h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

Jim, I think it basically needs a re-write, most of it needs editing / replacing / deleting. This is the little ‘pick’ I had at it initially. I’ve now got much more info, it just doesn’t fit into the way this guide is arranged. It would be easier to re-write a more accurate and complete guide than try to make it fit into this entry. Take a look:



Original article between > and <
Comments between **** and ****

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Neuropathy:



*****Might be worth mentioning the meaning of neuropathy here – neuro-nerve, pathy-harm or illness, and a brief outline of neuropathy.****

>Neuropathy is sometimes referred to as the 'silent disease', because not many people (including doctors and patients) know about it. Currently in the US alone 2,000,000 people are estimated to suffer from it, including about ten per cent of diabetics.<

****Looks ok so far. ****

>Heavy alcohol users are also prone to peripheral neuropathies, a condition sometimes called alco-neuropathy1, which can have an insidious onset and there are many alcoholics out there with usually peripheral sensory, but also motor neuropathies. Likewise diabetics are also prone to peripheral neuropathies.<

*****(this section is best omitted - a more accurate and detailed discussion of causes should follow in it’s own section) ****

****I think a section here on the anatomy of the nerve would be simple enough to do: something uncomplicated like: ****

“
****Anatomy of the nerve (or better title )

The nerve is comprised of a core, the axon: through which the signals flow to and from the brain, a sheath – made of a substance called myelin, which protects the axon, and schwann cells: which create the myelin coating around the nerve.

Neuropathy occurs when the nerve is damaged – sometimes only the myelin is damaged – this may regrow, allowing the sufferer to recover, sometimes the axon is damaged, which is more serious. Different diseases affect the nerves in different ways, with varying levels of severity” ****


>What is it<

*****(Probably best to change the titles – perhaps this one should be: “types of neuropathy” ****

>Sensory Neuropathic Damage –<

>This is when some parts of your body lose all sensation. <

****No, not some parts, one or more. Not all sensation, some or all, would probably be more accurate, imho****

>For example the loss of feeling in the hands or feet. <

****If it is necessary to give an example here, it may be better to say “For example, with diabetic neuropathy, it is not uncommon for the sufferer to lose sensation in the feet.” ****

>Some parts of the body become hypersensitive and you wake up in the night screaming as you receive random pain signals from every nerve in your body<

****This is just meant to scare. Some parts *may* become hypersensitive – but the chances of ‘every nerve in your body’ sending random pain signals is low, (though I’m sure it happens to some) especially if you’ve completely lost feeling in a part. ****

>Sensory neuropathy is by far the most common manifestation of alcoholic neurological dysfunction. This is manifested by poor peripheral sensation and occasionally neuropathic pain - which is more common in diabetics and people with multiple sclerosis than in alcoholic peripheral neuropathy.<

**** Again, this one belongs both under a causes section and in proportion.****


>Autonomic Neuropathic Damage - This is when you can't feel when you need to go to the loo and you can't feel if you've already let it go. Alcoholics do not tend to get autonomic neuropathies, certainly not as commonly as say diabetics. Loss of bladder function is one manifestation of autonomic neuropathies but this is usually not being able to pass urine rather than being incontinent. Others are a fall in blood pressure on standing and a fast heart rate. A condition alcoholics can get is Wernicke-Korsakoff disease due to vitamin B1 deficiency and heavy alcohol abuse which leads to ataxia (poor co-ordination and unsteady walking) and dementia.<

****Oh no, really! Puh-Leeeeese! This one needs a rewrite imho: something like:

“Autonomic neuropathic damage affects the system that controls functions such as blood pressure, heart rate, digestion, bladder function, vision, and perspiration. This can result in a plethora of different symptoms such as: diarrhea, constipation, dizziness, excessive perspiration and many more, which are too legion to list here.” ****

****I don’t know where the Wernicke-Korsakoff bit comes in, this is supposed to be about neuropathy not alcoholism. ****


>Motoric Neuropathic Damage - You're practically paralyzed and can't do anything at all. Your mouth has problems with speaking, people have difficulty understanding what you're saying and muscles think they receive signals from your brain and start to move uncontrollably. Motor neuropathies do not tend to involve the muscles of the face but often involve muscles of the extremities, with decreased power making walking difficult and also decrease in proprioception2. Uncontrollable muscle movement is not characteristic of alcoholic neuropathy and occurs with primary brain lesions.<

