Understanding and managing peripheral neuropathy

Consultant neurologist Jessica Hfner explains myeloma-related peripheral neuropathy, with a practical focus on what patients can do to prevent symptoms, manage pain, and reduce day-to-day impact.

She breaks down what neuropathy is (sensory, motor, and autonomic), common symptoms (burning or electric nerve pain, numbness, balance issues, bowel/bladder changes, dizziness, and sweating changes), and why neuropathy can occur in myeloma—through the disease itself, nutritional issues, infections (like shingles), and treatments such as bortezomib and thalidomide.

Jessica outlines how neuropathy is assessed and diagnosed (clinical exam, nerve conduction studies, and selected specialised tests), when a neurologist review is most important, and key prevention strategies like optimising diabetes control, limiting alcohol, treating vitamin deficiencies (especially B12), and reviewing medications when symptoms worsen.

The session includes practical symptom management—non-drug pain strategies, graded activity, physio supports, topical options, and careful use of neuropathic pain medications—plus advice on cramps, autonomic symptoms, foot care, and supplements (including the risk of excessive vitamin B6). She also briefly covers medicinal cannabis as an option when other measures fail, and points viewers to clinical trial registries for emerging research.

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