Polyneuropathy is a mostly chronic nerve disease. Several nerves are always affected and limited in their function. This often manifests itself in sensory disturbances or states of pain, which can occur more or less severely.
The cause of a polyneuropathy is usually a previous underlying disease. The leading causes are diabetes mellitus, alcohol addiction and vitamin deficiency. Specific infections can also trigger neuropathies.
The therapy is often complicated. In principle, the responsible underlying disease must be treated, but pain reduction should also be aimed for. Particularly for the latter goal, a variety of approaches have been found, both on a drug basis and on the basis of interventional therapy.
Guidelines
With regard to the pharmacological therapy of “chronic neuropathic pain“, various therapeutic goals have been formulated which should be met as far as possible during the course of treatment. According to the patient’s subjective perception, the pain should be reduced by at least 30 to 50 percent and the quality of sleep should be improved. By maintaining or even resuming social and professional interactions and activities through the therapy, the patient’s quality of life increases.
All goals of therapy for polyneuropathy must be discussed with the patient in advance. Expectations should not be too high, in order to avoid disappointment later on. Such emotional stress situations have a negative effect on the sensation of pain and can cause it to worsen.
A therapy with medication can reduce pain by 50 to 80 percent on average. Complete relief from pain is rare and should therefore be sought, but never promised. There is also the risk that the patient may prove resistant to therapy.
In this case, the reduction in pain is usually less than 30 percent. About 30 percent of all patients suffering from polyneuropathy are either resistant to therapy or suffer from severe side effects, so that treatment must be discontinued. Trigeminal neuralgia, which is also a neuropathy, must be considered separately. There are drugs that are effective in this, but are useless in polyneuropathy.
