What are the causes of peripheral neuropathy?

Question

Hi doctor,

My father was diagnosed with stage IV lung cancer last month. Before that, he could not walk, and he became paralyzed entirely (arms and legs). We then took him to a local hospital, and the neurologist mentioned that he has Guillain-Barre syndrome, and they treated him for that. However, he did not recover after treatment. After a month, we moved to another hospital, and the new hospital found that he has Stage IV lung cancer. Currently, he is on medication, and he received some injections and had radiotherapy. My father is now able to move a little, but still, he cannot walk for that we are getting physiotherapy. My concern now is that he keeps complaining that his entire leg and palm feel numb. I checked BP, and it is 92/70 mm Hg, and he is on tablet Lyrica 100 mg (Pregabalin) morning and evening but still complaining about numbness. When I spoke to the oncologist, he said the cancer treatment could cause this. I still wanted to get another opinion to see if there is anything we can do to improve his quality of life and any other medication for his neuropathy condition. I have attached all the reports to give some clarity on his condition. Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I understand the situation. I have seen the reports and documents (attachment removed to protect the patient's identity). It shows carcinoma of the lung, probably small cell carcinoma associated with peripheral neuropathy and paraneoplastic syndrome due to Carcinoma of the lung itself (I did not find the biopsy report).

Numbness of limbs are challenging to treat. However, I suggest capsule Duloxetine 20 mg after dinner with the continuation of tablet Lyrica (Pregabalin) as before.

I can see his blood pressure is low. I suggest you avoid the medicine until his blood pressure is corrected. Give him ORS (oral rehydrating solution) solution. If blood pressure remains low, consult a physician locally.

Thank you.