Instituut voor Neuropathische Pijn

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Patients on Youtube, movies

In this section you can find Youtube movies from our institute, patient presentations, discussions of proper therapy and related items.

Chronic pain due to neuropathy and sciatica treated with PEA

sciatic-pain-normast.jpg Chronic pain due to neuropathy and sciatica treated with PEA. Severe neuropathic pain due to and a chronic neuropathy as well as due to nerve compression by a herniated disk, both pains reacted quick and after administering PEA the patient’s pain decreased considerably, and he could start working again, after being on sick leave for a long period of time. Since 2012 PEA is available as PeaPure, capsules containing only palmitoylethanolamide, without any chemical excipients. 

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Neuropathyinfo4u’s Channel

Our institute developed a Youtube channel, titel: Neuropathyinfo4u’s Channel. We will collect a variety of Youtube movies within the field of neuropathy, neuropathic pain and its treatment. We provide you with all kinds of information on neuropathy. Hence the title.

The adres: http://www.youtube.com/user/Neuropathyinfo4u?feature=mhw4

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MAG neuropathy

Here an entry from a patient’s blog with a description of a patient of what he experienced:

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Axonal painful neuropathy treated with palmitoylethanolamide and alpha lipoic acid

ciap-lipoic-acid.jpg This patient was diagnosed with axonal painful neuropathy in one of the Dutch academic hospitals. His pain was severe and the neuropathic changes on the EMG moderate to severe. The hospital physicians tried the obvious, amitriptyline and pregabalin, but due to side effects both analgesics had to be stopped. We started a treatment regime with PEA and alpha lipoic acid. The pain decreased more than 50% and the patient was able to return to his work and stand for longer periods of time with much less pain. Furthermore, the slowly deteriorating CIAP did stabilize and furthermore the functionality, as measured by the physiotherapist on different objective tests improved in time! For CIAP this is remarkable, as functionality mostly decreases by time.

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Integrated Medicine Approach for neuropathic pain

jan-keppel-hesselink-neuropathie.jpg Integrative medicine (IM) can be seen as an attempt to combine regular academic medical therapies with more evidence-based compelementary and alternative medicine (CAM). In any IM approach one should not simply add CAM to conventional medical care. IM treatment should emphasize health and healing rather than disease and symptomatic treatment, and patient coaching plays a central role.

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Small fibre neuropathy pain and palmitoylethanolamide (PEA)

small-fiber-neuropathy-palmitoylethanolamide.jpgA patient with severe pain in small fibre neuropathy, resistant to treatment with Gabapentine, responded positive within 3 weeks on treatment with body own fatty acid and mast cell stabilizer as well as anti-gliopathic pain medication palmitoylethanolamide, PEA.

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Angina pectoris pain decreases after palmitoylethanolamide

In our clinic we saw a 79-old lady, with a history of myocardial infarctions, a pacemaker was implanted, and severe artrosis in various joints as well as a knee replacement. She suffered from angina attacks and was treated with a betablocker and nitroglycerin under the tongue. She came under our care due to severe pain based on a herniated disk at two levels, L4/L5 and L5/S1. We prescribed palmitoylethanolamide 600 mg bid. On the sciatic pain the efects were very modest, but since the beginning of palmitoylethanolamide, now 7 weeks ago, no attacks of angina were seen. She explicitely asked us whether the attacks vanished due to palmitoylethanolamide. The attacks before our treatment were quite frequent, couple of times each week. Due to the fact that mast cells have been found in the coronary system and around nerve endings this by accident therapeutic effect might be a result of the pharmacological action of palmitoylethanolamide on the mast cells.

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Advising R&D for neuropathic pain

jan-keppel-hesselink-neuropathy-rd.jpg Many patients suffering from neuropathic pain are currently not optimal treated using the drugs on the market. The total value of the neuropathic pain market is supposed to double from 2006 to reach over $7 billion by 2016. There is a lot of space in the marketplace for  improved pain management.

In our institute we are specialized in the treatment of neuropathic pain and adbvising R&D processes related to the identification of new potential painkillers for neuropathic pain. A short explanation of the experience we have in helping pharmaceutical companies developing new drugs, by professor Jan M. Keppel Hesselink, MD, PhD, consultant.

