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Mark Saleh, MDMark Saleh, MDNeurologySutter Pacific Medical Foundation
Mark Saleh, MDNeurologySutter Pacific Medical Foundation

Dr. Mark Saleh attended medical school at Tufts University and completed neurology residency at Stanford. He was in general neurology private practice for 10 years at Atherton Neurology and Sequoia Hospital. At Sequoia, he was medical director of the stroke program since its inception in 2007 to 2012. Additionally, he served a 2-year term as Chair of Internal Medicine at Sequoia. Dr. Saleh started work at CPMC in August of 2012 as director of the General Neuroconsultative and Referral Service with the goal of developing a neurohospitalist and teleneurology program.

Question of the Week

I have neuropathy in both feet and legs. They feel heavy and at night they sometimes burn. My feet feel like I have a second skin, which makes it difficult to wiggle my toes and arch my feet.

Mark Saleh, MD answered: Pain from neuropathy can be quite problematic. It is often described as a burning or a "pins and needles" sensation. This pain is often more noticeable at bedtime and can therefore disrupt sleep.

The first step in the management of neuropathy is to determine and treat the underlying cause, which can include metabolic problems, a drug/toxin effect, certain vitamin deficiencies, and direct nerve compression, as well as other causes. If no cause can be found, treatment will consist of relieving the symptoms.

Certain medication types are effective for the symptomatic treatment of nerve pain. These include some seizure medications and certain types of antidepressants. Also, some topical medications, such as lidocaine, can be helpful depending on the circumstances.

The appropriate choice of medication(s) depends on many factors, such as other medications you are taking and other pre-existing medical conditions. Therefore, specific treatment options should be discussed with your healthcare provider.

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