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P&S Journal

P&S Journal: Spring 1997, Vol.17, No.2
Clinical Advances
Peripheral Neuropathy: Common Yet Under Recognized

By Devera Pine
The new Peripheral Neuropathy Comprehensive Care Center--the most comprehensive center in New York and one of only a few in the nation--is now open. Peripheral neuropathy is a disorder caused by injury to the peripheral nerves--the nerves that connect the central nervous system to the muscles, skin, and internal organs. Symptoms include muscle weakness, numbness, tingling, and pain in the arms and legs. Its most severe form causes paralysis and complete loss of sensation. The Neuropathy Association

 "Peripheral neuropathy has been called the silent disease. Although more than 2 million people in the United States suffer from it, its extent and importance have not been recognized," says Dr. Norman Latov, professor of neurology and medical director of the new center. "Too often, it is misdiagnosed or improperly treated, and the development of new therapies has been slow and under funded." The center aims to improve treatment of peripheral neuropathy by taking an integrated approach that combines diagnosis and treatment with education and research.

 Causes of neuropathy include diabetes and alcoholism, the two most common causes. Nutritional imbalance, kidney disease, infections, toxins, cancer, and autoimmunity also cause the disorder, but the cause is unknown in approximately a third of all cases.

 It is not uncommon for peripheral neuropathy to be misdiagnosed or to go untreated. For example, alcoholism is too often blamed for the neuropathy in cases where no other cause is found, says Dr. Latov. Or, patients are told nothing can be done for them before they receive a proper evaluation.

 In Mary Ann Donovan's case, prompt treatment might have spared her the disabling effects of her disease. Ms. Donovan, president of the new Neuropathy Association, was told nothing could be done to help her when she was diagnosed in 1987. Her condition, caused by autoimmune disease, continued to worsen. Once an active person, she had trouble walking more than a few blocks. In 1994--seven years after she was originally diagnosed--a friend recommended Dr. Latov. Since then she has been on medication that has stopped the progression of her disease and she is now able to walk better. "But," she says, "if I had been treated at the beginning of the disease, it might have been possible to cure it."

 To make both doctors and patients more aware of peripheral neuropathy, Ms. Donovan and other patients at the P&S Peripheral Neuropathy Center founded the Neuropathy Association, a national non-profit organization. "There's very little help out there: Most doctors don't even know that there are 30 kinds of peripheral neuropathy--some curable, some not, but most can be helped with proper medication. And many people think they have arthritis when they actually have peripheral neuropathy. It's a disease that nobody has talked much about, but it needs to be brought out."

 At P&S, a range of specialists--experts in pain management, electrophysiology, physical therapy, peripheral nerve surgery, and rehabilitation medicine--are available to help people with neuropathy. In addition, the center researches the causes and treatment of peripheral neuropathy. Dr. Latov's laboratory is widely recognized for its discovery of autoimmune causes of neuropathy, and P&S researchers at the new center will participate in clinical trials of nerve growth factor for diabetic neuropathy and of intravenous gamma globulins in patients with motor neuropathies.

 The Peripheral Neuropathy Comprehensive Care Center is located at Columbia-Presbyterian/Eastside, 16 E. 60th St., in New York City and can be reached at (212) 305-5704. The Neuropathy Association can be reached at 1-800-247-6968 or on the World Wide Web at

copyright ©, Columbia-Presbyterian Medical Center

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