Polyneuropathy

Polyneuropathy accounts for the greatest number of Peripheral Neuropathy cases. It occurs when many peripheral nerves throughout the body malfunction at the same time. Polyneuropathy can have a wide variety of causes, including exposure to certain toxins, poor nutrition (particularly vitamin B deficiency), and complications from diseases such as cancer or kidney failure.

One of the most common forms of chronic Polyneuropathy is diabetic Neuropathy, a condition that occurs in people with diabetes. It is the result of poorly controlled blood sugar levels. Though less common, diabetes can also cause Mononeuropathy, often characterized by weakness of the eye or of the thigh muscles.

Because people with chronic polyneuropathy often lose their ability to sense temperature and pain, they can burn themselves and develop open sores as the result of injury or prolonged pressure. If the nerves serving the organs are involved, diarrhea or constipation may result, as well as loss of bowel or bladder control. Sexual dysfunction and abnormally low blood pressure also can occur.

Joints are particularly vulnerable to stress in people with polyneuropathy because they are often insensitive to pain.

One of the most serious polyneuropathies is Guillain-Barre syndrome, a rare disease that strikes suddenly when the body’s immune system attacks nerves in the body. Symptoms tend to appear quickly and worsen rapidly, sometimes leading to paralysis. Early symptoms include weakness, tingling, and loss of sensation in the legs that eventually spreads to the arms. Blood pressure problems, heart rhythm problems, and breathing difficulty may occur in critical cases. However, despite the severity of the disease, recovery rates are good when patients receive treatment early.

Symptoms

  • Tingling
  • Numbness
  • Loss of sensation in the arms and legs

Symmetrical weakness that usually affects the lower limbs first, and rapidly progresses in an ascending fashion. Patients generally notice weakness in their legs, manifesting as “rubbery legs” or legs that tend to buckle, with or without dysesthesias (numbness or tingling). As the weakness progresses upward, usually over periods of hours to days, the arms and facial muscles also become affected. Frequently, the lower cranial nerves may be affected, leading to bulbar weakness, oropharyngeal dysphagia (drooling, or difficulty swallowing and/or maintaining an open airway) and respiratory difficulties. Facial weakness is also common.

Resources

  • http://www.hopkinsmedicine.org/neurology_neurosurgery/specialty_areas/peripheral_nerve/conditions/idiopathic_polyneuropathy.html
  • Andrade C (1952). “A peculiar form of peripheral neuropathy; familiar atypical generalized amyloidosis with special involvement of the peripheral nerves”. Brain : a journal of neurology 75: 408–27. doi:10.1093/brain/75.3.408. PMID 12978172.
  • Coelho T (1996). “Familial amyloid polyneuropathy: new developments in genetics and treatment”. Current
  • opinion in neurology 9 (5): 355–9. doi:10.1097/00019052-199610000-00007. PMID 8894411.
  • ^ D. Gaist; U. Jeppesen; M. Andersen; L. A. García Rodríguez; J. Hallas; S. H. Sindrup (2002). “Statins and risk of polyneuropathy – A case-control study”. Neurology (American Academy of Neurology) 58 (9): 1333–1337. doi:10.1212/WNL.58.9.1333. PMID 12011277. Retrieved 2009-10-06.

Treatments

If possible, treatment focuses on the underlying disease. Further, pain medications may be given and physical therapy is used to retain muscle function. Vyndaqel or Tafamidis is a European Medicines Agency approved drug for the treatment of familial amyloid polyneuropathy caused by transthyretin amyloisis.

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