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2018
Over half of the patients with chronic hepatitis C attending the DGH have a neurological manifestation, mainly presenting as sensory peripheral neuropathy. Routine screening of chronic hepatitis C patients for peripheral neuropathy is therefore necessary, with prime focus on those with older age and longer duration of illness.
2017
Peripheral neuropathy is present in more than half of cirrhosis patients and is unrelated to etiology and nutritional status but related to the severity of cirrhosis.
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Peripheral Neuropathy & Liver Disease
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Peripheral Neuropathy & Liver Disease
Peripheral neuropathy is any nerve disorder affecting nerves outside of the spinal cord and brain, including those carrying messages to and from the organs of the torso and pelvis.The liver plays a key role in all body functions
.
Liver disease, or hepatic insufficiency, compromises the nervous system and can ultimately lead to death.
Function
The liver is the body's largest gland. It is responsible for making proteins and enzymes that control blood volume and clotting. It stores carbohydrates for conversion to glucose, and produces bile that extracts vitamins A, E, D and K from fat while removing potentially harmful metabolic byproducts from the blood.All blood flows through the liver. You cannot survive without a liver
Function
The liver is the body's largest gland. It is responsible for making proteins and enzymes that control blood volume and clotting. It stores carbohydrates for conversion to glucose, and produces bile that extracts vitamins A, E, D and K from fat while removing potentially harmful metabolic byproducts from the blood.All blood flows through the liver. You cannot survive without a liver
.
Misconceptions
While alcoholism is associated with cirrhosis, any condition that causes fat to build up in the liver will cause cirrhosis. Obesity, diabetes, hereditary disorders, infections and medications can cause fatty liver, or cirrhosis, in the absence of alcoholism. The secondary problem of peripheral neuropathy will develop with the changes in the liver.
Infection
According to the UCLA Department of Medicine, peripheral neuropathy can develop when hepatitis C infects the liver. As the body fights the infection, immune proteins, called cryoglobulins, circulate in the blood. Theory holds that the chronic hepatitis C induces overproduction of infection-fighting proteins. These proteins may lodge in capillary walls, causing inflammation and pain
.Malabsorption
According to the UCLA Department of Medicine, peripheral neuropathy can develop when hepatitis C infects the liver. As the body fights the infection, immune proteins, called cryoglobulins, circulate in the blood. Theory holds that the chronic hepatitis C induces overproduction of infection-fighting proteins. These proteins may lodge in capillary walls, causing inflammation and pain
.Malabsorption
According to Merck Medical Library, impaired liver function associated with cirrhosis or alcoholism decreases the absorption of vital nutrients, such as vitamin B12. Vitamin B12 deficiencies disrupt the formation of the myelin sheaths that insulate nerve fibers.Without proper sheathing tingling, pain, muscle spasms and loss of sensation can develop as messages from one exposed nerve influence messages from adjacent exposed nerves
Compression
Compression
Impaired liver function prevents effective albumin production, which regulates fluid levels in the body. Fluids initially build up in the abdomen. This condition, called ascites, causes the belly to bulge. Swelling can also develop in the limbs and joints. This condition, called peripheral edema, can put abnormal pressure on the peripheral nerves and cause pain, tingling and numbness
Diagnosis
Diagnosis
If you develop unexplained peripheral neuropathy with symptoms of liver disease such as vomiting, yellowing skin and eyes, fatigue and unexplained weight loss, the doctor may order blood tests to check the liver, called a hepatic function panel. If your liver's albumin, bilirubin and enzymes are higher or lower than normal, the doctor must assess the cause of liver impairment to determine a management plan for the peripheral neuropathy
Treatment
Treatment
Your doctor may prescribe vitamin B12 supplements when liver disease has triggered a B12 deficiency. Diuretics and salt restrictions may be implemented to control swelling, due to fluid retention, which can relieve some of the pain associated with nerve compression.Your doctor may also prescribe antidepressants, non-steroidal anti-inflammatory drugs or anticonvulsant medications for pain management. Transcutaneous electrical nerve stimulation, or TENS, may be used to ease pain without medication. Long-acting morphine might be prescribed when hepatitis C is present.
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