SLE-associated neuropathy is not a single entity, but can be caused in different parts of the nervous system and by various mechanisms. Sometimes the myelin sheath (the substance that covers the extensions of the nerve cells and serves to accelerate the nervous messages) may undergo degenerative changes, other times the disease affects blood vessels that supply the nervous system (vascular neuropathy) etc. Depending on the underlying disease mechanism, different treatments with varying degrees of response are noted. Complete remission, however, so far remains elusive.
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Lupus is a broad term for autoimmune disorders that weaken the body's immune system by producing antibodies that attack healthy cells, tissues and organs. The name "lupus" usually refers to the most common form, systemic lupus erythematosus. This disease is called systemic because it can affect many parts of the body. It is characterized by inflammation and damage to different tissues and organs with many symptoms including fatigue and fever, swollen or painfully inflamed joints, and skin rashes. Lupus may affect the kidneys, heart, lungs, blood and blood vessels, central nervous system and peripheral nerves. It may suddenly flare up and then retreat into remission.
The cause of lupus is unknown, environmental and other factors may trigger the disease.
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.
Medical treatment focuses on relieving pain by reducing inflammation, slowing joint and bone damage and improving the ability to function with the disease.
Rest and exercise programs
Use safety-measures due to loss of sensation
The following drugs are prescribed:
-Aspirin, ibuprofen NSAIDs or Cox-2 inhibitors (NSAIDs)to reduce joint inflammation and pain
-Antimalarial medication (hydroxychloroquine ) to suppress immune response
-Corticosteroids (prednisone ], hydrocortisone, methlyprednisolone , dexamethasone to suppress inflammation
-Immunosuppresive medications (azathioprine , cyclophosphamide to slow or reduce immune response)
-Anti-seizure medications. Medications such as gabapentin (Neurontin), topiramate (Topamax), pregabalin (Lyrica), carbamazepine and phenytoin were originally developed to treat epilepsy. However, doctors often also prescribe them for nerve pain
-Capsaicin. A cream containing this naturally occurring substance found in hot peppers can cause modest improvements in peripheral neuropathy symptoms
-Lidocaine patch. This patch contains the topical anesthetic lidocaine (Xylocaine). You apply it to the area where your pain is most severe, and you can use up to four patches a day to relieve pain. Lidocaine may help reduce pain from peripheral neuropathy.
-Antidepressants. Certain tricyclic antidepressant medications, such as amitriptyline, doxepin and nortriptyline (Aventyl, Pamelor), have been found to help relieve pain by interfering with chemical processes in your brain and spinal cord that cause you to feel pain.
- immune globulin therapy, you're given high levels of proteins that work as antibodies (immunoglobulins), which can help reduce your immune system's activity.
So if the neuropathy is caused by SLE and id due to an autoimmune responce damage to the nerves ,then it is quiet logically that since SLE is not curable for ever then consequently also neuropathy caused by it is not fully curable but follows the SLE flare ups ,and the best treatment to do in this case id to minimize the number of flare ups to deal with neuropathy by taking the necessary medications carefully ,in the remission period neuropathy must be stable,check with your doctor for the possible treatment right for your case .
The cause of lupus is unknown, environmental and other factors may trigger the disease.
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.
Medical treatment focuses on relieving pain by reducing inflammation, slowing joint and bone damage and improving the ability to function with the disease.
Rest and exercise programs
Use safety-measures due to loss of sensation
The following drugs are prescribed:
-Aspirin, ibuprofen NSAIDs or Cox-2 inhibitors (NSAIDs)to reduce joint inflammation and pain
-Antimalarial medication (hydroxychloroquine ) to suppress immune response
-Corticosteroids (prednisone ], hydrocortisone, methlyprednisolone , dexamethasone to suppress inflammation
-Immunosuppresive medications (azathioprine , cyclophosphamide to slow or reduce immune response)
-Anti-seizure medications. Medications such as gabapentin (Neurontin), topiramate (Topamax), pregabalin (Lyrica), carbamazepine and phenytoin were originally developed to treat epilepsy. However, doctors often also prescribe them for nerve pain
-Capsaicin. A cream containing this naturally occurring substance found in hot peppers can cause modest improvements in peripheral neuropathy symptoms
-Lidocaine patch. This patch contains the topical anesthetic lidocaine (Xylocaine). You apply it to the area where your pain is most severe, and you can use up to four patches a day to relieve pain. Lidocaine may help reduce pain from peripheral neuropathy.
-Antidepressants. Certain tricyclic antidepressant medications, such as amitriptyline, doxepin and nortriptyline (Aventyl, Pamelor), have been found to help relieve pain by interfering with chemical processes in your brain and spinal cord that cause you to feel pain.
- immune globulin therapy, you're given high levels of proteins that work as antibodies (immunoglobulins), which can help reduce your immune system's activity.
So if the neuropathy is caused by SLE and id due to an autoimmune responce damage to the nerves ,then it is quiet logically that since SLE is not curable for ever then consequently also neuropathy caused by it is not fully curable but follows the SLE flare ups ,and the best treatment to do in this case id to minimize the number of flare ups to deal with neuropathy by taking the necessary medications carefully ,in the remission period neuropathy must be stable,check with your doctor for the possible treatment right for your case .
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