Polyneuropathy: diagnosis and treatment

Polyneuropathy is a disorder of the peripheral nervous system of various causes, which is associated with muscle weakness and emotional disorders. The nervous system of the human with the brain as the highest authority serves the control and control of all body and organ functions. Basically, a distinction is made between the central nervous system and the peripheral nervous system, the former comprising all the nerve structures above the spinal cord plane including the brain, the latter all peripheral nerve fibers.

Polyneuropathy and nervous system

Like fine barking of a tree, the nerve fibers of the peripheral nervous system arise from the spinal cord and establish contact with the "executive organs" such as muscles, skin or internal organs. The information exchange takes place via control impulses directed away from the brain and information conveyed via the brain, for example by the sense organs or the skin.

But the - apparently passive - upright standing of a person requires the brain a tremendous coordination performance to vote in-depth information from sensory organs such as organ of balance, eyes or touch sensors in the skin with the control of important muscle groups especially the legs. Of course, these processes, which occur predominantly in the subconscious mind, are even more complicated in complex movement sequences.

The ability of the healthy person to function presupposes the existence of numerous, differently specialized sensors in the skin for sense of touch, heat and cold measurement or pain sensation and the transmission of the corresponding information about the nervous system. The sensory qualities just described are conducted in the nerve as well as impulses from the brain to the musculature of specific fibers.

Triggers of polyneuropathy

The individual forms of polyneuropathy represent diseases of the peripheral nervous system as a whole. The following diseases or factors are considered as triggers of polyneuropathy:

  • Diabetes mellitus
  • Immune system disorders
  • poisoning
  • alcoholism
  • vascular
  • Rheumatic diseases
  • tumors
  • kidney disease

The polyneuropathies are thus often expression or reaction of the peripheral nervous system to a disease or injury affecting the organism as a whole. Depending on which functions of the nerve are particularly affected, one speaks of sensitive, motor or mixed sensory-motor polyneuropathies.

Symptoms of polyneuropathy

On the basis of the predominantly affected nerve quality, the pattern of infestation as well as the course, very different forms of polyneuropathy are distinguished. The spectrum ranges from purely sensitive polyneuropathies with sensory disorders or skin discomfort to purely motor polyneuropathies with muscle paralysis to mixed forms of polyneuropathy.

diagnosis

An important distinguishing criterion, which also allows a better causative clarification of the disease, is the question of whether the nerve damage primarily affects the inner wiring of the nerve or rather the outer sheath, also called myelin sheath. The latter acts as "electrical isolation" and is of considerable importance for the conduction velocity of the nerve.

The diagnosis of a polyneuropathy results from the patient's symptoms, the neurological examination findings, blood tests and special examination procedures of the musculature and the peripheral nerves, which allow a differentiation of the individual polyneuropathy forms. By means of electromyography and determination of the nerve conduction velocities, damage to the "nerve isolation" of damage to the nerve fibers themselves can be delimited, which can be of diagnostic as well as therapeutic significance.

Treatment of polyneuropathy

The treatment options of the individual forms of polyneuropathy depend on the underlying cause. In immune-related polyneuropathies such as Guillain-Barré syndrome, panarteritis nodosa or rheumatoid arthritis are primarily immunosuppressant forms of therapy, for example with cortisone, azathioprine or other substances into consideration. Other alternative methods in Guillain-Barré syndrome include the administration of so-called immunoglobulins or plasmapheresis, in which damaging immune factors are washed out of the body.

For the treatment of diabetic polyneuropathy effective control of the diabetic metabolic state by weight reduction, drugs or insulin is indicated. The emotional disorders, pain and muscle spasms on the legs also react in individual cases to preparations such as carbamazepine or thioctic acid.

In the case of poisoning, the spontaneous or medicinal removal of the respective toxin from the body comes first. Alcoholism requires strict abstinence from alcohol and the administration of vitamin B1 supplements.

Polyneuropathies, which occur in the context of other underlying diseases such as kidney damage or tumors, are treated by the therapy of the underlying disease.

Polyneuropathy: prevention

There are possibilities for prevention in poisoning, partly in diabetes, but not in immune-related polyneuropathies. The corresponding principles are dealt with in the presentation of the respective underlying diseases.

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