Peripheral neuropathy in children and teens

Cancer treatment, or sometimes the disease itself, can cause peripheral neuropathy—damage to nerves of the peripheral nervous system, which transmits information from the brain and spinal cord to every other part of the body. Peripheral neuropathy can be caused by:

• Certain chemotherapeutic agents, such as vincristine (Oncovin®), bortezomib (Velcade®), thalidomide (Thalomid®), lenalidomide (Revlimid®), cytarabine (Cytosar-U®), interferon or methotrexate
• Radiation therapy, although it may take several years for symptoms to appear
• Shingles, a rash that may develop in people with weakened immune systems
• Certain diseases such as myeloma

Some conditions associated with peripheral neuropathy include:

• Diabetes
• Nerve compression caused by vertebral fractures
• Vitamin deficiencies, particularly folate or vitamin B12
• Autoimmune diseases, such as lupus and rheumatoid arthritis
• Hypothyroidism
• Kidney disease

Before you start cancer treatment, let your doctor know if you suffer from any of the above conditions or if you experience any of the following symptoms in your arms or legs:

• Numbness
• Tingling
• Burning
• Coldness
• Weakness

Let your doctor know right away if you develop any of the above symptoms as you undergo cancer treatment. If you develop PN as a result of chemotherapy, reducing the prescribed drug dose or stopping the drugs completely may help avoid lasting damage to nerves.

Peripheral neuropathy caused by treatment may gradually decrease after you complete therapy. Many people recover fully over a few months or years. In some cases, the symptoms may persist.

Managing peripheral neuropathy

While there are currently no treatments to cure peripheral neuropathy, there are treatments that can help manage symptoms, including

• Physical therapy to improve balance and strength
• Occupational therapy to improve fine motor skills
• Medication such as pain medications, antidepressants, anti-seizure medications, muscle relaxers or steroids to help relieve pain and discomfort
• Creams or patches of numbing medicine that can be put directly on painful areas
• Regular exercise. Talk with your doctor before starting an exercise program.
• Massage, acupuncture and relaxation techniques
• Dietary supplements such as a B12 vitamin and folic acid. Ask your doctor before taking any supplements because they may interfere with treatment.

10 safety measures to take for children with peripheral neuropathy

1. Keep all rooms, hallways and stairways well lit
2. Install handrails on both sides of stairways
3. Remove small area rugs and any other clutter that someone could trip over or slip on
4. Install grab bars in the shower or hand grips in the tub, and lay down skid-free mats
5. Use a thermometer to check that any water they bathe in or use is below 110° F or set your water heater temperature accordingly
6. Clean up any spilled water or liquids immediately
7. Use nonbreakable dishes
8. Use potholders while cooking and rubber gloves when washing dishes
9. If they drive, make sure they can fully feel the steering wheel and gas and brake pedals. Also, make sure they can quickly move their foot from the gas to the brake.
10. If prescribed, use a cane or walker when moving from one room to the other