What is polyneuropathy?
Polyneuropathies are generalised disorders of the peripheral nervous system. They affect individually or in combination the motor, sensory and vegetative nerves, the sheath-like structures of their connective tissue and the blood vessels, which supply them. Motor nerve fibres conduct instructions to the muscles. Sensory nerve fibres conduct sensations from the skin, neuromuscular spindles, tendons and joints to the spinal cord. Vegetative or autonomous nerve fibres innervate the internal organs, the blood vessels and the sweat glands in the skin.
Acute or chronic neuropathy?
Polyneuropathies are differentiated according to the rapidity of their onset: acute = within 4 weeks, subacute 4-8 weeks, chronic more than 8 weeks). A further differentiating feature is the type of distribution. The most frequent type is distal-symmetrical polyneuropathy, i.e. affecting the hands and feet, proximal affecting the proximal regions and cranial the cerebral nerves. In addition there is differentiation of the types of nerve fibres affected. Depending on this, physicians speak about sensory, motor, combined sensory-motor or autonomous polyneuropathy.
Polyneuropathy. Information from A-Z
Symptoms. Signs of polyneuropathy
What symptoms can occur in polyneuropathy?
In the case of a polyneuropathy sensory and motor irritation with signs of neurological deficits may occur.
Sensory neurological irritation as a symptom of polyneuropathy.
Sensory neurological irritations are often noticed, if anything, more than signs of neurological deficits. There may be tingling, stabbing and electrified sensations and hot or cold parasthaesias, with feelings of swelling or constriction. The feet or hands are often the first affected since it is the longest nerve fibres, which suffer most severely, this is then also referred to as stocking-glove distribution of symptoms. Sensory neurological deficits lead to numbness, lack of sensory perception of hot or cold and if there is loss of perception of pain to an increased danger of injuries
Signs of motor neurological irritation as a symptom of polyneuropathy.
Motor symptoms are muscle weakness and wasting (atrophy) in most cases more noticeable in the hands and feet together and muscle cramps and twitches. Symptoms of autonomic neuropathy include feelings of fullness, constipation or diarrhoea, impotence, incontinence and absence of sweating. It is important to know that many of these symptoms can be caused by other illnesses for instance muscle cramps are a common symptom in healthy people too.
Causes. How does polyneuropathy develop?
There are literally hundreds of causes of polyneuropathies of which a few are very common and explain the majority of the diseases. The causes are classified into acquired, hereditary (genetic causes) and idiopathic. The acquired forms in turn can be classified into inflammatory, infectious, toxic and metabolic. In 20% of polyneuropathies experts cannot find any cause in the first instance.
Many different types of polyneuropathy.
We find the most common neuropathies with us are metabolic including in particular alcoholic and diabetic polyneuropathy. We find infectious neuropathies, which are very common in the third world (e.g. leprosy) very rare here. Medication-induced toxic neuropathies are triggered by some cytostatics (e.g. as part of a chemotherapy regimen), HIV therapeutics, interferon-alpha and some other substances. Acute inflammatory polyradiculoneuritis also called Guillain-Barré Syndrome, and critical illness polyneuropathy, are acute clinical pictures which can lead to high-grade paralyses; being bed-ridden and even respiratory paralysis with dependency on mechanical ventilation. Patients usually need inpatient rehabilitation.
These centres of excellence in our clinics and hospitals have doctors and therapists qualified to treat polyneuropathy.