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

2 thoughts on “How is epilepsy a factor in Dupuytren contracture?

  1. Casey says:

    My name is Casey. I’m an active 36 yr. old male that resides in Oklahoma

    I like this article and it would almost answer some questions of my own, but I’m nearly the exact opposite of this situation. I still feel like its a shot in the right direction.

    This is an a new interest to me. I am am pulling some research together that is starting to make sense. I have been developing Dupuytren’s contracture since I was a very small child (5 yr. old). The family physicians then were not familiar with Dupuytren’s contracture and only referred to the condition as a “fatty tumor”, this continued until a Navy doctor properly diagnosed the condition when I joined the Marine Corps.

    As I was growing up the condition only showed in my left foot until my teenage years, it began to appear on the posterior of my left hand. Although, the nodules were never an emergency I have had 2 different surgeries to have the nodule removed from my left foot. My first was when I was 7yr. old and the second when I was 15 yr. old. Of course it always came back and now all four of my extremities have nodules. I was never on any long term medication.

    Now, fast forward to 2016, I was diagnosed with Narcolepsy 1 (with cataplexy). With the given information that I currently have, DC and Cataplexy both derive from auto-immune issues and Narcolepsy is in some cases only diagnosed as epilepsy (petit mal).

    I feel I am closing in on several pieces of research to find a relevant answer, but my new challenge is that experienced physicians don’t typically specialize in neurology and orthopedics simultaneously. So now I’m reaching out wherever I can that might elicit some critical thinking from the wise. I am just to the point that there are too many coincidences to be coincidences any more. Thank you.

    Respectfully,
    Casey

  2. Dr. Herazy says:

    Greetings Casey,

    Thanks for your interesting post.

    Yes, it does seem that your situation is not typical of Dupuytren’s contracture and could be considered the opposite in some ways. Assuming that your diagnosis of Dupuytren’s contracture is correct, your age of onset is unusually young. And, you report that you have nodules on the posterior (back) of a hand, not the anterior (front or palm) of the hand.

    You gave your name as Casey. This is either your first name or or related in some way to your last name. If so, this suggests you have an Anglo-Saxon heredity factor to explain your unusually strong and early expression of quadrupedal (all hands and feet) fibromatosis. It would not be surprising if there are not other family members (parents, siblings, aunts, uncles, grandparents) with Dupuytren’s contracture (hands), Ledderhose disease (feet), Peyronie’s disease (penis) and Garrod’s pads (knuckles).

    As is typical of Dupuytren’s contracture, you note that surgery only resulted in return of your problems. I suggest you be very skeptical about any further suggestion for additional surgery to remove any other lesions. As you have likely noted, these surgeries result not only in the return of the initial problem, but exacerbation of it along with structural weakening of the involved body part.

    Please let me know if you would have questions about natural Dupuytren’s contracture treatment. You could be an excellent candidate. TRH

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