Polyneuropathy is a disorder in the peripheral nervous system in which the nerves no longer properly transmit incoming stimuli to the brain. It results in insensations and pain. Polyneuropathy is often triggered by one or more underlying diseases present.
What is polyneuropathy?
Polyneuropathy is a disease of the peripheral (on the edge) nervous system (PNS). Peripheral nerves are the nerves that are not part of the central nervous system (CNS), which is located in the brain and spinal cord. Peripheral nerves begin as they exit the spinal column and continue to branch throughout the body until they eventually reach muscles and skin in thin branches. A distinction is made between motor and sensory nerves. The motor nerves are responsible for movements, the sensory nerves for feeling in and on the body. In polyneuropathy, the transmission of stimuli from the body to the brain is disturbed. The prefix “poly” means that many nerves are affected by the disease at the same time, “neuro” means “affecting the nerves” and “pathie” is the technical term for “disease”. Polyneuropathy can occur in various forms and is a common nerve disease.
Causes
To date, about 200 possible causes of polyneuropathy are known. A distinction is made between congenital and acquired polyneuropathy. The congenital form is relatively rare. It can be caused, for example, by a congenital disorder of nerve conduction velocity or by an inherited enzyme defect. Acquired polyneuropathy is far more common than the congenital form and is usually triggered by certain underlying diseases. The most common causes are diabetes mellitus and alcoholism (chronic alcohol abuse). In diabetes, the disturbed sugar metabolism leads to an undersupply and damage of the finely branched nerves. In alcoholism, the disorder occurs due to the toxic effect of alcohol. Drugs or toxic substances, such as arsenic or lead, can also cause toxic polyneuropathy. Other possible causes of polyneuropathy include kidney disease and long-term dialysis. Rarely, tumors, infections, or deficiency diseases can also cause polyneuropathy.
Symptoms, complaints, and signs
The disease can cause several different symptoms, depending on whether sensitive, motor, or autonomic nerve fibers are affected. When sensitive nerves are damaged, sensation in the arms and legs decreases. It usually starts in the toes or fingers. They start to tingle; as it progresses, burning and stabbing pains are added. The patient has the feeling that toes or fingers are swollen, although this is not really the case. Temperature and pain sensations worsen, leading to an increased risk of injury. Patients may burn or injure themselves without realizing it. If motor nerves are affected, this is indicated by a loss of strength in the corresponding muscles. In addition, muscle cramps may occur; calf cramps at night are very common. Paralysis is also possible and muscle atrophy may occur as a consequence. If the disease causes disturbances in autonomic nerves, this can become life-threatening. Autonomic nerves supply organs such as the intestines, heart or lungs. If they are damaged, the corresponding organ no longer functions. If the intestine is affected, diarrhea or constipation can be the result. In addition, bladder emptying may be difficult and impotence is possible. If the disorders are located in the nerves of the heart muscle, this causes cardiac arrhythmias or fluctuations in blood pressure. If the nerve conduction of the lungs is disturbed, respiratory arrest may occur in extreme cases.
Diagnosis and course
The symptoms of acquired polyneuropathy are very diverse and occur in varying degrees. Perceptual disturbances in the arms and legs are typical, with the legs more commonly affected than the arms. Patients feel tingling in the limbs as if they have “fallen asleep” and can no longer perceive heat and pressure, which can lead to burns and other injuries. Nighttime calf cramps, burning pain in the feet (burning feet), muscle twitching and restless legs (restless legs) are also typical. If the autonomic nervous system is also affected by polyneuropathy, organ dysfunction may occur.Congenital polyneuropathy often results in paralysis, gait disturbances and visual impairment, which can lead to blindness. Diagnosis is made based on the patient’s symptoms and medical history. A neurological examination is performed to check the functioning of the nerves and muscles. Furthermore, if polyneuropathy is suspected, nerve conduction velocity is measured using electroneurography. A blood test can detect infections or detect toxic (poisonous) substances in the blood.
Complications
As a result of polyneuropathy, the affected person suffers from severe pain and furthermore also from various insensations. As a rule, however, the further course of the disease depends strongly on the underlying disease, so that a general course cannot be predicted. Patients mainly suffer from sensory disturbances or paralysis. Pain in the legs or arms can also occur, leading to movement restrictions and other difficulties in everyday life. Furthermore, there is a typical tingling sensation or cramps. The pain is often burning. There is also muscle twitching and muscle weakness. The patients themselves often feel irritable due to the permanent pain and suffer from a significantly reduced quality of life. Gait disturbances and coordination disorders can also occur as a result of polyneuropathy. Vision is also not infrequently affected by the disease, so that in the worst case, sufferers can go completely blind. The treatment of polyneuropathy depends on the underlying disease. As a rule, however, the complaints and symptoms of this disease can be well limited.
