Medical history (history of illness) represents an important component in the diagnosis of polyneuropathy. Family history
- Are there any diseases (diabetes mellitus, neurologic diseases) in your family that are common?
Social history
- Do you have a job that exposes you to environmental stress?
Current medical history/systemic history (somatic and psychological complaints).
- Have you noticed symptoms such as burning, tingling, or loss of sensation in the arms and/or legs?
- Do you have any painful sensory abnormalities?
- Burning of the feet?
- Pain in the lower leg or feet?
- Nocturnal accentuation of pain?
- Has your sensation of heat/cold changed?
- Do you suffer from muscle weakness, muscle tremors or pain?
- Have you noticed any unsteadiness in your gait?
- Do you have skin lesions/ulcers that heal poorly?
- Do you have a high resting heart rate (> 100 beats/min)?
- Have you noticed gait unsteadiness?
- Do you suffer from discomfort of the gastrointestinal tract?
- Difficulty swallowing?
- Painful swallowing?
- Abdominal pain?
- Nausea/vomiting?
- Feeling of fullness
- Flatulence?
- Diarrhea?
- Constipation?
- Fecal incontinence (inability to retain intestinal contents as well as intestinal gases arbitrarily in the rectum)?
- Do you suffer from discomfort of the urinary and genital apparatus?
- Do you have bladder emptying disorders?
- Do you suffer from erectile dysfunction?
- How long have the above symptoms been present? In what chronological order did they occur?
Vegetative anamnesis incl. nutritional anamnesis.
- Are you overweight? Please tell us your body weight (in kg) and height (in cm).
- Do you smoke? If so, how many cigarettes, cigars or pipes per day?
- Do you drink alcohol? If yes, what drink(s) and how many glasses per day?
- Do you use drugs? If yes, what drugs (nitrous oxide) and how often per day or per week?
- Have you noticed any changes in bowel movements or urination?
Self history including medication history.
- Pre-existing conditions (diabetes mellitus, neurological diseases).
- Operations (organ transplant?)
- Allergies
Medication history
- Anti-infectives – quinolones/fluoroquinolones/gyrase inhibitors (ciprofloxacin, moxifloxacin, nalidixic acid, norfloxacin, lomefloxacin, levofloxacin, ofloxacin), chloroquine (D), dapsone (A), dideoxycytidine, isoniazid, nitrofurantoin (A), metronidazole (A), thalidomide.
- Antiarrhythmics – amiodarone (G), flecainide (A), procainamide (D).
- Antirheumatic drugs and immunosuppressants – chloroquine, colchicine, gold, tacrolimus.
- Bortezomib (proteasome inhibitor) (A).
- Digoxin (cardiac glycoside) (A)
- Hydralazine (antihypertensives) (A)
- Immune checkpoint inhibitors (such as ipilimumab, nivolumab, and pembrolizumab) → acute inflammatory demyelinating or axonal polyneuropathies (AIDP [acute inflammatory demyelinating polyradiculoneuropathy]/ASMAN [acute sensorimotor axonal neuropathy]/AMN [adrenomyeloneuropathy]) and CIDP.
- Immunomodulators – Tacrolimus (D).
- Immunosuppressants – leflunomide (A)
- Interferon-α (A)
- Levodopa (antiparkinsonian drug) (A)
- Lithium (A)
- Gold (G)
- Psychiatric medication and sedatives – disulfiram, lithium.
- Phenytoin (A)
- Reverse transcriptase inhibitors
- Statins (A)
- Thalidomide (A)
- TNF-α antagonists (D)
- Tuberculostat – isoniazid (A).
- Vitamin B6 overdose (A)
- Cytostatic drugs (chemotherapy-induced neuropathy (CIN)) – doxorubicin (A), etoposide (A), gemcitabine (A), ifosfamide (A), platinum(derivatives) (A), cisplatin, vincristine, vinca alkaloids (A), taxanes (A), taxol (A), or proteasome inhibitors.
Legend: A = axonal; D = demyelinating; G = mixed axonal-demyelinating.
Environmental history
- Acrylamide – formed during frying, grilling, and baking; used in the manufacture of polymers and dyes
- Alcohol (= alcohol-associated polyneuropathy) → sensitive symptoms, such as numbness, stinging, or unsteadiness of gait.
- Arsenic
- Hydrocarbons
- Heavy metals such as lead, thallium, mercury
- Carbon disulfide
- Trichloroethylene
- Triorthocresyl phosphate (TKP)
- Bismuth (due tobismuth-containing dental material or in the case of long-term treatment with bismuth preparations).
* If this question has been answered with “Yes”, an immediate visit to the doctor is required! (Data without guarantee)
