Polyneuropathy

Neuropathies, PolyneuritidesA polyneuropathy is a broadly diversified disease of several peripheral nerves, which are responsible, for example, for the sense of touch (sensitive) and muscle movement (motor), with many different causes (e.g. toxic, infectious, metabolic (metabolic), genetic factors). The disease practically always starts at the lower extremity, is usually symmetrically pronounced and has a slowly progressing symptomatology. Polyneuropathy often leads to inflammation of the nerves.

The worldwide prevalence of polyneuropathy is estimated at 40 per 100000 inhabitants, but there are regional differences. These differences are based on ever new causes of damage, especially environmental toxins such as insecticides, toxic drugs and medicines, while the traditional harmful substances (noxious agents) such as thallium and arsenic (e.g. used as a murder or suicide agent) are now rather rare. As an example, polyneuropathies are more common in Morocco as a result of poisoning caused by mixing cooking oil and weapon lubricants.

Polyneuropathy as a result of diphtheria has become increasingly rare, whereas the frequency of polyneuropathy involving the meninges (meningopolyneuritis) as a result of a tick bite (borreliosis) has increased. In Europe, by far the most common causes are diabetes mellitus and alcoholism, whereas in tropical and subtropical regions malnutrition and leprosy are the most common causes. Diabetic polyneuropathy, with a proportion of 30-40%, occurs ten times more frequently than other polyneuropathies.

Alcohol polyneuropathy affects men more frequently and usually manifests itself between the ages of 50 and 60, while diabetic polyneuropathy affects women more frequently and usually manifests itself between the ages of 70 and 80. However, both diseases can also occur in adolescents. Hereditary polyneuropathy manifests itself in early to middle age.

There are many different causes of polyneuropathy. The most common ones are listed below:

  • Genetic causes, e.g. hereditary polyneuropathy
  • Metabolic disorders, e.g.

    in diabetes mellitus

  • Malnutrition or malnutrition
  • Vitamin B12 uptake disorder and other intestinal uptake disorders (absorption disorders)
  • Disorders of the protein balance (dysproteinemia) in the blood
  • Infections, e.g. after a tick bite (borreliosis)
  • Disorders of the vessel walls (arteriopathy)
  • Toxic disorders, e.g. triarylphosphate poisoning
  • Tumor diseases, e.g. in one third of cases of lung cancer and one third of cases of lymphatic tissue tumors

At the beginning of a polyneuropathy mostly both legs are affected symmetrically, but especially the lower legs.

Occasionally, unilateral complaints in the area of the thighs and the pelvic girdle can also be observed. Rarely, affected persons describe complaints in the face or trunk. A distinction is made between symptoms affecting the sensitive nerve tracts and complaints in the motor system.

Characteristically, symptoms of polyneuropathy start mainly at rest or at night. Patients report all kinds of sensations, which can culminate in painful sensations. Possible sensations can be:

  • Tingling
  • Burn (