****No, you may or may not be ‘practically paralyzed and can't do anything at all’ your mouth may or may not have ‘problems with speaking’ and again the alcoholic things is too prominent imho. Perhaps something like:

“Motor Neuropathic Damage affects the sufferer’s ability to control muscles, this can occur in any part of the body, and is common in the extremities (hands, feet, etc.) as the nerves that carry motor signals there are the longest.
The sufferer may be unable to move the affected part at all, or it may be very weak. It may have an uncontrollable twitch. The lack of function in the affected area may also cause other muscles around it to tire, as they may be compensating for it.” ****

>Not all sufferers of neuropathy have all three types of nerve damage. If only one type is damaged, the condition is called mononeuropathy; polyneuropathy usually means more than two nerve groups affected rather than a combination of sensory, autonomic and motor.<

****okay, though a little clumsy, perhaps:

“Not all sufferers of neuropathy have all three types. If only one type of neuropathy is present, the condition may be labeled mononeuropathy; polyneuropathy usually means more than two nerve groups are affected rather than a combination of sensory, autonomic and motor neuropathies. ****

****though I'm not sure about the above. I still have a mountain of info to dig through"****


>How do you get it?
B vitamins are essential, B1, B12, B6 and folate especially. However, in most cases the lack of vitamin B1 is not caused by eating too little. Vitamin B1 is broken down very quickly by alcohol, and drinking two bottles of wine or about eight bottles of beer a day for a few years will do the trick. The onset of peripheral neuropathy is often insidious, although stopping drinking does usually help.
Other common causes are related to diabetes, auto-immune disorders, or genetic problems. Sometimes it can be brought on by extreme trauma or shock.<

****Ummm, methinks the above needs rewriting – if only for no other reason than it sucks like a dyson. It’s just too simplistic and it is focused on the one cause, with the rest getting a byline. ****

****I think something like:
“There are too many well-defined causes of neuropathy to list. For example: diabetes, uremia, or nutritional deficiencies. In fact, diabetes is one of the most common causes of neuropathy.
Other causes include mechanical pressure such as compression or entrapment, impact damage, penetrating injuries, fracture or dislocated bones; pressure involving the superficial nerves (ulna, radial, or peroneal) which can result from a tumor, among many other things; intraneural hemorrhage; exposure to cold or radiation; and vascular or collagen disorders such as atherosclerosis, systemic lupus erythematosus, guillain-barre syndrome (and it’s variants) scleroderma, sarcoidosis, rheumatoid arthritis, polyarteritis nodosa and a host of others far to numerous to name, even lightning-strikes!!”****

>Cures<
****I think ‘treatment and recovery’ would be a better heading****

>If you're lucky you can be cured, but it will take at least six months and loads of medicine, a lot of hospital visits where they will push and pull at the most painful parts of your body, and a lot training for your weakened muscles. If you're less lucky, then it will take you years to recover, if you recover at all. There is a very small chance that you will regain about 90% of your nervous system. There is a big chance you will get back less.<

****This again, is less information and more scare tactics, no discussion of the various types of treatment available for the various illnesses.****

****to write this one, would require either a general statement stating that “your mileage may vary” so to speak, or an in depth look at the treatments for the ‘top ten’, say. It’s tricky, but if it’s worth doing, it’s got to be right.***

****at the very least, typical info for the most common illnesses and maybe info on symptomatic treatments for neuropathic pain, such as neurontin / gabapentin should have been discussed here****


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I'll continue to read through the info I’ve got, and post it here, but, as I said, it would be easier for us all to re-write a longer guide, better structured, with more sections and more accurate information.


If a re-write were to be on the cards, I think the best way to go would for us all to discuss a format initially: which headings to include and what to put under them, sounds like stating the obvious I know, but I've got so much info and so little direction atm, so some help on that one would be great.

I could also, if it would be helpful, post what I've written of an alternative guide already, though it is very raw and I'd rather get some help from you guys and start fresh.

Please excuse any typograopshicsal erors




P.

ON a first read I'd say you have done well.

I am wondering if it is possible to make an editorial change in the original entry title? Alc should be mentioned in the title. (for a search)Then a short disclaimer and link to a more appropriate , extensive and updated article..Yours!

You could write a fresh article linking ;it as an example of alc. but not recommended as a good source due to the following reasons listed by paragraph.

Sounds complicated any way it's done.
You have covered the neccesary points I think