Managing Peripheral Neuropathy: Medications and Symptoms Explained

Q: Managing Peripheral Neuropathy: Medications and Symptoms Explained

Hello： You mentioned, "Is taking medications like Lyrica and Topamax, as well as Rivotril, helpful?" Based on clinical experience, the recommendation for neurological disorders is to "start low and go slow." You can begin with a low dose and try one medication at a time. <br>Taki

Systemic neuropathy

Hello Dr.
Jiang: I would like to ask, if this is a peripheral nerve issue, what medications should be used for management? After receiving the vaccine last year, the burning sensation in my palms disappeared after about a month, while the burning in my soles lasted for about five months.
After that, it turned into a wandering cool sensation.
Now, after being diagnosed, the burning in my soles has reappeared on August 30, and I also experience shaking and weakness, along with some internal signals.
If this is a peripheral nerve issue, will the burning sensation naturally resolve? Additionally, I previously had a neurologist prescribe Lyrica, Klonopin, and Rilutek.
Do these medications help? I have seen the side effects and am concerned since I am already very fatigued and have weak legs.
I have to work the next day, so I have been hesitant to take them.
Thank you.

Jean, 40~49 year old female. Ask Date: 2022/11/06

Dr. Jiang Junyi reply Neurology

Hello: You mentioned, "Is taking medications like Lyrica and Topamax, as well as Rivotril, helpful?" Based on clinical experience, the recommendation for neurological disorders is to "start low and go slow." You can begin with a low dose and try one medication at a time.
Taking multiple medications at once may lead to dizziness and lightheadedness.
It is advisable to start with a low dose of Lyrica.
I recommend discussing your treatment strategy with your attending physician.
Thank you for your question, and feel free to discuss any related issues further! Wishing you good health and peace.
Dr.
Jiang Junyi from Taoyuan cares about you.

Reply Date: 2022/11/06

More Info

Peripheral neuropathy is a condition that affects the peripheral nervous system, which includes all the nerves outside the brain and spinal cord. It can result from various causes, including diabetes, infections, autoimmune diseases, and exposure to toxins. Symptoms often include pain, tingling, numbness, and weakness in the affected areas, typically the hands and feet. In your case, the symptoms you describe—burning sensations, tingling, and weakness—are consistent with peripheral neuropathy.

The management of peripheral neuropathy often involves a combination of medications and lifestyle changes. The medications you mentioned, such as Lyrica (pregabalin) and Rivotril (clonazepam), are commonly prescribed for neuropathic pain. Pregabalin is specifically indicated for neuropathic pain and has been shown to be effective in reducing symptoms. It works by modulating the release of neurotransmitters and stabilizing electrical activity in the nervous system. Rivotril, on the other hand, is primarily an anxiolytic and anticonvulsant medication, which may help with muscle relaxation and anxiety but is not primarily used for neuropathic pain.

Regarding your concerns about side effects, it is essential to weigh the benefits of these medications against their potential risks. Common side effects of pregabalin include dizziness, drowsiness, and peripheral edema, while Rivotril can cause sedation, dizziness, and potential dependence with long-term use. If you are already feeling fatigued and weak, it is crucial to discuss these symptoms with your healthcare provider. They may adjust your medication regimen or suggest alternative treatments that could be more suitable for your situation.

As for the burning sensations you experienced after vaccination, it is not uncommon for some individuals to develop neuropathic symptoms following vaccinations, although the exact mechanism is not fully understood. In many cases, these symptoms can resolve on their own over time, but the duration can vary significantly from person to person. The fact that your symptoms have changed from burning to a more diffuse cool sensation suggests that your nervous system is undergoing changes, which can be part of the healing process.

If you are experiencing a resurgence of burning sensations and additional symptoms like shaking and weakness, it is crucial to follow up with your neurologist. They may recommend further evaluations, such as nerve conduction studies or imaging, to assess the underlying cause of your symptoms. Additionally, they can provide guidance on the appropriate use of medications and whether adjustments are needed based on your current condition.

In summary, managing peripheral neuropathy often requires a tailored approach that includes medication, lifestyle modifications, and regular follow-up with healthcare providers. If you have concerns about your medications or symptoms, do not hesitate to reach out to your doctor for personalized advice and support. Your well-being is paramount, and addressing these issues proactively can lead to better management of your condition.

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