How fast (or slow) do nerves and, therefore muscles regenerate?
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June 13, 2011 at 11:26 pm
My intention is to bring up this subject to foster a better understanding regarding our expectations about recovery from CIDP.
So, for mdorn, you were diagnosed in Dec 2010, yet you described symptoms thusly-
“…but I was hoping to be walking and with out a cane and walking more then from the car to the store. I was hoping to be out riding the mower. My balance is horrible and I can not carry things….”
implies you have had this condition for a long, long time. The following is from a website for Columbia University Medical Center:
http://www.cumc.columbia.edu/dept/peripheral-nerve/what_pn.html
and, while I recommend everybody read it all, it says, in part:
“..[I].When a peripheral nerve is cut, the axon segments distal to the injury (furthest away from the spinal cord) die off in a process called “Wallerian degeneration.” When the nerve is repaired, the axons in the proximal segment (closest to the spinal cord) regrow into the distal, denervated segment. This growth occurs at a rate of about 1 mm per day. This translates roughly to 1 inch per month, or 1 foot per year. Once the axons regrow back into the denervated muscles, the muscles will begin to function again. During the time it takes for the axons to regrow into the muscles, a process that can take many months, or even years, the muscles will be paralyzed and will atrophy…[/I]”
Nevermind that it says the nerve is cut. Focus on the fact that the nerve was damaged, for whatever reason.
One foot per year??? Oh, my goodness can you imagine if you have drop foot or weak hands how many feet of length are involved?
Now, don’t despair. Perhaps your (or my) demyelination is also far from the spine and therefore, not so far from the damaged part to the non-working muscles.
Be patient. Look at another post I made about ‘How does CIDP affect your activities of daily living?’ It has taken months, yes, even years, to recover some of those functions. hmmm, it is here:
http://gbs-cidp.org/forums/showthread.php?t=7384&highlight=adls
Good luck to everybody and, a reminder, “ivig, by itself, does nothing to cure the disease.”
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June 15, 2011 at 12:19 am
Thank you for the information and listening , I will look up your forms etc.
When I first was tripping over plants in the garden and after 2 back surgerys and then was sent to a nerou and dx with CIDP the total months were 20 months. Then I started IVIGs Dec 2010 and had the 11th one today.:)
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June 17, 2011 at 10:53 am
Great info particularly for someone as impatient as I am.
PS I read on the forum that cyclosporine worked when the standard treatments did not so I recommended cyclosporine treatment to my neurologist (Cyclosporine was on his list of possibilities )
I have been on cyclosporine for just under a year (100mg/day) and I am improving. The Columbia Univ. info gives me additional hope that the improvement will continue.
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June 18, 2011 at 12:03 am
[COLOR=black]Yuehan,[/COLOR]
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[COLOR=black]Please don’t take offense, but it is not obvious to me that mdorn has necessarily suffered axonal loss. Without specific information from a nerve conduction study, the symptoms could be the result of inflammation, demyelination, or axonal damage. [/COLOR]
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[COLOR=black]Severe symptoms do not necessarily mean either long disease duration or axonal damage. The inflammatory response, especially at the nerve root, can lead to considerable disability. I was not as bad off as Mdorn is currently, so my example is not as strong as it might be. Still, I could not go up a single 7″ step, which I think counts as a significant disability. My very first treatment with Solumedrol made it possible for me to walk up stairs, not just a single step. Admittedly, it did not last, but it certainly suggested that inflammation was a big part of the process and that there was no axonal damage. So if Mdorn’s treatment is not relieving the inflammation, that alone could lead to long-term disability. [/COLOR]
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[COLOR=black]It is also possible that the treatment is just balancing the demyelination and remyelination processes. If so, improvement will be slow. A more aggressive approach might yield faster results. [Or it would if immunosuppressants did not take so long to be effective.][/COLOR]
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[COLOR=black]I think you may have confused axonal growth with remyelination. The two are different processes. Remyelination is much faster than axonal regeneration. As long as there is no axonal damage, and as long as nothing is continually damaging the myelin, remyelination takes between 2 and 12 weeks. Here is a link to an interesting article on nerve injury: [URL=”http://scottsevinsky.com/pt/reference/shoulder/upenn_oj_ncv_emg_pni_evaluation.pdf”][COLOR=#800080]http://scottsevinsky.com/pt/reference/shoulder/upenn_oj_ncv_emg_pni_evaluation.pdf[/COLOR][/URL][/COLOR]
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[COLOR=black]~MarkEns[/COLOR] -
June 18, 2011 at 7:37 pm
MarkEns,
No, no offense taken. My purpose in bringing up these subjects, and of sharing my opinions, is to encourage exactly these types of discussions.
Indeed, I’m happy to read about the distinctions and commonalities between these three conditions. And yes, it is helpful, to understand the posters’ symptoms and their timelines. This often requires asking them to tell more about their condition.
It is by continuing to explore, research, share and learn all we can that we all may benefit the most from each other.
The article is very informative. Thank you for caring enough to take time to respond.
The highlighted section on page 5 sums it up for me when it talks about ‘EMG identifies situations when no further nerve recovery is expected.’ I’d like to learn more about what, exactly an EMG identfies in that situation.
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