Polyneuropathy
Polyneuropathies are motor, sensory and autonomic disorders caused by damage to peripheral nerves outside the central nervous system (brain and spinal nerves) due to various causes.
Polyneuropathies can be classified according to the affected nerve fibres (motor, sensory, autonomic, mixed or sensorimotor) as well as according to their onset and course (acute, subacute, chronic).
The symptoms that may occur when polyneuropathy occurs may vary depending on which nerves are damaged. The treatment method to be applied is determined by the physician depending on the underlying causes of the disease.
What Is Polyneuropathy?
All nerves outside the central nervous system are called the peripheral or peripheral nervous system. While the brain and spinal cord receive and send information from other parts of the body via the central nervous system, the peripheral nervous system connects the central nervous system to the limbs, organs and skin.
If several different nerves that form part of the peripheral nervous system are damaged at the same time, this is called polyneuropathy.
Here poly means many, neuro means nerve and pati means damage. It can occur in the skin, muscles, organs or different parts of the body.
In polyneuropathy, the nerves in the body lose their function and neurological deficits occur. During the disease, the nerves that allow us to control emotions and movements can be damaged, as well as autonomic nerves can be damaged. Advancing age increases the likelihood of polyneuropathy.
Why Does Polyneuropathy Occur?
Although there are many underlying causes of polyneuropathy, the most common cause is diabetes.
In addition, metabolic diseases, infectious diseases or genetic diseases can also cause polyneuropathy. We can list the prominent causes of polyneuropathy as follows:
- Inability of the insulin hormone to control blood glucose levels, type 2 diabetes,
- Excessive alcohol consumption and irregular nutrition,
- Lupus, celiac disease, guillain barre syndrome, rheumatoid arthritis, Sjögren’s syndrome and various autoimmune
- diseases that occur when the immune system attacks healthy tissues,
- Viral and bacterial infections such as hepatitis B, hepatitis C, shingles, lyme disease and HIV,
- Abnormal proteins in the blood, various types of cancer and bone marrow disorders such as lymphoma,
- Some hereditary diseases such as Charcot-Marie-Tooth,
- Some drugs used in the treatment of HIV and AIDS or in chemotherapy,
- Kidney or liver disorders such as cirrhosis of the liver,
- Injuries and physical traumas,
- Inadequate dietary intake of vitamin E and vitamins B1, B6 and B12,
- Abuse of drugs and chemicals or prolonged exposure to harmful chemicals such as arsenic, mercury and lead, heavy metal poisoning,
- Underactive thyroid glands, also called hypothyroidism.
Patients with the aforementioned causes and various symptoms of polyneuropathy should be examined by a physician. As with almost all diseases, early diagnosis is important in polyneuropathy.
What Are The Symptoms Of Polyneuropathy?
Symptoms of polyneuropathy vary depending on which nerves are damaged. For example, symptoms such as weakening of the muscles, numbness in the arms or legs, impaired coordination and balance, and loss of sensation are encountered.
Since the symptoms are similar to those of fibromyalgia or multiple sclerosis, they can sometimes be confused with these diseases. We can list the symptoms of polyneuropathy as follows:
- Numbness, numbness, burning, pain or pins and needles and tingling sensation in the hands and feet,
- Difficulty in using the limbs, weakness, gait disturbance and inability to perform simple movements such as making a fist and opening the hand,
- Lack of coordination, falls and dizziness,
- Development of leg or foot ulcers,
- Hypersensitivity to touch,
- Muscle wasting
- Delayed healing of wounds,
- Various deformations of the skin, hair and nails, such as hair loss, skin and nail infections,
- Excessive sweating,
- Blood pressure and pulse rate different from normal,
- Problems in the digestive system or bladder,
- Difficulty eating and swallowing,
- Difficulty breathing.
Some of these symptoms may manifest themselves alone or some symptoms may be present together. In order to develop the most appropriate treatment method, it is important that the necessary examinations are performed and diagnosed by a physician.
How Is Polyneuropathy Diagnosed?
To diagnose polyneuropathy, the patient’s complaints are first listened to, a clinical examination is performed and laboratory tests are ordered. A blood test may be necessary to investigate causes such as diabetes, malnutrition or impaired thyroid function.
Apart from all these, MRI and CT scans, electro-diagnostic tests and biopsies can be used for diagnosis. One of the most commonly used methods for definitive diagnosis is electromyography, which is an electro-diagnostic method.
- Electromyography: With this method, electrical activity in the muscles and nerves is measured. Cables are connected to the patient’s arms and legs and low-level electricity is applied. Thus, a clear information about the condition of the nerves can be obtained.
- CT and MRI Scan: With these methods, causes such as tumours or herniated discs that may cause nerve damage are investigated.
- Biopsy: Abnormalities in the nerves and nerve endings can be detected by removing a part of the nerve or a skin sample.
In addition to the methods mentioned above, the patient’s height, weight, blood pressure, pulse and body temperature may also be needed. Additional tests may also be requested to evaluate the state of reflexes, to determine muscle strength, to check posture and balance.
How Is Polyneuropathy Treated?
The first approach in the treatment of polyneuropathy is to identify the underlying causes and to eliminate these causes first. For example, diabetes is one of the most common causes of polyneuropathy and therefore diabetes must be controlled first in order to control polyneuropathy. The methods used in the treatment of polyneuropathy can be analysed in three main groups: drug therapy, medical therapies and complementary therapies.
In drug treatment, depending on the severity of the patient’s pain, it is possible to use painkillers to relieve these pains. Complementary treatments include methods that will reduce the severity of symptoms such as massage, acupuncture, ozone therapy, cupping therapy and meditation.
Medical treatment methods that can be used in the treatment of polyneuropathy are as follows:
- Transcutaneous electrical nerve stimulation method applied by sending a mild dose of electric current through the skin,
- Plasma exchange in which blood is removed from the body, separated from antibodies and proteins and then returned to the body,
- Immunoglobulin therapy, which is the process of controlling high levels of antibodies and proteins in the blood to regulate the immune system,
- Physiotherapy for patients with incoordination or muscle weakness,
- Treatment with orthoses and devices such as braces, wheelchairs and wrist devices to provide hand, foot, arm or leg relief.
Apart from all these methods, various exercises may be recommended by physiotherapists in order to eliminate the difficulties suffered by patients.
Patients may also require a rehabilitation process in which they will be taught how to perform muscle strengthening and joint stretching exercises or how to use various orthoses and assistive devices.
If the polyneuropathy in patients is caused by nerve compression, then surgical intervention may be required to solve this problem. Of course, the physician will make the final decision on the diagnosis of the disease and what kind of treatment will be applied.
