{"id":741,"date":"2020-02-06T01:17:38","date_gmt":"2020-02-06T01:17:38","guid":{"rendered":"https:\/\/imedicalsociety.org\/?p=741"},"modified":"2020-02-06T01:17:38","modified_gmt":"2020-02-06T01:17:38","slug":"polyneuropathy","status":"publish","type":"post","link":"https:\/\/imedicalsociety.org\/polyneuropathy\/","title":{"rendered":"Polyneuropathy: symptoms, causes, therapy"},"content":{"rendered":"
In polyneuropathy, peripheral nerves are damaged. These can be, for example, nerves that command muscle contractions (motor nerves) or control digestion or breathing (autonomic nerves). Often nerves are also affected, which are responsible for the sensitive sensation of touch, temperature, pressure and vibration (sensitive nerves).<\/p>\n
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Early if you notice that you have, for example, sensations in your feet or coordination problems when walking. Then the family doctor and, together with him, the neurologist can go on cause research before the nerve is permanently damaged. Moreover, the recovery of nerves takes time – and therefore patience. Those who are treated early and well can be more likely to be symptom-free again.<\/p>\n<\/div>\n<\/section>\n There are people in whom the disease has a genetic cause. The people affected are then correspondingly younger. However, the symptomatic polyneuropathies, which are much more common, mainly affect older people. Nerve suffering is here for example a concomitant symptom of diabetes, vitamin deficiency diseases or alcohol dependency.<\/p>\n<\/div>\n<\/section>\n Unfortunately it is not easy to discover – often it is real detective work. Statistically speaking, only about 50 to 60 percent find a reason for the complaints and can then often treat them directly. Nevertheless, there are some things that can be done without knowing the cause of the relief, for example physiotherapy or gait training. Vitamin B complexes support the nerves in healing. And last but not least, there are also drugs that can alleviate the pain.<\/p>\n<\/div>\n Which polyneuropathy symptoms occur in a patient therefore depends on the damaged nerves. Accordingly, a distinction is made between motor, autonomic and sensitive disorders<\/strong>.<\/p>\n Polyneuropathy symptoms can also be classified according to their distribution in the body:<\/p>\n Nerves that lead from the skin to the brain are called “sensitive”. They inform the brain, for example, about touch, pressure, temperature or pain stimuli or vibrations. If this sensitivity is disturbed by polyneuropathy, the perception in arms and legs suffers. The toes are often the first to be affected. For example, there is sensation of discomfort, tingling or stinging, burning pain<\/strong>.<\/p>\n Feelings of numbness<\/strong> are also possible polyneuropathy symptoms. If these occur in the legs, those affected have coordination problems when walking<\/strong>, for example.<\/p>\n If the temperature sensation<\/strong> is disturbed<\/strong>, injuries can occur more easily. Polyneuropathy patients, for example, do not notice that their footbath is much too hot. People with pronounced polyneuropathy can also perceive pain only to a lesser extent<\/strong>. This also increases the risk of injury.<\/p>\n Most polyneuropathies are associated with sensitive disorders.<\/p>\n Motor nerves transmit commands from the brain to the skeletal muscles. The commands cause a muscle to contract (contract). In motor polyneuropathy, these nerves are damaged. As a result, the muscles<\/strong> in question lose strength<\/strong>. In the worst case muscle paralysis<\/strong> occurs. Muscle cramps<\/strong> are also possible.<\/p>\n In general, when tissue is insufficiently or not at all activated by the supplying nerves for a longer period of time, it degenerates: it shrinks and disappears. This happens particularly quickly in the skeletal muscles. Thus, motor polyneuropathy can lead to muscle<\/strong> atrophy in severe cases.<\/p>\n The autonomous (vegetative) nerves control the function of internal organs such as the heart, lungs, stomach, intestines, genitals and bladder. They are not subject to the will. For example, you cannot consciously command the heart muscle to contract.<\/p>\n If autonomic nerves are damaged, serious or even life-threatening symptoms can occur. For example, if intestinal nerves are damaged in a polyneuropathy, diarrhoea<\/strong> or constipation<\/strong> may occur. If the nerves that regulate bladder function are affected, urination, i.e. the emptying of the bladder, is disturbed<\/strong>. Nerve damage in the lungs can cause respiratory arrest<\/strong>. If the autonomic polyneuropathy affects nerves in the heart muscle, dangerous cardiac arrhythmia<\/strong> can result.<\/p>\n In the following table you will find important polyneuropathy symptoms at a glance:<\/p>\n <\/p>\n <\/p>\n In the case of polyneuropathy due to diabetes mellitus, the symptoms develop insidiously. The first to be damaged are usually the sensitive nerve fibres. Those affected then notice, for example, a numbness or tingling in the legs<\/strong>. Many also feel a burning pain in their feet<\/strong> (“burning feet syndrome”).<\/p>\n These polyneuropathy symptoms are particularly noticeable at rest or at night<\/strong>. Some patients say that they can barely stand the weight and touch of the blanket.<\/p>\n Diabetic polyneuropathy often leads to a reduced perception of pain. Then small injuries often go unnoticed<\/strong>. Because in many cases the blood circulation is also disturbed in diabetes, poorly healing wounds<\/strong> can develop. This usually happens on the feet (diabetic foot syndrome). The affected tissue may even die (necrosis). Most diabetics are affected by polyneuropathy on both feet or legs.