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Pain in Chronic idiopathic axonal polyneuropathy treated with palmitoylethalonamide (PEA)

ciap-pea.jpg There is no evidence from randomised trials of drug therapy for chronic idiopathic axonal polyneuropathy, accrding to a Cochrane review. We quote from that review. Chronic idiopathic axonal polyneuropathy is a not uncommon disorder of the elderly causing very slowly progressive numbness or weakness of the feet and lower legs, and sometimes also the hands. By definition, the cause is not known. No randomised trials of drug treatment for chronic idiopathic axonal polyneuropathy have been conducted. Trials will need sensitive outcome measures and long follow-up periods.

That is why treatments like these need attention, palmitoylethalonamide clearly resulted in decreasing pain in an intractable pain patient suffering from CIAP.

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Bedsore pain treated with palmitoylethanolamide

decubitus-pea.jpg A patient suffering from neuropathic pain after a bed sore. Pain did not change under pregabaline, treatment with Normast decreased the pain considerably.

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Amitriptylin cream for neuropathic pain

david-kopsky-center-for-neuropathy.jpg The treatment of neuropathic pain with a topical cream containing 5% amitryptilin helped the patient considerably, and his pain score decreased from 8-9 to 2, the onset of action was 15 minutes and the analgesic effects remained for 4-5 hours. A patient presentation by David J Kopsky, MD, brought to you by the institute for neuropathy and neuropathic pain, Soest, the Netherlands, www.neuropathy.nl

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Central neuropathic pain and IBD treated with palmitoylethanolamide

wallenberg.jpg A patient suffering from the syndrome of Wallenberg, due to a stroke in the brainstem, lateral side, with severe neuropathic pain, visus difficulties, gait abnormalities and all this in combination with symptoms of colitis ulcerosa, was treated with palnitoylethanolamide (Normast®). To the patients surprise, the severe pain, which was Lyrica insensitive, reacted vary positively, and decreased 50%. And, as a very special bonus, the diarrhoea and fecal incontinence also decreased 50% in frequency…

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Angina pain and pain due artrosis treated with palmitoylethanolamide (PEA)

angina-pectoris-pea.jpg Pain due to severe artrosis and pain due to angina pectoris, which did only partly respond to two dotter procedures, and 4 anti angina drugs, reacted positive on the treatment with the endocannabinoid palmitoylethanolamide, Normast, available as foodsupplement in the Netherlands.

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Physiotherapy for polyneuropathy

keppel_hesselink_polyneuropathy_physiotherapy.jpg We use physiotherapy and physiofitness as a part of an integrative medicine treatment concept to treat neuropathy or polyneuropathy including HMSN such as the disease of Charcot Marie Tooth: training on muscular strenght, compensation, stability and balance as well as condition in general. In this field we speak of Neurological Physiotherapy, and this can be of important help individuals with neuropathies. Physiotherapy treatment will control your symptoms improving your quality of life.  A Physiotherapy treatment program may involve:A structured exercise program increasing muscle strength and endurance. Advice on hand and foot orthotics to help with muscle weakness and pain. Active and passive movement to reduce muscle cramps, improve muscle and prevent muscle wasting.Improving stability, gait and coordination.

A presentation by the director R&D for the institute for the treatment of neuropathy and neuropathic pain in the Netherlands, Jan M. Keppel Hesselink, MD, PhD. www.neuropathy.nl 

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CRPS type 1 and ketamine cream

crps-ketamine.jpg CRPS type 1 and ketamine cream:

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CIAP, pain after stroke and treatment with PEA

A nearly 80 year old lady suffering from CIAP pain, pain due to a polyneuropathy, as well as after a stroke. Due to the combination of these two diseases, her pain was difficult to treat. The first line analgesics gave too much side effects on the cognitive level. We treated with Normast and the patient could take up her life again. PEA is in Holland available asa foodsupplement (since 2012 peaPure) with analgesic properties and many patients find great relief if treated with this body-own compound.

