The treatment of peripheral nerve hyperexcitability.
The first line of treatment is by the use of drugs that are from the family of anti-convulsants. This type of drug is normally used in the treatment of epilepsy. Phenytoin and Carbamazepine are quite successful at reducing the symptoms. Others that may be prescribed are Sodium valporate, Lamotrigine or Gabapentin.
Combinations of two maybe tried if a reduction of the symptoms is not observed. A combination can be more beneficial because each one acts in a slightly different way and taken together, a lower dose of two can avoid the side effects of a high dose of one. Painkillers and or Diazepam can be effective for relieving pain for a short period of time if this is one of the symptoms, but due to the addictive qualities they are not a long term solution.
It can be a time consuming process when it comes to finding which type of drug offers a reduction in the symptoms. Giving each one time to become effective by increasing the dose gradually can take a period of weeks. Likewise, when no improvement is observed it may require a slow reduction of the dose before starting a new a systematic plan of therapy.
I have been prescribed all of the above drugs at different doses in the past. Only the combination of Lamotrigine and Gabapentin has had a stabilising effect on the symptoms making them more manageable and almost abolishing the use of Diazepam and painkillers.
As with most drugs there is always the possibility of side effects with these medications. In my case drowsiness has been the most noticeable.
Other forms of treatment that I believe have been used in patients with PNH include the use of steroids and plasma exchange. When employed, plasma exchange can show a marked reduction in the symptoms which can be observed for a number of weeks. However, I understand that plasma exchange would only be used in cases where the symptoms are debilitating. Suppressing the immune system by the use of steroids may be employed in some cases when the anti-convulsant type drugs fail to improve matters.
From experience and prior to diagnosis, no form of alternative medicine such as osteopathy or acupuncture offered any reduction in the symptoms. Vitamin and mineral supplements along with herbal remedies where also remarkably unsuccessful.