Consensus recommendations for the management of peripheral neuropathy in India
Journal Title: Journal of the Indian Medical Association - Year 2018, Vol 116, Issue 10
Abstract
Peripheral neuropathy (PN) poses a high disease burden in India as compared to developed countries, owing to higher prevalence of diabetes cases, nutritional deficiencies, infectious diseases, and exposure to toxins. There are currently no Indian clinical guidelines in place for the management of this neurological condition. Hence, there exists a need to develop standard guidelines for management of PN specific to the Indian population considering international guidelines may not be fully applicable to this patient population. To better understand the causes and management of PN in India and develop a multi-disciplinary expert consensus statement providing guidance to primary care physicians for the diagnosis and treatment of PN in India. In November 2017, a meeting of experts in the field of neuropathy, including neurologists, diabetologists, and endocrinologists was conducted in Chennai, India. The expert committee discussed underlying causes, current clinical practice(s) for diagnosis, treatment guidelines and alternative treatment options for PN in India. The group of experts arrived at consensus-based recommendations for (a) simple steps for diagnosis and (b) treatment as per the guidelines and treatment options used in clinical practice in India. Recommendations based on consensus on PN management in India were developed. The experts developed a simple, fourstep, clinical diagnostic checklist as a guidance tool to help improve the diagnosis and identification of the cause of PN by primary care physicians. For treatment, the experts recommended that in addition to symptom management, treatment of underlying cause and restoration of nerve health is a vital step in PN management. The importance of alternative treatment options such as neurotropic B vitamins and alpha-lipoic acid, in the treatment of PN and nerve health restoration was highlighted. The expert group also discussed prophylactic, therapeutic and maintenance treatment options in different patient settings. This consensus statement is aimed at providing useful clinical guidance to primary care physicians on PN diagnosis, treatment and management. Nonetheless, there is a need for further experience-based cross-speciality deliberations to formulate holistic guidelines for the management and treatment of PN in India.
Authors and Affiliations
A V Srinivasan, S Paranjothi, Kalyan B Bhattacharyya, Debasish Maji, Daya Kishore Hazra, Pradeep Talwalkar, Sanjiv Shah, Rakesh Kumar Sahay, Deepak Khandelwal
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