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Suggest Treatment For Nerve Pain When Diagnosed With Peripheral Nerve Disease
Question: I have peripheral nerve disease (erythromelalgia ) and also brachioradialis pruritus. I am 72 and in fairly good health. I have had nerve pain in my legs before. I took neurontin which helped but gave me severe balance problems. for the sciatica now I take cortisone shots every 6 mos which mostly controls it.
these new diseases give me burning and itching and purple hands and feet, and an itchy rash on my arms. neurontin helps but if I take over 100
these new diseases give me burning and itching and purple hands and feet, and an itchy rash on my arms. neurontin helps but if I take over 100
Brief Answer:
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Detailed Answer:
I read your question carefully and I understand your concern.
The symptoms you describe which seem to be caused by erythromelalgia are at times difficult to treat because it is a rare disorder for the treatment of which there aren't any randomized studies. However there are several alternatives which have produced results.
Topical application of cream containing a mixture of amitriptyline and ketamine (respectively 4% and 2%) does produce benefit in many patients. Brand name is AmiKet but it may vary in different countries.
If that is not enough oral medications may be tried. Apart fro Gabapentin there are other options which may relieve the symptoms, though not necessarily in all patients, so different ones may be tried. Such options include magnesium supplements, propranolol, duloxetine, amitriptyline and antihistamines.
Simple measures such as elevating the extremities or exposing to cold water/air when symptoms appear are also beneficial.
I remain at your disposal for other questions.
Read below
Detailed Answer:
I read your question carefully and I understand your concern.
The symptoms you describe which seem to be caused by erythromelalgia are at times difficult to treat because it is a rare disorder for the treatment of which there aren't any randomized studies. However there are several alternatives which have produced results.
Topical application of cream containing a mixture of amitriptyline and ketamine (respectively 4% and 2%) does produce benefit in many patients. Brand name is AmiKet but it may vary in different countries.
If that is not enough oral medications may be tried. Apart fro Gabapentin there are other options which may relieve the symptoms, though not necessarily in all patients, so different ones may be tried. Such options include magnesium supplements, propranolol, duloxetine, amitriptyline and antihistamines.
Simple measures such as elevating the extremities or exposing to cold water/air when symptoms appear are also beneficial.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have used the cream which sort of helped but not so much. I'm using 100mg of gabapentin. if I use any more my balance is terrible and I may fall. that seems to help the erythromylalgia but I still have rash itchy arms. I use Salon pas gel morning and night which stings but cuts the itching. I guess people take 1800mg of gaba but I cant. any other suggestions? tegretol? this is really hard.
Brief Answer:
Read below
Detailed Answer:
Tegretol is a valid option in terms of efficacy but I didn't mention it because it can cause balance issues as well, more likely than Gabapentin.
So I would try the other medications which I mentioned in my answer, before trying another anticonvulsant. Since itching seems to be what troubles you most an antihistamine may be first choice. If I were to use an anticonvulsant I would consider Pregabalin (Lyrica) before Carbamazepine, fewer side effects.
Let me know if I can further assist you.
Read below
Detailed Answer:
Tegretol is a valid option in terms of efficacy but I didn't mention it because it can cause balance issues as well, more likely than Gabapentin.
So I would try the other medications which I mentioned in my answer, before trying another anticonvulsant. Since itching seems to be what troubles you most an antihistamine may be first choice. If I were to use an anticonvulsant I would consider Pregabalin (Lyrica) before Carbamazepine, fewer side effects.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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