<\/p>\n As the disease progresses, polyneuropathy can also spread to autonomous nerves. Possible consequences are, for example, difficulty swallowing<\/strong>, vomiting<\/strong> and alternating diarrhoea and constipation<\/strong>. Urinary incontinence<\/strong> and erectile dysfunction<\/strong> (men) can also turn out to be symptoms of polyneuropathy.<\/p>\n Alcoholic polyneuropathy is also widespread. It usually progresses slowly. Most of those affected have nerve disorders in the legs<\/strong>, both of them (symmetric polyneuropathy): pain, sensation, sensitivity disorders, muscle atrophy and severe muscle relaxation (paresis) occur. For example, the affected persons can then no longer stand properly.<\/p>\n In severe cases, polyneuropathy symptoms also develop in the eye area, such as pupil disorders<\/strong> and paralysis of the eye muscles<\/strong><\/p>\n In some cases, alcoholic polyneuropathy also proceeds without symptoms.<\/p>\n<\/section>\n Doctors now know more than 200 different causes of polyneuropathy. The most common cause of nerve damage is diabetes<\/strong> (diabetic polyneuropathy) or alcohol<\/strong> (alcoholic polyneuropathy).<\/p>\n Diabetic polyneuropathy is the most common form of polyneuropathy. It can occur in both type 1 and type 2 diabetes.<\/p>\n It is estimated that every second diabetic develops a polyneuropathy in the course of his or her life. The decisive factor is whether and how well the diabetes is treated: Diabetics whose blood sugar values are poorly adjusted fall ill particularly early and with particular severity with polyneuropathy.<\/p>\n The mechanisms by which a permanently elevated blood sugar level damages the nerves have not yet been clarified in detail.<\/p>\n In most cases, this nerve damage proceeds insidiously in diabetes patients. So the polyneuropathy symptoms are slowly developing. The nerve damage also proceeds differently with each patient. The type and severity of symptoms can therefore vary considerably.<\/p>\n The second most common trigger of polyneuropathy is alcohol, namely chronic alcohol consumption. Again, the exact mechanisms leading to the nerve damage are not yet fully understood. However, studies indicate that alcohol can directly affect the nerves. This mechanism is considered to be mainly responsible for the nerve damage in alcoholics.<\/p>\n A second factor may make matters worse: alcoholism is often associated with malnutrition. Many alcoholics have a poor and unbalanced diet. Among other things, this can lead to a lack of vitamin B12. However, this vitamin is very important for the function of the nervous system. A vitamin B12 deficiency could therefore further promote nervous disorders in alcoholics. Because even on its own it can cause polyneuropathy.<\/p>\n Other possible causes of polyneuropathy include<\/p>\n Most polyneuropathies are triggered by such diseases or poisoning. More rarely, nerve damage is genetically determined<\/strong>. There are several congenital diseases that are accompanied by polyneuropathy. These include HMSN (hereditary motor sensitive neuropathy), of which there are several subtypes.<\/p>\n In about 20 percent of all patients, the cause of polyneuropathy<\/strong> remains unexplained<\/strong>.<\/p>\n If nerve toxins such as alcohol, heavy metals or drugs damage the nerves, it is a “toxic polyneuropathy”.<\/p>\n Each nerve cell is composed of a cell body and a nerve extension (axon). The axon can be up to one meter long. One can imagine the nerve extensions like cables. The body protects its “nerve cables” with an insulating layer. This is called the myelin layer or myelin sheath. In addition to its protective function, myelin has another task: it accelerates the transmission of electrical nerve signals.<\/p>\n Depending on which part of a nerve cell is damaged, a distinction is made between demyelinating and axonal polyneuropathy:<\/p>\n Demyelinating polyneuropathy<\/strong> is characterized by the disintegration of the protective marrow layer (myelin layer). If, on the other hand, the axon itself is affected, it is an axonal polyneuropathy<\/strong>. In the case of shapes, they can also appear in combination. Then myelin sheaths and axons are equally damaged.<\/p>\n\n
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Polyneuropathy symptoms: Sensitive nerves<\/h3>\n
Polyneuropathy symptoms: Motor nerves<\/h3>\n
Polyneuropathy symptoms: Autonomic nerves<\/h3>\n
Polyneuropathy symptoms at a glance<\/h3>\n
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\n Sensitive symptoms<\/strong><\/td>\n Motor symptoms<\/strong><\/td>\n Autonomic symptoms<\/strong><\/td>\n<\/tr>\n \n Tingling, formication<\/td>\n Muscle twitching<\/td>\n Pupil disorders<\/td>\n<\/tr>\n \n Stinging<\/td>\n Muscle cramps<\/td>\n Water retention (oedema)<\/td>\n<\/tr>\n \n Furry and numb<\/td>\n Muscle weakness<\/td>\n Ulcers<\/td>\n<\/tr>\n \n Feeling of being constricted<\/td>\n Muscular atrophy<\/td>\n reduced sweating<\/td>\n<\/tr>\n \n Feelings of swelling<\/td>\n <\/td>\n Heartbeat at rest<\/td>\n<\/tr>\n \n Sense of unpleasant pressure<\/td>\n <\/td>\n Gastric paralysis (gastroparesis)<\/td>\n<\/tr>\n \n Feeling like walking on cotton wool<\/td>\n <\/td>\n Diarrhoea, constipation<\/td>\n<\/tr>\n \n Gang insecurity (especially in the dark)<\/td>\n <\/td>\n disturbed urination<\/td>\n<\/tr>\n \n lack of temperature sensation<\/td>\n <\/td>\n Impotence (Erectile Dysfunction)<\/td>\n<\/tr>\n \n painless wounds<\/td>\n <\/td>\n Dizziness \/ fainting when getting up<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n Diabetic polyneuropathy: Symptoms<\/h3>\n
Alcoholic polyneuropathy: symptoms<\/h3>\n
Polyneuropathy: causes and risk factors<\/h2>\n
Polyneuropathy in diabetes<\/h3>\n
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Polyneuropathy due to alcohol<\/h3>\n
Other causes of polyneuropathy<\/h3>\n
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Which part of the nerve cells is damaged?<\/h3>\n