Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Neuropathy is a general term that refers to diseases or malfunctions of the
nerves. Any nerves at any location in the body can be damaged from injury or
disease. Neuropathy is often classified according to the types or location of
nerves that are affected. Neuropathy can also be classified according to the
disease causing it. (For example, neuropathy from the effects of
diabetes is
called diabetic neuropathy.)
Types of Neuropathy
Peripheral neuropathy: Peripheral neuropathy is when the nerve problem affects the nerves outside of
the brain and spinal cord. These nerves are part of the peripheral nervous
system. Accordingly, peripheral neuropathy is neuropathy that affects the nerves
of the extremities- the toes, feet, legs, fingers, hands, and arms. The term
proximal neuropathy has been used to refer to nerve damage that specifically
causes pain in the thighs, hips, or buttocks.
Cranial neuropathy: Cranial neuropathy occurs when any of the twelve cranial nerves (nerves that
exit from the brain directly) are damaged. Two specific types of cranial
neuropathy are optic neuropathy and auditory neuropathy. Optic neuropathy refers
to damage or disease of the optic nerve that transmits visual signals from the
retina of the eye to the brain. Auditory neuropathy involves the nerve that
carries signals from the inner ear to the brain and is responsible for hearing.
Autonomic neuropathy: Autonomic neuropathy is damage to the nerves of the involuntary nervous
system, the nerves that control the heart and circulation (including blood
pressure), digestion, bowel and bladder function, the sexual response, and
perspiration. Nerves in other organs may also be affected.
Focal neuropathy: Focal neuropathy is neuropathy that is restricted to one nerve or group of
nerves, or one area of the body. Symptoms of focal neuropathy usually appear
suddenly.
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Certain prescription medications have been shown to bring relief for those
with neuropathy. In severe cases, a combination of medications may be necessary.
Oral medications that have been successfully used to help the pain of neuropathy
include:
Antidepressants such as:
amitriptyline
(Elavil, Endep),
imipramine (Tofranil, Tofranil-PM),
desipramine (Norpramin, Pertofrane)
duloxetine (Cymbalta),
venlafaxine (Effexor, Effexor XR),
bupropion
(Wellbutrin),
paroxetine (Paxil), and
citalopram (Celexa).
Anticonvulsants such as
pregabalin (Lyrica),
gabapentin (Gabarone,
Neurontin),
carbamazepine
(Carbatrol, Equetro, Tegretol, Tegretol XR), and
lamotrigine
(Lamictal).
Opioids and opioid-like drugs such as:
controlled-release
oxycodone, and
tramadol (Ultram).
Topical medications that may bring pain relief include capsaicin cream and
lidocaine patches (Lidoderm, Lidopain).
