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Polyneuropathy - symptoms, description and treatment

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Polyneuropathy

Does the sensitivity in your hands or feet decrease? Do you feel a tingling, burning or weakness in them? Polyneuropathy may be to blame. It is a disease of the peripheral nerves that can profoundly affect your life. Balance and coordination problems can occur, which can lead to falls and injuries. [1]

Find out what are the causes and manifestations of the disease. What are the treatment options for polyneuropathy? How can the symptoms such as pain and inflammation that usually accompany this disease be suppressed? Read more here.

Symptoms of polyneuropathy

  • Decreased sensitivity to numbness in various parts of the body
  • Burning pain and tingling
  • Weakness of the legs or arms
  • Impaired coordination of movements
  • Unsteady walking with risk of falls [2]
  • Muscle cramps
  • Fatigue and disturbed sleep [3]
Notice

Only a doctor can make a correct diagnosis. Do not use this or any other article on the internet to make a diagnosis. Don’t put off seeing a doctor and address your condition early.

Description and causes of polyneuropathy

Příznaky polyneuropatie nohou a rukou:
 slabost a snížená citlivost
Symptoms of polyneuropathy of the feet and hands: weakness and decreased sensitivity

Polyneuropathy – what is it?

It is a group of diseases affecting peripheral nerves, i.e. nerves in the peripheral parts of the body outside the central nervous system. The term polyneuropathy includes various types of nerve disorders. [4]

The course of the disease can vary depending on the cause and individual patient factors. Most often it is a polyneuropathy of the lower limb, often starting at the toes. In polyneuropathy of the foot, impaired nerve function causes many different difficulties ranging from loss of sensation in the feet to the inability to maintain balance.

In the case of polyneuropathy hand disease can lead not only limitations in everyday activities, but also the risk of injuries or burns.

Types and types of polyneuropathy

It is distinguished according to what causes it and what its manifestations are. It can also be divided according to time, i.e. acute and chronic.

Common types of polyneuropathy are:

  • chronic symmetrical peripheral neuropathy – a long-term disease affecting both limbs, usually the lower limbs,
  • mononeuropathy, in which individual nerves are damaged,
  • acute symmetrical peripheral neuropathy – usually caused by the severe autoimmune disease Guillain-Barré syndrome. [5]
Rozdíl mezi zdravou nervovou buňkou a poškozenou vlivem neuropatie
Difference between a healthy nerve cell - detail 2 and a damaged one due to neuropathy - detail 1. Area 3 shows damage to the myelin sheaths, the pathways do not work, there is a loss of feeling. Region 4 - dendrites, 5 - cell nucleus, 6 - cell body, 7 - axon (neuronal process), 8 - synapse, 9 - axon termination .

Types of polyneuropathy according to the cause of the disease:

  • Diabetic polyneuropathy,
  • alcoholic polyneuropathy,
  • autoimmune polyneuropathy,
  • related to bacterial or viral infection,
  • related to endocrine diseases (for example, thyroid disorders.),
  • related to liver and kidney diseases,
  • caused by medication or treatment (for example, after chemotherapy),
  • caused by a deficiency of certain B vitamins and vitamin E. [6]

You may also encounter the terms:

  • Sensomotor polyneuropathy – this is damage to nerve cells, nerve fibres and the protective layer of neurons. [7]
  • Polyneuropathy with paretic manifestations – a disease of various origins, which is accompanied by paresis (partial paralysis of a part of the body). [8]
  • Sensitive polyneuropathy – affects the sensory fibers.
  • Chronic inflammatory demyelinating polyneuropathy – CIDP (a condition where the immune system damages peripheral nerves and causes muscle weakness and impaired reflexes ). [9]

Causes of polyneuropathy

  • Diabetes,
  • Liver or kidney disease
  • Vascular diseases
  • Autoimmune diseases
  • Hormonal imbalance
  • Deficiency of certain nutrients and vitamins
  • Excessive alcohol consumption
  • Toxic substances
  • Oncological diseases including benign tumours
  • Chemotherapy
  • Infectious diseases [12]

Polyneuropathy from stress?

Patients may wonder if stress is one of the causes. This disease is not itself caused by stress, but prolonged stress can exacerbate neuropathic pain. [13]

Risk factors for polyneuropathy:

  • Diabetes mellitus – especially if your blood sugar is at the wrong level for a long time,
  • high blood pressure,
  • alcohol consumption and exposure to toxic substances including cigarette smoke,
  • overweight and lack of physical activity,
  • poor lifestyle and unbalanced diet,
  • weakened immunity. [14]

Diagnostics

Příznaky periferní polyneuropatie:  reflexy nefungují
 správně a  pacienti cítí slabost v nohou.
Symptoms of peripheral polyneuropathy: reflexes do not work properly and patients feel weakness in their legs.

