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Shingles, Neuropathy, Spasticity




Shingles

Shingles (herpes zoster) is a painful, blistering skin rash. It is caused by the varicella-zoster virus. This is the virus that also causes chickenpox.
 

Causes

After you get chickenpox, the virus remains inactive (becomes dormant) in certain nerves in the body. Shingles occurs after the virus becomes active again in these nerves after many years. The reason the virus suddenly becomes active again is not clear. Often only one attack occurs. Shingles can develop in any age group. You are more likely to develop the condition if:

  • You are older than 60

  • You had chickenpox before age 1

  • Your immune system is weakened by medications or disease

If an adult or child has direct contact with the shingles rash and did not have chickenpox as a child or the chickenpox vaccine, they can develop chickenpox, not shingles.
 

Symptoms

The first symptom is usually pain, tingling, or burning that occurs on one side of the body. The pain and burning may be severe and are usually present before any rash appears.
Red patches on the skin, followed by small blisters, form in most people:

  • The blisters break, forming small sores that begin to dry and form crusts. The crusts fall off in 2 to 3 weeks. Scarring is rare.

  • The rash usually involves a narrow area from the spine around to the front of the abdomen or chest.

  • The rash may involve the face, eyes, mouth, and ears.

Other symptoms may include fever and chills, general ill feeling, headache, joint pain, or swollen glands (lymph nodes). You may also have pain, muscle weakness, and a rash involving different parts of your face if shingles affects a nerve in your face. This may include difficulty moving facila muscles, hearing loss, or taste and vision problems.
 

Treatment

Your health care provider may prescribe a medicine that fights the virus, called an antiviral drug. This drug helps reduce pain, prevent complications, and shorten the course of the disease. The medicines should be started within 72 hours of when you first feel pain or burning. It is best to start taking them before the blisters appear. Strong anti-inflammatory medicines called corticosteroids, such as prednisone, may be used to reduce swelling and pain. Other medicines may include Antihistamines to reduce itching, pain medicine, Zostrix, a cream containing capsaicin (an extract of pepper) to reduce pain.

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Neuropathy

Peripheral nerves carry information to and from the brain. They also carry signals to and from the spinal cord to the rest of the body. Peripheral neuropathy means these nerves don't work properly. Peripheral neuropathy may be damage to a single nerve. It may be damage to a nerve group. It may also affect nerves in the whole body.
 

Causes

Neuropathy is very common. There are many types and causes. Often, no cause can be found. Some nerves diseases run in families. Diabetes is the most common cause of this type of nerve problem. High blood sugar levels over a long time can damage your nerves. Other causes of neuropathy include:

  • Autoimmune disorders such as rheumatoid arthritis or lupus

  • Chronic kidney disease

  • HIV

  • Liver infections

  • Poor blood flow to the legs

  • Underactive thyroid gland

  • Broken bone that affects a nerve

  • Long-term, heavy alcohol use

  • Glue, lead, mercury, and solvent poisoning

  • Pressure on a nerve, such as carpal tunnel syndrome
     

Symptoms

Symptoms depend on the nerve that is damaged. Symptoms also depend on whether the damage affects one nerve, several nerves, or the whole body.

  • Pain and Numbness

  • Muscle Problems

  • Problems with Body Organs

  • Other symptoms including sexual problems, bladder problems or sweating at unusual times
     

Treatments

Treating the cause of nerve damage, if known, may improve your symptoms.

  • People with diabetes should learn to control their blood sugar.

  • If you use alcohol, stop.

  • Your medicines may need to be changed. Do not stop taking any medicine before talking to your health care provider.

  • Replacing a vitamin or making other changes in your diet may help. If you have low levels of B12 or other vitamins, your doctor may recommend supplements or injections.

  • You may need surgery to remove pressure from a nerve.

  • You may have therapy to learn exercises to get better muscle strength and control. Wheelchairs, braces, and splints may improve movement or the ability to use an arm or leg with nerve damage.
     

Treating Pain

Medicines may help reduce pain in the feet, legs, and arms. They usually do not bring back loss of feeling. You may take pain pills. Medicines used to treat other medical problems, such as seizures or depression, can also help manage the pain. Use the lowest dose possible to avoid side effects. Your doctor may refer you to a pain specialist such as Deaconess Comprehensive Pain Center. These specialists will work with you and your primary doctor to create an effective pain treatment.

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Spasticity

Spasticity is stiff or rigid muscles. It may also be called unusual tightness or increased muscle tone. Reflexes (for example, a knee-jerk reflex) are stronger or exaggerated. The condition can interfere with walking, movement, or speech.
 

Causes

Causes for Spacticity can include:

  • Brain damage caused by lack of oxygen, as can occur in near drowning or near suffocation

  • Cerebral palsy

  • Head injury

  • Multiple sclerosis

  • Neurodegenerative illness -- illnesses that damage the brain and nervous system over time

  • Phenylketonuria

  • Spinal cord injury

  • Stroke
     

When to Contact a Medical Professional

Contact your health care provider if:

  • The spasticity gets worse

  • You notice deformity of the affected areas
     

Treatment

After determining the cause of your spasticity, the doctor may refer you to a physical therapist. Physical therapy involves different exercises, including muscle stretching and strengthening exercises. Physical therapy exercises can be taught to parents who can then help their child do them at home.
Other treatments may include:

  • Medicines may be prescribed to treat spasticity. These need to be taken as instructed.

  • Sometimes surgery is needed to release the tendon or to cut the nerve-muscle pathway.

  • In rare cases, a pump may be inserted into the spinal fluid to directly deliver medicine to the nervous system.

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