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Will Methylcobalamin help in neuropathy?

Q: My mother, 55 years old, has diabetes since 12 years. The following is her nerve conduction report: Absent right and left sural sensory nerve action potentials, right superficial peronel sensory nerve action potential. Slowed and low amplitude right and left median, sensory nerve action potentials (across the wrist). Normal right radial and ulnar sensory nerve action potential. Normal distal motor latency, normal F-wave low evoked response amplitude with normal/mildly slowed motor nerve conduction velocity in the right and left tibial nerves. Normal distal motor latency, normal F-wave low evoked response amplitude with and normal motor nerve conduction velocity in right & left ulnar nerves. Prolonged distal motor latency, prolonged F-wave. Normal distal evoked response amplitude with normal motor nerve conduction velocity in the right and left median nerves. EMG findings are: Absent Sympathetic Skin response, right sole, Normal from Right palm. Impression: generalised lower limb, upper limb, sensory-motor, symmetrical, disal, axonal peripheral neuropathy, affecting small and large fibres-possibly related to diabetes mellitus. Can Methylcobalamin injections help her? What about the FDA approved drug Lyrica?

A:Your mother is apparently suffering from diabetic neuropathy which is quite common in patients with long term diabetes. Lyrica (pregabalin) is meant to relieve neuropathic (nerve) pain irrespective of cause. Hence it should be used only if pain relief is desired since it has no curative role in diabetic neuropathy. Methylcobalamin, also called mecobalamin, is a vitamin B-12 substance and is sold under the brand name of Methycobal by Wockhardt. It is indicated in the treatment of peripheral neuropathy. The dose is 1 tablet 2-3 times daily for about two months. If there is no improvement, it should be discontinued after three months.

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