Diagnosis

In order to make a diagnosis of polyneuropathy, the treating family doctor or neurologist first takes a detailed anamnesis. For this purpose, he asks questions regarding the type of symptoms, their temporal occurrence and their course. He is also interested in previous illnesses (such as diabetes mellitus), family history or medication.

A physical examination can then quickly provide further information. For this purpose, the doctor tests sensitivity, temperature, pain and vibration sensation. Various devices, such as a small tuning fork, are used for this purpose.

In addition, the reflexes in the affected area are examined, which are typically weakened in polyneuropathy. These examinations are completely painless for patients. If the suspicion of a polyneuropathy is confirmed, further examinations must be initiated to confirm the diagnosis.

For example, the nerve conduction velocity (NLG) can be measured to determine the stage of the disease. Laboratory tests, neural fluid puncture, biopsies and further neurological examinations are then initiated. Thioctic acid is given for pain and sensory disturbances, and its effect has been proven especially in diabetic polyneuropathy.

Acetylsalicylic acid, e.g. aspirin, and paracetamol can be used as painkillers, but for persistent pain, carbamazepine, pregabalin, both of which are actually drugs for epilepsy, and antidepressants (thymoleptics) and so-called “nerve suppressants” (neuroleptics) must be used. Of course, the respective underlying disease requires special treatment measures. Also important are physiotherapeutic movement exercises and occupational therapy training.

If the cause is a known harmful substance, it should of course be avoided, as for example with excessive alcohol consumption. Polyneuropathies are usually slowly progressive and usually disappear gradually. However, residual symptoms, especially a loss of reflexes, can be detected even after years.

The prognosis also depends on the cause, e.g. the symptoms and the reduction of symptoms (remission) in alcoholic polyneuropathy depend on the dose of alcohol. Polyneuropathies associated with diseases such as leprosy progress with their underlying disease, but can be influenced therapeutically. With well-controlled diabetes mellitus and well-treated diphtheria, the symptoms gradually recede (remission), but with acute porphyria, relapses (recurrence) occur more often.