Peripheral Neuropathy case

[Guest guest]

Hi All,

 

Here is another puzzling one for you to ponder.

 

By the way thanks for your advice with my lady patient with the possible Spleen

Yang deficiency.

 

Male aged 69, diagnosed with Peripheral Neuropathy, pain in the right buttock

(at point of the ischial tuberosity) descending right leg with burning

sensation in right foot (also left but not as bad), he describes this by saying

that it's difficult to say whether its burning or freezing sensation. The

strange thing is that this occurs every other day. He refers to it as " good day "

bad day " . He has seen a whole host of neurologists, who have tested

everything (excluding pudendal nerve entrapment) and are now scratching their

heads and just classified it as chronic PN and prescribed Amitriptyline (50mg)

he takes this occasionally and it does relieve the symptoms for a while.

 

He started with this 10 years ago, and it coincides with an inguinal hernia

operation (although no-one seems to have made a possible link here). He does not

smoke, or drink, he exercises regularly (golf three times per week) he is very

fit, not overweight, reasonably healthy diet is generally  very healthy for a

man approaching 70 years old.

 

His tongue points to yin deficiency, (no coating) slightly reddish, with

scalloped edges  (sp qi xu) and a fairly deep vertical crack in the middle of

the tongue (sp/st), his pulse is fairly nondescript (but pulse diagnosis is  a

weakness in my armoury), He does not sweat, (even after exercise), he does not

have any issues regarding digestion, or bowel movements, albeit he is not the

most expressive of people and he tends to want to talk only about the pain in

his " ass " (his words)

 

I have followed where the dermatomes reach and I have been using tuina and

huatojaji points and needled at T3/T7/L2/3/4/5 GB20, DU20, GB34, GB30, BL54,

BL40, SI3 left side and BL62 right side, LIV3. Initially I used electro

acupuncture on GB 30 and GB34.

 

His reaction after 5 sessions, is that I have made some difference, he describes

it as  " the bad days are worse and the good days are better " , progress? maybe !

 

After a whole load of thought, I considered that the Pudendal nerve maybe

implicated here, on the basis that it hurts to sit for too long, he gets the

occasional problem with hesitancy during urination on " bad days " (not prostate,

tests came back clear), MRI show nothing, having said that a possible pudenal

nerve entrapment is a possibility which lead me down the current path, (MRI 

does not show nerve entrapment anyway, MRN does, but these are not readily

available in the UK) and on the basis of this, and applying acupuncture needling

technique that I was trained in, local, adjacent and distal, at the last session

I needled Ren 1  as an adjacent point. I await to see if there was any reaction

to this at the next session tomorrow, and if I have stimulated something I will

apply mild electro acupuncture to Ren 1..

 

He insists that this pain only occurs every other day, which doesn't make any

sense. The neurologists have given up a little, and like many people who get

nothing back from WM he has turned to alternative medicine. I'm not totally

certain where I'm going with this, but I'm taking some heart from the fact that

I have got some reaction, where WM has achieved nothing to date.

 

Any ideas?

 

Thanks

 

Andrew Colombini BSc. (Hons) TCM MBAcC  MAcSCA

 

[Guest guest]

On Mon, Apr 5, 2010 at 12:12 PM, Andrew Colombini <andycolombini

> wrote:

 

>

>

> Hi All,

>

> Here is another puzzling one for you to ponder.

>

> By the way thanks for your advice with my lady patient with the possible

> Spleen Yang deficiency.

>

> Male aged 69, diagnosed with Peripheral Neuropathy, pain in the right

> buttock (at point of the ischial tuberosity) descending right leg with

> burning sensation in right foot (also left but not as bad), he describes

> this by saying that it's difficult to say whether its burning or freezing

> sensation. The strange thing is that this occurs every other day. He refers

> to it as " good day " bad day " .

>

Some of the keywords associated with shao yang bing (disease, syndrome) is

alternative chills and fever. However, they don't have to present exactly

like malaria, but can be a dis-regulation of any yin/yang pair. Including,

in some cases, problems that arise with a regularity such as one day on, one

day off.

 

>

>

> I have followed where the dermatomes reach and I have been using tuina and

> huatojaji points and needled at T3/T7/L2/3/4/5 GB20, DU20, GB34, GB30, BL54,

> BL40, SI3 left side and BL62 right side, LIV3. Initially I used electro

> acupuncture on GB 30 and GB34.

>

Maybe add San Jiao 5 for the shao yang connection on the arm?

 

--

, DAOM

Pain is inevitable, suffering is optional.

http://twitter.com/algancao