track record of diagnosing, treating and researching peripheral neuropathy.
- Fellowship trained in neuromuscular medicine and clinical neurophysiology.
Completed advanced training in the performance and interpretation of nerve biopsies
- Personally interpreted over 50,000 biopsies of small nerve fibers
Neuropathy Videos
FREQUENTLY ASKED QUESTIONS
- Nerve conduction and EMG testing
- Assessment of blood flow
- Autonomic testing
- Nerve ultrasound
- MRI scans
- Nerve or skin biopsy
- Immunologic testing
- Genetic testing
- Spinal tap
- Medications such as gabapentin or Lyrica
- Intravenous immunoglobulin (IVIG) and other biology therapies
- Physical therapy
- Calmare Scrambler Pain Therapy Treatment (medication-free treatment for nerve pain)
Sometimes, standard medications such as gabapentin or Lyrica can help. Many of you may be on these medications or tried them in the past. We find that very often medications are not dosed as optimally as they could be, and this affects the effectiveness and the occurrence of side effects.
Aside from medications, sometimes natural products, nutritional and dietary changes, as well as cutting-edge neuromodulating therapy, such as the Scrambler pain therapy treatment using the Calmare device is helpful. This is a medication-free treatment that can retrain the brain to no longer register neuropathy pain.
Unfortunately, often the neuropathy cannot be corrected and treatment focuses on relieving or decreasing symptoms. Even if this is the case, much can be done to help. This may involve improving balance or easing pain.
Depending on the cause of small fiber neuropathy, nerves can heal. For example, if there is a vitamin deficiency or autoimmune problem, treatment might be able to regenerate nerve fibers.
If MCAS or another condition is causing or contributing to SFN, then treating this condition can improve the SFN.
Small fiber neuropathy typically refers to patients in whom only the small nerve fibers are affected. In CIDP medium and large nerve fibers are affected. Small fibers may be affected as well. Someone with a purely small fiber neuropathy (SFN) does not technically have CIDP, but. some doctors will refer to any SFN that they think is immune-mediated as CIDP. CIDP and an immune-mediated SFN may be treated with similar therapies.
SFN is very common in people with MCAS.
Yes. But we do not know how to predict who will improve and who will not.
We are not currently accepting any new neuropathy or neuromuscular patients. Patients who are already established will continue to be followed.