Making a diagnosis may not be easy, as the range of symptoms is very wide. The doctor will discuss all the difficulties with you in detail and will also ask about neurological diseases in the family.

Blood tests will include tests for diabetes, thyroid and liver diseases and immune status. During an examination by a neurologist, the quality of reflexes, muscle strength, sensitivity or coordination are examined, which can show the extent of nerve damage. [10]

If necessary, the doctor will recommend an MRI or CT scan or electromyography. Sometimes a biopsy (sampling) of the nerve is also done. [11]

Did you know?

  • Up to 25% of patients with diabetes may be affected by diabetic polyneuropathy. [15]

Complications of non-treatment

If it is not treated or the treatment is not effective, complications can occur with a significant impact on your life.

  • Muscle wasting. It can lead to muscle wasting.
  • Difficulty walking. May cause unsteady gait, difficulty maintaining balance.
  • Increased risk of falls and injuries. Exhaustion in polyneuropathy can lead to falls.
  • Exceptionally, amputation. [16] In the final stage, it can mean a complete loss of sensation in the feet. In practice, this brings major limitations, such as the inability to walk and a high risk of amputation of the limb. [17]
Ochabování svalstva

Muscle wasting

Potíže s chůzí

Difficulty walking

Zvýšené riziko pádů

Increased risk of falls

Amputace

Amputation

Notice

We recommend not to delay treatment of polyneuropathy

Do not delay treatment for polyneuropathy, and see a specialist if you have any health problems or doubts about your health. This will prevent unnecessary health complications.

Treatment of polyneuropathy

All patients with this nerve disease wonder if polyneuropathy is curable. Treatment begins with determining the cause of the problem and your doctor will recommend a specific course of treatment accordingly.
There is no miracle cure for polyneuropathy that will quickly rid you of all the troubles, but various types of drugs and complementary treatment methods are used.

  • Proper blood sugar control is essential for patients with diabetes.
  • It is advisable to limit alcohol and take care of proper nutrition, including supplementation of missing vitamins. [18]
  • Symptom relief can be provided by painkillers, for example.
  • Antidepressants also have their place in treatment [19]

Nerve stimulation, physiotherapy, acupuncture or orthopaedic devices are sometimes used to improve the quality of life of patients with polyneuropathy. [20]
Patients often wonder if polyneuropathy can subside. If it is related to viral jaundice, for example, its symptoms may subside after the jaundice symptoms disappear. [21] Regression of polyneuropathy can also occur after the end of chemotherapy if the problems occurred in connection with this anti-cancer treatment. [22]

Notice

Attention

Treatment for polyneuropathy can only be determined by your doctor after considering your overall health. Therefore, do not use this article as a guide to treatment, which can only be determined by a doctor.

Drugs for polyneuropathy

Terapie polyneuropatie zahrnuje například léky proti bolesti a křečím
Therapy for polyneuropathy includes, for example, painkillers and antispasmodics

Treatment involves the use of drugs depending on the specific cause of the disease – for example, diabetes drugs or thyroid hormones in the case of thyroid dysfunction. Analgesics (painkillers) are used to control pain, but their use should not be long-term.

Doctors sometimes also prescribe antidepressants and anticonvulsants (drugs to prevent epilepsy and convulsions). You can also get a prescription from your doctor for corticosteroids, which are medicines that relieve itching, swelling and inflammation. [23] For some types, drugs acting on the immune system are used. [24]

Polyneuropathy diet - What diet is suitable?

The composition of the diet can influence the development and severity of polyneuropathy. It is important to get enough B vitamins and vitamin E, which are essential for good nerve health. [25] For diabetics, adherence to a diabetic diet as recommended by a doctor is crucial.

For many people, regardless of age, morning coffee is a lifelong habit. But does coffee combine with polyneuropathy? Although the caffeine in coffee is stimulating, excessive amounts can have a negative effect on the nervous system. Caffeine itself does not cause polyneuropathy, but it can place a burden on the nervous system and accentuate neuropathic pain. [26]

Polyneuropathy and rehabilitation

Rehabilitation improves mobility, stability and the ability to engage in normal daily activities. The rehabilitation programme always respects the symptoms and condition of the individual patient.

What is usually part of rehabilitation for polyneuropathy?

