Reversing Neuropathy

Neuropathy refers to damage to the peripheral nerves which interferes with the normal functioning of the nerve. Neuropathy can be secondary to another disease or due to direct injury to nerves (trauma, toxins, immune attack, etc). Knowing which neuropathy is reversible and, which is not is of paramount importance. Many a times there may be a permanent damage to the nerve, and the neuropathy cannot be reversed while sometimes it is fully reversible. The nerve damage may also be intermediate between the two, and there may be some reversal of neuropathy with appropriate treatment.

Neuropathies due to food allergies are often reversible and avoiding the allergy inciting food is the mainstay of therapy. In almost all the cases, the neuropathy is fully reversible and nerve function becomes normal after few weeks of stopping the intake of allergen. In most of the cases, the neuropathy secondary to adverse effects of a drug is also reversible and stopping the drug or reducing its dose often reverses the neuropathy. The neuropathy due to Guillain-Barre syndrome is often almost fully reversible with adequate treatment, although full reversal may take up to a year. The main treatment is with immunoglobulin given as intravenous injection and supportive care to prevent any complications.

The neuropathy due to vitamin deficiency is most of the times reversible but there can be also some permanent damage to the nerve and hence a neuropathy that is not fully reversible. The treatment for reversing the neuropathy is replenishment of the deficient vitamin by either oral supplementation or by intramuscular injection.

Neuropathies secondary to other systemic illness may or may not be reversible or sometimes only partially reversible. Diabetes mellitus is a disease in which many different patterns of neuropathy can occur. Some forms of diabetic neuropathies like mononeuropathies (involving only one nerve) and radiculopathies (involving nerve roots) are fully reversible and do not require any specific therapy. However, one another form, which most often involves lower limbs, is often progressive and irreversible despite treatment. Still tight control of blood-glucose levels should be followed to at least slow the progression and prevent other complications of diabetes. Hypothyroidism (Myxedema) causes entrapment neuropathies, and majority of these are reversible in the early stages if adequate treatment with thyroid hormone replacement is provided. Other types of entrapment neuropathies like Carpal Tunnel Syndrome are fully reversible in initial stages if treated adequately. Treatment is providing rest to the wrist, NSAID drugs (like Ibuprofen), or steroid injection in wrist and surgery (done in refractory cases not responding to treatment options). Later there may be some permanent damage, and it may be only partially reversible even with surgical treatment.