CIAP is also referred to as Idiopathic sensory-motor polyneuropathy, and it is an illness where sensory and motor nerves of the peripheral nervous system are affected and no obvious underlying etiology is found. In many respects, the symptoms are very similar to diabetic polyneuropathy. In idiopathic sensory-motor polyneuropathy, the patients may experience unusual sensations (paresthesias), numbness and pain in their hands and feet. In addition, there may be weakness of the muscles in the feet and hands. In this patient pain was the most troublesome symptom.

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Pudendal neuropathy: treatment with amitriptyline cream

pudendusneuropathie.jpg A patient suffering from pudendal neuropathy or neuralgia, or perineodynia, with high pain scores reacting positive on our in house developed 5% amitrptyline cream, pain severity decreased more than 50% after starting this cream. The pudendal nerve carries senations from the external genitals, the lower rectum, and the perineum (between the genitals and the anus).

Neuropathy is in general  disease of the peripheral nerves, so pudendal neuropathy can cause symptoms in any of these areas. Some people have mostly rectal pain, sometimes with defecation problems. Others have mostly pain in the perineum or genitals. The symptoms may include stabbing, twisting or burning pain, pins and needles, numbness or hypersensitivity, all classical neuropathic symptoms. Usually the symptoms are made worse by sitting, as in this patient.

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Small fibre neuropathic pain treated with palmitoylethanolamide (PEA)

normast-thin-fibre-neuropathy.jpg Small fibre neuropathic pain is very difficult to treat. By prescribing PEA, a body own fatty compound modulating neuropathic pain via glia, we succeeded to reduce more than 50% the pain scores within 4 weeks, while the diagnostic neuropathic pain score on the DN4 decreased from 5 to 2! Small fiber peripheral neuropathy is a type of neuropathy. It is also called a small fiber neuropathy or small fiber sensory (or panful) neuropathy (SFSN) and also C fiber neuropathy. 

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Treatment of small fiber neuropathy

dunne_vezel_neuropathie_soest.jpg In our institute in the Netherlands we treat patients suffering from small fiber neuropathy with an integrative medicine concept, and one of the pillars are topical creams. Here a patient tells his story sufferng from serious pains treated with a compound cream consisting of isosorbide dinitrate, lidocaine and capsaicine. The pain decreased 50% in intensity after a treatment period of 1 week. Small nerve fibers are the nerve fibers in the skin that carry specific sensation’s. These  fibers are unmyelinated, and the impuls conducion is slow. These small nerve fibers carry mostly pain and temperature sensation. This  neuropathy is considered a separate clinical entity from a regular large-fiber polyneuropathy. Small fiber neuropathy is difficult to diagnose, as the EMG findings are basically normal.

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A natural remedy for pain in Idiopathic sensory-motor polyneuropathy

ciap-neuropathie.jpg CIAP and chronic pain treated with Normast; palmitoylethanolamide or Normast is a supplement with analgesic properties and many patients find great relief if treated with this body-own compound.CIAP is also referred to as Idiopathic sensory-motor polyneuropathy, and it is an illness where sensory and motor nerves of the peripheral nervous system are affected and no obvious underlying etiology is found. In many respects, the symptoms are very similar to diabetic polyneuropathy.

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Diabetes leading to neuropathy: video

diabetes.jpg High blood sugar, glucose, in diabetes patients can lead to diabetic neuropathy. Learn more in this simple video about how diabetic neuropathy can cause damage to the nervous system, and how a healthy lifestyle can prevent diabetic neuropathy in diabetes sufferers.

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Diabetic painful neuropathy treated with palmitoylethanolamide (PEA)

normast-diabetes.jpg This patient visits our clinic already for more than one year for the treatment of painful neuropathy, and initially he was a good responder on our treatment protocol, consisting of TENS, topical analgesic creams and certain supplements, as well as neuroacupuncture. Since some months pain is increasing again, and we started treatment with palmitoylethanolamide (Normast), a body own fatty compound, related to anandamide and proven to have analgesic activity in neuropathic pain in many patients in several clinical trials. Normast is registered as medical food and so far in our clinic we did not see any side effects. This patient too responded well to the addition of Normast to his treatment scedule.

