Lupus and Nerve Damage
Everyone suffers from the occasional tingling or numbness in their hands or feet, usually when limbs "fall asleep." But, when you're living with lupus, numbness or tingling in your hands or feet may not be minor, passing symptoms. They can signal a condition called peripheral neuropathy, or nerve damage.
Lupus is an autoimmune condition that causes the immune system to attack normal, healthy cells and tissue. About 10 to 15 percent of people with lupus experience symptoms of peripheral neuropathy. When several nerves in the body are affected it's referred to as polyneuropathy—the most common type of peripheral neuropathy.
How Lupus Causes Neuropathy or Nerve Damage
The peripheral nervous system is responsible for motor responses and sensation. Lupus, and other autoimmune conditions rheumatoid arthritis, may cause antibodies in the immune system to directly attack nerve cells and blood vessels.
Also, inflammation and swelling from surrounding tissue can damage these nerves. Or, lupus may impair blood flow to the brain, spinal cord and nerves, which can damage nerve cells and disrupt how they function.
In most cases, peripheral neuropathy is symmetrical, which means it affects both sides of the body. However, peripheral neuropathy may also be non-symmetrical or more sporadic, affecting patches of areas in the body. This can result from vasculitis, or inflammation of the blood vessels.
Symptoms of Neuropathy in Lupus
Symptoms of peripheral neuropathy from lupus can range from mild to serious and mainly affect the hands, feet, legs or arms. They include:
- burning sensation
- inability to sense heat or cold
- vision problems
- carpal tunnel syndrome
Treatment for Peripheral Neuropathy in Lupus
First, a neurologist will need to diagnose that you have neuropathy. This usually requires a series of tests, including a neurological exam, nerve conduction tests, and imaging tests such as an electromyogram. Once you're diagnosed, there are several treatment options available.
Getting lupus under control to lower inflammation is essential. Immunosuppressants and corticosteroids that help to reduce flares reduce inflammation and provide relief from neuropathic pain and symptoms. Also, you should try to stick to your medication schedule, as symptoms can become worse when you don't.
Peripheral neuropathy can be painful, so opioid pain medications may provide relief (over-the-counter medications such as acetaminophen are usually ineffective when it comes to neuropathic pain). Also, the antidepressant amitryptyline (Elavil®), and the epileptic drug gabapentin (Neurotin®) are sometimes prescribed to treat neuropathic pain in people with lupus. However, these drugs may have serious side effects, so make sure you understand the risks.
Try to avoid situations that trigger lupus flares and increase your risk of neuropathy. Get more rest, limit your exposure to sun or fluorescent lighting, reduce stress as much as possible, and treat infections immediately. Avoid certain medications such as antibiotics, and eat healthy, nutritious meals daily. You may also need to take a vitamin B supplement.
Sources: Lupus Foundation of America, Hospital for Special Surgery, Jack Miller Center for Peripheral Neuropathy (University of Chicago), National Institute of Neurological Disorders and Stroke
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