  • Exercises to strengthen muscles and increase overall fitness,
  • exercises to promote musculoskeletal mobility,
  • promoting balance to minimise the risk of falling,
  • soft tissue massage,
  • practical tips on how to use orthotics correctly. [27]

Polyneuropathy and baths

Spa treatment options should be discussed with the treating physician. The latter also issues a proposal for spa treatment under the conditions set by the health insurance company. [28]

The exact programme of spa treatment depends on the patient’s condition and may include, for example, hydrotherapy in addition to exercise, physiotherapy or massage. Hydrotherapy brings pain relief, relaxes muscles and improves blood circulation. [29]

Lifestyle and polyneuropathy

A healthy lifestyle is an important part of both prevention and treatment. Varied blood values in polyneuropathy can be improved by a varied diet rich in vitamins and minerals and alcohol restriction. Make sure you also take regular exercise, which supports the body’s defences. You should, of course, follow the treatment of any additional diseases. [30]

What is the life expectancy in polyneuropathy?
It may not be any different from the life expectancy of healthy persons. Adherence to all recommendations from the doctor is a prerequisite. However, some types of polyneuropathy can worsen over time. [31] [32]

Dietary supplements

Dietary supplements can supply the body with missing vitamins or minerals. The emphasis is on vitamins B1, B12 and vitamin E. Supplements containing vitamin B12 are particularly important for vegans and vegetarians. [34] Consult your physician for the appropriate supplement.

Suitable exercises and sports

Patients with polyneuropathy need to choose sports activities and exercises that do not compromise their safety and do not increase the risk of falls or injuries. Physical activity should respect current fitness and movement abilities. [35]

Properly selected exercises and physiotherapy will promote mobility, motor skills or stability. It can also relieve neuropathic pain.

Prevention of polyneuropathy

One of the most important measures is to prevent diabetes. [36]
Preventive measures include:

  • Adherence to a healthy lifestyle,
  • early resolution of any health problems,
  • limit alcohol consumption and smoking,
  • following the doctor’s recommendations. [37]
Notice

Keep an eye on your blood sugar

Keep an eye on your blood sugar levels and go to your GP for regular check-ups.

Summary and recommendations in the management of polyneuropathy

1.

See a doctor

The treatment of polyneuropathy is always determined by your doctor based on a general examination, an assessment of your condition and an accurate diagnosis.

2.

Causal treatment of polyneuropathy

After a general examination, your doctor will recommend treatment for the cause of polyneuropathy. They will also advise you on possible lifestyle adjustments and the next course of action.

3.

Pain and inflammation relief

Symptomatic treatment focuses on the manifestations or signs (symptoms) of the disease. Such treatment can significantly improve your quality of life and support comprehensive treatment during the course of the disease.

Sources, references and literature

[1] Campellone J. V. Sensorimotor polyneuropathy. The Mount Sinai Health System, 11. September 2021. https://www.mountsinai.org/health-library/diseases-conditions/sensorimotor-polyneuropathy

[2] Campellone J. V. Sensorimotor polyneuropathy. The Mount Sinai Health System, 11. September 2021. https://www.mountsinai.org/health-library/diseases-conditions/sensorimotor-polyneuropathy

[3] Falck S. What to know about polyneuropathy. Medical News Today, 3. February 2022. https://www.medicalnewstoday.com/articles/317212

[4] Campellone J. V. Sensorimotor polyneuropathy. The Mount Sinai Health System, 11. September 2021. https://www.mountsinai.org/health-library/diseases-conditions/sensorimotor-polyneuropathy

[5] Falck S. What to know about polyneuropathy. Medical News Today, 3. February 2022. https://www.medicalnewstoday.com/articles/317212

[6] Falck S. What to know about polyneuropathy. Medical News Today, 3. February 2022. https://www.medicalnewstoday.com/articles/317212

[7] Campellone J. V. Sensorimotor polyneuropathy. The Mount Sinai Health System, 11. September 2021. https://www.mountsinai.org/health-library/diseases-conditions/sensorimotor-polyneuropathy

[8] Sommer C., Geber C., Young P. et al. Polyneuropathies. Dtsch Arztebl Int 2018 Feb 9; 115 (6): 83-90, doi: 10.3238/arztebl.2018.083. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5832891/

[9] Peripheral Neuropathy Fact Sheet. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/peripheral-neuropathy-fact-sheet

[10] Peripheral Neuropathy Fact Sheet. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/peripheral-neuropathy-fact-sheet

[11] Falck S. What to know about polyneuropathy. Medical News Today, 3. February 2022. https://www.medicalnewstoday.com/articles/317212

[12] Peripheral Neuropathy Fact Sheet. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/peripheral-neuropathy-fact-sheet

