ITEMS IN AFP WITH KEYWORD:
Key clinical questions and their evidence-based answers directly from the journal’s content, written by and for family physicians.
Most peripheral nerve injuries seen by family physicians will involve neurapraxia, resulting from entrapment along the anatomic course of the nerve. History and physical examination alone are often enough to identify the injury or entrapment; advanced diagnostic testing with imaging helps to confirm the clinical diagnosis and is indicated if conservative management is ineffective. Initial treatment is conservative, with surgical options available for refractory injuries or entrapment caused by anatomic abnormalities.
Peripheral neuropathy is one of the most common neurologic problems encountered by family physicians. Common identifiable causes include diabetes mellitus, nerve compression or injury, alcohol use, toxin exposure, hereditary diseases, and nutritional deficiencies, although many cases are idiopathic. Diagnosis requires a comprehensive history, physical examination, and judicious laboratory testing.
Recognizing Charcot neuroarthropathy of the foot and ankle is critical because if untreated, patients are at risk of ulceration, infection, and amputation. Physicians should suspect Charcot foot in patients older than 40 years who present with peripheral neuropathy and acute swelling with associated erythema and warmth. The mainstay of treatment is immobilization in a total contact cast.
Dec 1, 2017 Issue
Topical Capsaicin for Treatment of Chronic Neuropathic Pain in Adults [Medicine by the Numbers]
Based on low-quality evidence, high-concentration capsaicin patches reduce neuropathic pain from herpes and human immunodeficiency virus infection by 30% to 50% compared with the low-concentration capsaicin control group.
Painful diabetic neuropathic pain causes patients to experience burning pain, paresthesias, and numbness that progress from the feet and hands to the rest of the body. Although several therapeutic modalities are available for its treatment, many patients do not receive adequate care.
May 1, 2016 Issue
Alpha-Lipoic Acid for Treatment of Diabetic Peripheral Neuropathy [FPIN's Help Desk Answers]
Intravenous (IV) ALA can improve neuropathy symptoms when administered for three weeks, but symptom improvement with oral ALA is not clinically significant. There is no evidence evaluating long-term treatment.
Studies show that 1 in 6 patients were helped with diabetic neuropathy and 1 in 8 were helped with postherpetic neuralgia. Find out more.
A man who had recently started an intensive exercise regimen had weakness in his arm and dull, achy shoulder pain. Examination revealed an obvious deformity.
Jul 1, 2015 Issue
The Role of Levetiracetam in Treating Chronic Neuropathic Pain Symptoms [Cochrane for Clinicians]
Based on low-quality evidence, levetiracetam was found to be ineffective for the treatment of chronic neuropathic pain symptoms. Moreover, patients who were taking levetiracetam experienced adverse effects at a significantly higher rate than those who were taking placebo.