Motor nerves, or efferent nerves, transmit impulses from the brain and spinal cord to the muscles.
Sensory nerves, sometimes called afferent nerves, carry information from the outside world, such as sensations of heat, cold, and pain, to the brain and spinal cord. See Appendix 2-6 and see color plates.ĭepending on their function, nerves are known as sensory, motor, or mixed. Even in this latter group, a subsequent URI may again “waken the monster” and necessitate resuming medication.A macroscopic cordlike structure of the body, comprising a collection of nerve fibers that convey impulses between a part of the central nervous system and some other body region. Some persons must remain on medication indefinitely others whose cough is virtually abolished for at least a month may successfully taper off medication. Successful treatment may mean dramatic reduction of symptoms, but not necessarily that they are completely abolished. Often, physicians help patients work their way through a list of such medications, looking for the one that works best. Common ones in use are amitriptyline, desipramine, gabapentin or pregabalin, citalopram, effexor, capsaicin spray, and so forth. Otherwise, the standard of care involves use of what we call colloquially “nerve ending medicines.” These typically come from two general classes of drugs: seizure medications and those used for depression. Treatment of neuropathy in general, and SNC in particular, is always first directed at any known ongoing cause of the neuropathy. Thankfully, many do not cough at night, but some unfortunate people are awakened several times every night to cough, and may be come sleep-deprived and “zombified.” Treatment of Neuropathy Public instances of this kind of coughing are humiliating. After a particularly bad attack of SNC, the individual may feel exhausted chest wall may hurt. In some, laryngospasm (sudden locking shut of the throat making breathing difficult and noisy for 30 to 60 seconds) may occur on occasion. The most severe attacks are often associated with turning red, tearing of the eyes, running of the nose, retching or actual vomiting, and even leakage of urine or worse. When extremely urgent, the sensation might initiate a violent attack of coughing lasting up to several minutes. As for that spectrum of responses: If the sensation is subtle, the individual might only clear the throat or cough once or twice. The resulting neuropathic tickle, dry sensation, pinprick, itching, pressure, or dripping sensation initiates a spectrum of responses, depending on urgency of the sensation. The idea here is that nerve endings supplying sensation to the lining of the mouth, throat, larynx (voicebox), and trachea (windpipe) are neuropathic. General symptomatic treatments are as described below for sensory neuropathic cough.Ī special kind of neuropathy is becoming better known in the medical community- Sensory Neuropathic Cough or SNC. When the cause cannot be found to direct treatment, the disorder is called idiopathic. Neuropathy can follow injury, viral illness, alcoholism, endocrine disorders, certain chemotherapy drugs, diabetes, Herpes zoster (shingles), and other more elusive and undiagnosable causes. Different sensory nerve endings are designed to detect pain, change of temperature, vibration, touch, pressure, and so forth.
The variety of sensations possible likely relates partly to the degree of damage, and also to the many kinds of sensory receptors found in the body. The person might feel pain, tingling, burning, itching, pins and needles, tickling, and so forth. The result can be any number of sensations that all originate in the nerve itself, rather than from an external stimulus. Sensory neuropathy involves damage to nerve endings that provide sensation.
A person with peripheral neuropathy of the motor (movement) nerves to the lower legs might, for example, develop a slapping walking sound or unsteadiness. Thus, nerve ending damage would cause weakness. Motor nerve endings insert into muscle to allow them to contract. Motor neuropathy involves muscle-supplying nerve fibers. In other words, a neuropathic stinging sensation might be arising from misfiring of the sensory nerve ending all by itself, and not in response to, for example, an actual bee sting. Neuropathy, in a basic, practical, and somewhat literal sense means “nerve-ending suffering.” The idea is that the patient’s suffering is from the damaged nerve ending and not from something that is stimulating that nerve ending.
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