How is epilepsy a factor in Dupuytren contracture?

Dear Dr. Herazy,

Thank you for offering natural solutions! I’ve not been formally diagnosed with Dupuytren and have not seen progression pictures to conceptually know for sure if this is my diagnosis.   I have the nodules in both palms and both feet. Oddly enough, it affects my left hand more than my right. Middle, ring and now the pinky is starting to show pain. I can no longer make a fist and I have arthritis like conditions in the joints of the fingers that are affected. The right hand has only the middle finger affected. This has been going on for about 6-8 months.

From what I have read about this issue, epilepsy is a factor. Could you please explain how this is a factor? I received my epilepsy DX at 15 and I’m now 47 yrs. old.

I’m also a massage therapist and have learned to use forearms much more than hands. I sparely use my hands and use them more for swedish massage with little to no gripping. Could you please give instruction on how to massage the affected areas? I haven’t found that in your website other than not to do deep tissue or stretching.

Since I am self-employed and have a $7500 deductible on my insurance, I’m not anxious about adding yet another DX and underwriting nightmare to my life. Can using the products you mention do any harm and how hard is it to diagnose this? I would certainly like to think this is an overuse issue and that some PT would fix the problem but there are too many things that point to this DX.

Thank you in advance for your time and any help you provide!

Angela

Greetings Angela,

First of all, it is important that you show your hands and feet to your family doctor, or the physician who is treating your epilepsy so he/she can diagnose your condition.   Diagnosis is usually a relatively simple matter made on simple observation and history alone.  Given your situation I would almost guarantee the doctor who has been prescribing your anti-convulsion medication is very much aware of DC.

You see, as with most topics related to Dupuytren contracture, there is controversy regarding the causal relationship between epilepsy and collagen nodular formation of the hands and feet that appear in a disproportionately high percent of epileptics.

There are several studies of chronic epilepsy in which Dupuytren contracture has been found in 45-60% of epilepsy patients.  It is speculated that the Dupuytren development stems not from a genetic or neurological causation but from long term use of the anti-epilepsy drug, phenobarbitone.  The cause of the epilepsy is not an issue in regard to the Dupuytren development, nor is the neurological category or related symptoms.  these studies conclude that the most significant correlation is the duration of treatment with phenobarbitone; the longer you take it, the more likely you will develop Dupuytren contracture and Ledderhose disease (nodules and contractures of the soles of the feet.

Other studies do not find the same correlation between DC and phenobarbitone.   Instead they conclude that given the evidence of a genetic component of both Dupuytren contracture and idiopathic (without a medical cause) epilepsy, that the correlation is based on inherited defects of adjacent genes that cause Dupuytrens and epilepsy in the same individual.

I tend to believe that Dupuytrens is a side effect of phenobarbitone simply because there was no known pattern of high incidence of DC in epileptic patients until the use phenobarbitone for convulsions. The fact that many of these people have it not only in both hands but also both feet – as you do – points to a systemic drug reaction.

Unfortunately your massage therapy occupation must have previously placed a considerable amount of physical stress on your hands, and hand trauma is another of those causes that is often mentioned for Dupuytrens.

Use of massage to help Dupuytren contracture is a complex and detailed discussion.  I am more than half way through writing a book on this subject.   There is no way I can provide the kind of answer you deserve in the limited space available.

In doing this work since 2002 and communicating with thousands of people who use this form of  Alternative Medicine treatment for Dupuytren contracture and Peyronie’s  disease,  I have never been told of any adverse reaction to our therapy concept.  I suggest that you go to our testimonial page to learn how many people have helped themselves naturally.  TRH

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