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Treatment of HMSN and neuropathic pain

charcot-marie-tooth.jpg Presentation of a patient suffering from HMSN type II, the disease of Charcot, Marie, Tooth, a hereditary motor and sensory neuropathy.This patient sufferend from much pain and morfine did not really effectively ease the pain. He was depressive and overweight, as well as much in pain. We started treating him according to our treatment protocol, using several EBM based supplements, such as alpha lipoic acid, certain analgesic creams we developed and a form of neuroacupuncture. Within weeks the patient has lost weight, was taking up sports again, was less depressive and his painscore decreased from 8-9 to 2.
This clinical relevant effect is still acurate after 6 months of treatment.

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CIDP associated with MGUS treated with palmitoylethanolamide and low dose naltrexone

mgus.jpg MGUS is a very rare peripheral neuropathy, usually late-onset in terms of the sufferer’s age. It is one of the chronic demyelinating polyneuropathy group, that are mixed motor-sensory nerve affected and symmetrical in the damage caused. Paraproteinaemic Demyelinating Neuropathy may be known by a variety of other titles: MGUS-associated neuropathy, polyneuropathy, Paraprotein-associated demyelinating neuropathy, Paraprotein associated neuropathy/polyneuropathy, CIDP associated with a paraprotein, CIDP associated with MGUS, paraprotein-related or associated demyelinating neuropathy, demyelinating paraproteinaemic neuropathy, MGUS polyneuropathy and Peripheral Neuropathy associated with benign monoclonal gammopathy. We treated the pain, which was refractory to classical analgesics, with a combination of palmitoylethanolamide and low dose naltrexone, and a tiny amount of pregabaline (25 mg and 50 mg) and could reduce the pain for around 50%.

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Hereditary Sensory Neuropathy: pain and instability

erfelijke-sensibele-neuropathie-hsn.jpgHereditary sensory neuropathy: this patient suffers from neuropathic pain and instability in walking, but does not have other nasty symptoms you sometimes find in HSN type 1, or HSAN. We treated her with our treatment protocol, consisting of amongst others isosorbide dinitrate cream and lidocaine cream, against pain and specific physiotherapy, with focus on condition, muscle strenght and balance. Het QOL improved much and the pain decreased from 8 over 10 to 2 over 10. Her balance improved too.

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Severe Lyrica® refractory sciatic pain treated with palmitoylethanolamide

normast-sciatic-pain.jpg A medical doctor, former president of a big dutch hospital, suffered from severe neuropathic sciatic pain, painscore 10 over 10, without any response on pregabaline, only severe side effects, treated with palmitoylethanolamide, a body own fatty acid with analgesic properties.

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Syringomyelia and neuropathic pain, its treatment

syringomyelie.jpg The next patient is suffering from severe pain due to cervical syringomyelia. Here his story:

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Ten year old paralysed King Charles spaniel runs again after palmitoylethanolamide!

normast-spaniel.jpg Ten year old paralysed King Charles spaniel runs again after Normast! And no PSOM, no inflammed eyes anymore. Dose administered: 300 mg Normast granulate twice daily. 

After 6 months the dog was switched over to a new PEA product, PeaPure. The clinical reaction was even superior, probably due to the absence of pharmaceutical excipients. The dog walked better, longer and the mild eye inflammations under Normast treatment vanished totally and within 1 week. The now 11 year old dog is already 4 months stable on PeaPure, and nearly a year on PEA.  

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Chronic idiopathic polyneuropathy: tired and prone to falls

ciap-wankel-op-de-benen.jpg This patient, born in 1926, is a vital man, but due to CIAP he was falling frequently, and was very tired. One year after we started treating this all was very much reduced, more than 50%. Here his story:

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Pregabalin refractory sciatic pain treated with palmitoylethanolamide (PEA)

herniation-normast.jpg Severe sciatic pain treatment refractory to treatment with Lyrica®, treated with palmitoylethanolamide (PEA). Pain decreased totally within some days of treatment with sublingual micronized palmitoylethanolamide. The patient story: A medical doctor, former president of a big dutch hospital, suffered from severe neuropathic sciatic pain, pain score 10 minus over 10, without any response on treatment with pregabaline, apart from severe side effects such as confusion and dizziness, treated with palmitoylethanolamide, a body own fatty acid with analgesic properties.

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