DEAR DR. DONOHUE: I am extremely annoyed with you. I have sent you several letters regarding peripheral neuropathy, which my husband has, but you have ignored them. What is the treatment for this condition? – Z.D.

ANSWER: Peripheral nerves are nerves that take messages from the brain and spinal cord and deliver them to muscles and organs – the periphery. Those kinds of nerves are motor nerves. They tell muscles to contract or glands to secrete. Peripheral nerves also take information from the skin and inner organs and transmit it to the brain. Those are sensory nerves. They inform the brain when something is hurt by emitting pain. Many nerve cables are a combination of motor and sensory nerves.

“Neuropathy” means there is a nerve disturbance. The consequences can be many. With sensory neuropathy, people can lose all sensation, or, more commonly, they can have persistent and severe pain. The pain is described as burning, freezing, knifelike or similar to an electric shock. When motor nerves are affected, muscles become weak. One sign is foot drop. Peripheral neuropathy of the leg muscles can make them so weak that they cannot lift the foot when taking a step. Symptoms of both kinds of neuropathy can remain stationary for long periods, or they can progress rapidly and incapacitate people.

Treatment depends on cause, and the causes are many. Diabetes often leads to peripheral neuropathy. An assault on nerves by the immune system is another somewhat-common cause. A few infections cause neuropathies. The pain that lasts after a shingles attack is an example. In some parts of the world, vitamin deficiencies are the major cause. Some neuropathies are genetically induced. Quite often, however, no cause is found.

A large number of medicines can be helpful for pain relief – gabapentin, amitriptyline, lidocaine skin patches and Zostrix cream are examples. Cymbalta and Lyrica are newly approved drugs for diabetic neuropathy. They should be available soon, if they are not on the market by now. Occupational and physical therapists can provide programs and devices that help people with motor neuropathy to overcome muscle malfunction.

Let me get back on your good side, Z.D., by introducing you and all with peripheral neuropathy to The Neuropathy Association, on the Internet at www.neuropathy.org or by phone at 1-212-692-0662. You’ll find it a friend and an invaluable source for information and support.

DEAR DR. DONOHUE: My daughter was diagnosed with acromegaly, which my friends and I have never heard of. Her symptoms included enlargement of her forehead, hands and feet. Her nose enlarged too. Her shoe size went from 9 to 11. After seeing many doctors, she insisted on a brain scan, which showed a pituitary tumor. She has just had surgery. I hope you will tell this to your readers so they can know its symptoms. – R.A.

ANSWER: Acromegaly results from an overproduction of growth hormone caused by a pituitary tumor. Growth hormone is made by the pituitary gland, which is located at the base of the brain. In adults, growth hormone causes enlargement of soft tissues throughout the body. The forehead bulges, so hat size increases, as do shoe and glove sizes. The jaw can jut forward, and spaces between the teeth appear. The nose often grows bigger.

Internal organs, including the heart, can also increase in size, and that presents a grave health danger.

Treatment entails removing the pituitary tumor.

Readers and I appreciate your telling your daughter’s story. Acromegaly will be familiar to them now.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.