Thank you very much for your reply, and I will see to it that we see a neurologist. My other question is (she does cry at night because of the pains, thats after taking the arv's) how do we manage the pain Doctor.

Desperate son.

Severe PN May 30, 2007

My mother was treated for hernia 2months ago. She was then put on Truvada and Stocrin and she has had severe PN since the treatement of the hernia. She was put on Gabantin 1month ago and seems not to be getting better. She is also on tres orix multi vitamin. My pharmacist suggested Neurorubina (vit B12) and other vitamis. Please answer soon, she cant walk nor move her hands.

Response from Dr. Henry

It would be very unusual to rapidly develop peripheral neuropathy from Truvada/Stocrine. Other causes (including HIV) need to be considered. An evaluation by a neurologist is often very helpful. Use of N-acetyl carnitine may help some patients with HIV neuropathy but data is still limited. Vit B12 deficiency can cause a neuropathy (often checked with a blood test).KH

Pain relief is an important and under appreciated challenge. WHO and other organizations have a staged approach to pain control starting with non-narcotic drugs like ibuprofen or acetominephen and then moving up the narcotic scale. Other drugs that can help include a range of anti-depressants or anti-seizure meds, meds for diabetic neuropathy, or topical drugs like lidocaine or capzaicin. Your HIV specialist, neurologist, or pain specialist is often the best person to work with a patient to find an approach that provides pain relief. KH