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Charcot-Marie-Tooth UK
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My dad and I have HNPP and just recently my dad has been diagnose with Rhematoid Arthritis, the medication he has been given help him tremendously but recently his thumb and first two fingers have become numb and feel cold but are not cold if you know what I mean? So I would like some advice on whether this will be our HNPP or from the Arthritis? I personally think its our disease as Gabapentin seem to help with the pain. Any suggestions anyone?


2 Replies

Hello Pam49....

H.N.P.P. is a nerve disorder that affects the peripheral (near to surface) nerves. The main effect of H.N.P.P. are pressure palsies. Pressure on your peripheral nerves will cause tingling sensations, numbness, pain, weakness, muscle atrophy (wasting away), and even paralysis of the affected area:

Hereditary Neuropathy, with liability to Pressure Palsies, or called HNPP is a slowly progressive, hereditary, neuromuscular disorder which makes an individual very susceptible to nerve injury from pressure, stretch or repetitive use:

When injured, the nerves demyelinate, or lose their insulating covering called myelin. This causes episodes of numbness and weakness in the injured area, which are referred to as the ‘pressure palsies'.

These episodes can be mild, and more of a nuisance than anything, or so severe almost all movement in the affected limb is impossible. They may last several minutes to months. Because the symptoms can come and go, and most neurologists have not yet heard of or seen a case of HNPP, it can be very difficult and lengthy process to be diagnosed:

Neuropathic pain may have continuous and/or episodic (paroxysmal) components. The latter are likened to an electric shock. Common qualities include burning or coldness, "pins and needles" sensations, numbness and itching. Nociceptive pain, by contrast, is more commonly described as aching:

As the medications Gabapentin, and Amitriptilene appear to help, I would therefore assume that H.N.P.P. is responsible for his loss of sensations in your dads hands, and not Rheumatoid arthritis: However, be most cautious, as both C.M.T. and also Diabetes Type 2, display the same symptoms, due to damaged nerves, and also both these diseases can cause tingling sensations, numbness, pain, weakness, muscle atrophy, and loss of "fine finger dexterity":

Your Dad has been diagnosed with Rheumatoid arthritis (RA) which is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks flexible (synovial) JOINTS & BONES. It can be a disabling and painful condition, which can lead to substantial loss of functioning and mobility if not adequately treated:

The pathology of the disease process often leads to the destruction of articular cartilage and ankylosis (fusion) of the joints:

John ....(Glasgow)



Thanks for your reply John, it seems feasable to me too that the HNPP is the cause of this, but as you have pointed out 2 other possibilities how does dad get tested for either of them? Regarding the numbness his consultant for his RA told me to make him an appointment with a Neurologist but as my neurologist told me there is absolutely nothing they can do regarding the numbness, they can only help with the pain! so we are at a bit of a loose end really; I have told dad that the feeling will come back eventually but we can't say when! I thought CMT and HNPP were similar in all symptoms?

Regards Pam


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