When should you see a doctor?
Tingling in the arms or legs is considered a sign of an existing irregularity. If the discomfort occurs temporarily, in most cases there is a circulatory disorder due to an unfavorable posture taken. If the symptoms are completely relieved within a short period of time, a doctor is not normally required. If the sensitivity disorders increase in intensity or extent, a doctor should be consulted. If the symptoms recur, a visit to the doctor is also recommended. Of concern is additional pain or loss of existing muscle strength. If there are signs of paralysis or impaired locomotion, the affected person needs help. If there are restrictions on general movement, sporting activities can no longer be performed or there is internal weakness, a doctor should be consulted. If there are disturbances of the heart rhythm, an increased heartbeat as well as dizziness and unsteadiness of gait, clarification of the complaints is advisable. If the affected person suffers from diarrhea, constipation or general disturbances in urination, a visit to the doctor is necessary. Abnormalities during the sexual act as well as irregularities in breathing must be examined and treated. If left untreated, polyneuropathy can be fatal. In addition, anxiety develops and the risk of secondary diseases increases. Therefore, a visit to the doctor should be made at the first abnormalities or feeling of illness.
Treatment and therapy
Treatment of polyneuropathy is based on the cause. If the patient has diabetes or suffers from alcoholism, these conditions must be treated first, as they are the trigger for the polyneuropathy. In the case of diabetes, the blood sugar must be optimally adjusted, in addition, the diet should be adapted to the disease and a healthy lifestyle with sufficient exercise should be observed. Certain medications are also used to alleviate perceptual disturbances and pain. Careful foot care is also important to prevent infections from wounds. If a polyneuropathy is present that has resulted from alcoholism, vitamins are usually administered. People affected by alcoholism often neglect their diet, causing vitamin deficiencies that lead to nerve damage. If the polyneuropathy was caused by toxins, substances that bind the toxins are administered. If infections are present, the administration of antibiotics helps. Furthermore, pain-relieving and anti-inflammatory drugs as well as exercise therapy, massages and physiotherapy support the treatment of polyneuropathy.
Prevention
One can prevent polyneuropathy if one optimally adjusts one’s blood sugar and pays attention to a healthy lifestyle when diabetes is present. Alcoholism requires special treatment. With timely therapy, polyneuropathy can be prevented. In general, it is important to see the doctor immediately at the first sign of sensation in the legs or arms, so that the polyneuropathy can be treated as early as possible.
Follow-up
Polyneuropathy is usually chronic and requires patience and perseverance from the patient. After diagnosis and medical treatment, patients can do a lot themselves during aftercare to help them manage their daily lives and maintain independence as much as possible. The primary goal is to prevent falls and injuries. Therefore, it is important to focus on one activity and to train balance, coordination and perception regularly. Running, moderate walking and walking with and without poles can be helpful. Relaxation techniques such as Tai Chi, Qi Gong or Yoga also bring improvement to many patients. Occupational therapy can alleviate symptoms and often regain lost abilities. Physiotherapy exercises improve gait instability, balance and coordination. Regular alternating baths can make the tingling in the extremities more bearable. In diabetic polyneuropathy, it is essential to maintain optimal blood sugar control to prevent progression. The feet must be examined regularly and very closely by the patient for minor injuries to prevent diabetic foot syndrome. Alcohol is a neurotoxin and should therefore be avoided as far as possible. An overall positive attitude toward life, good social contacts, and psychological well-being can help the patient lead a fulfilling life despite polyneuropathy.
Here’s what you can do yourself
In the case of polyneuropathy, the focus is basically on intensive skin care and targeted perception training of the affected extremities. Affected persons can obtain skin-compatible care products with a low pH value for this purpose. In pharmacies and health food stores specific products can be asked for. When rubbing in, in conjunction with a light skin massage, the metabolic stimulation in the tissue is additionally promoted. Patients can use a hedgehog ball to firmly massage their affected extremities, thus training their perception. Simple household remedies such as an old hairbrush, rough doormat, etc. can also be useful for this purpose. Depending on the cause of the disease, a targeted change in diet may be helpful. If the disease is caused by diabetes, a targeted sugar diet helps to slow down the progression of the disease. Sports, as well as regular exercise series, promote blood circulation and thus the gas exchange between blood and cell tissue. Care should be taken to ensure that the affected areas of the body are included separately in the exercise series. Alternating warm baths, casts and massages also promote blood flow in the affected area. If affected individuals have a Tens device, it can provide gentle electrical pulses to promote nerve activity.