[13] Li M. J., Liu L. Y., Chen L. et al. Chronic stress exacerbates neuropathic pain via the integration of stress-affect-related information with nociceptive information in the central nucleus of the amygdala. Pain 2017 Apr; 158(4):717-739, doi: 10.1097/j.pain.0000000000000827. https://pubmed.ncbi.nlm.nih.gov/28225710/

[14] Falck S. What to know about polyneuropathy. Medical News Today, 3. February 2022. https://www.medicalnewstoday.com/articles/317212

[15] Bednařík J. Neuropathic pain as pain as a clinical syndrome. Department of Neurology, LFMU and FN Brno. https://www.fnbrno.cz/neuropaticka-bolest-jako-klinicky-syndrom/f324

[16] Campellone J. V. Sensorimotor polyneuropathy. The Mount Sinai Health System, 11. September 2021. https://www.mountsinai.org/health-library/diseases-conditions/sensorimotor-polyneuropathy

[17] Walker J. 5 stages of neuropathy. Ethos Health Group, 2.3.2021. https://ethoshealthgroup.com/5-stages-of-neuropathy/

[18] Campellone J. V. Sensorimotor polyneuropathy. The Mount Sinai Health System, 11. September 2021. https://www.mountsinai.org/health-library/diseases-conditions/sensorimotor-polyneuropathy

[19] Falck S. What to know about polyneuropathy. Medical News Today, 3. February 2022. https://www.medicalnewstoday.com/articles/317212

[20] Falck S. What to know about polyneuropathy. Medical News Today, 3. February 2022. https://www.medicalnewstoday.com/articles/317212

[21] Vondrová H. Polyneuropathy in metabolic, endocrine and dysproteinemic diseases. Neurology for Practice 2001 (3): 122-127. https://www.neurologiepropraxi.cz/pdfs/neu/2001/03/04.pdf

[22] Rajdová A., Raputová J., Vlčková E. Polyneuropathy as a consequence of anticancer treatment. Oncologická revue 3/2019. https://onkologickarevue.cz/cs/polyneuropatie-jako-nasledek-protinadorove-lecby

[23] Falck S. What to know about polyneuropathy. Medical News Today, 3. February 2022. https://www.medicalnewstoday.com/articles/317212

[24] Campellone J. V. Sensorimotor polyneuropathy. The Mount Sinai Health System, 11. September 2021. https://www.mountsinai.org/health-library/diseases-conditions/sensorimotor-polyneuropathy

[25] Falck S. What to know about polyneuropathy. Medical News Today, 3. February 2022. https://www.medicalnewstoday.com/articles/317212

[26] Bauer N. Caffeine and Neuropathy. Calgary Neuropathy Association, 12/31/2016. https://calgaryneuropathy.com

[27] Peripheral Neuropathy – Physiotherapy for peripheral neuropathy. Physio.co.uk. https://www.physio.co.uk/what-we-treat/neurological/conditions/peripheral-neuropathy.php

[28] Pitfalls in the design and approval of spa and rehabilitation care. General Health Insurance Company. https://www.vzp.cz/poskytovatele/informace-pro-praxi/poradna/uskali-v-navrhovani-a-schvalovani-lazenske-lecebne-rehabilitacni-pece

[29] Peripheral Neuropathy – Physiotherapy for peripheral neuropathy. Physio.co.uk. https://www.physio.co.uk/what-we-treat/neurological/conditions/peripheral-neuropathy.php

[30] Falck S. What to know about polyneuropathy. Medical News Today, 3. February 2022. https://www.medicalnewstoday.com/articles/317212

[31] Rassouli S. CIDP Life Expectancy. Ameripharma, 8. June 2022. https://ameripharmaspecialty.com/cidp-life-expectancy/#

[32] Truc M., Kobesová A. Rehabilitation of polyneuropathic syndromes. Sanquis 47/2006 (16). https://www.sanquis.cz/index2.php?linkID=art206

[33] Campellone J. V. Sensorimotor polyneuropathy. The Mount Sinai Health System, 11. September 2021. https://www.mountsinai.org/health-library/diseases-conditions/sensorimotor-polyneuropathy

[34] Falck S. What to know about polyneuropathy. Medical News Today, 3. February 2022. https://www.medicalnewstoday.com/articles/317212

[35] Falck S. What to know about polyneuropathy. Medical News Today, 3. February 2022. https://www.medicalnewstoday.com/articles/317212

[36] Peripheral Neuropathy Fact Sheet. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/peripheral-neuropathy-fact-sheet

[37] Falck S. What to know about polyneuropathy. Medical News Today, 3. February 2022. https://www.medicalnewstoday.com/articles/317212

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