What is Polyneuropathy?
Damage to multiple peripheral nerves is called polyneuropathy. Polyneuropathy in the nerves that transmit information between the central nerve and other parts of the body is also known as peripheral neuropathy. In polyneuropathy, multiple nerves are damaged at the same time, affecting the nerves responsible for movement and emotions. Polyneuropathy is often the result of diseases such as cancer, diabetes and autoimmune diseases.
Types of Polyneuropathy
Polyneuropathy is divided into three types depending on the rate of development.
Acute Polyneuropathy
In the rare acute polyneuropathy, the disease progresses rapidly. It is usually caused by autoimmune diseases or infection. They can be treated in a short time. Acute polyneuropathy is often seen in people with Gullian Barre syndrome, a fatal autoimmune disease.
Chronic Polyneuropathy
A type of polyneuropathy caused by diseases such as kidney disease or diabetes. Symptoms appear gradually and slowly. In addition, chronic polyneuropathy can be caused by many factors. Finding the underlying cause can therefore be challenging.
Multiple Polyneuropathy
In this type of polyneuropathy, at least two peripheral nerve regions are affected. Diseases that cause this type include inflammation of the blood vessels, sarcoidosis and some types of cancer.
Symptoms of Polyneuropathy
- Dizziness
- Difficulty walking,
- Difficulty eating and swallowing,
- Difficulty breathing,
- Abnormalities in blood pressure and pulse,
- Digestive system problems,
- Bladder problems
- Excessive sweating,
- Inability to tolerate heat,
- Leg and foot ulcers,
- Skin and nail infections,
- Falling attacks,
- Lack of coordination,
- Muscle weakness,
- Muscle twitching
- Weakness in perceiving temperature changes,
- Burning and stabbing pain,
- Feeling freezing pain,
- Hypersensitivity to touch,
- Sleep problems due to night pain,
- Difficulty using arms, legs, hands and feet,
- Numbness,
- Do not feel pain,
- Tingling and pins and needles,
Causes of Polyneuropathy
The main cause of polyneuropathy is damage to peripheral nerves. The causes of damage to peripheral nerves are as follows.
Diabetes
Failure to control blood sugar by insulin can lead to polyneuropathy. In particular, it occurs in one out of every 5 patients with type 2 diabetes.
Excessive Alcohol Consumption
Peripheral nerve damage is caused by excessive alcohol consumption as well as an unbalanced diet.
Autoimmune Diseases
Autoimmune diseases such as Sjögren's, lupus, Guillain Barre syndrome, celiac disease and rheumatoid arthritis cause damage to peripheral nerves.
Bacterial and Viral Infections
In addition to diseases such as hepatitis B, hepatitis C, Lyme disease, shingles, some viral and bacterial infections are among the most common causes of neuropathy.
Bone Marrow Disorders
Some bone marrow cancers can also cause neuropathy because they cause abnormal increases in protein levels in the blood.
Inherited Disorders
Some inherited disorders, such as Charcot Marie Tooth disease, can contribute to the development of neuropathy.
Medicines
Chemotherapy and some drugs used in HIV treatment cause neuropathy.
Liver and Kidney Diseases
Studies show that neuropathy develops in approximately half of kidney patients. Neuropathy is also common in patients with liver disease.
Malnutrition
Inadequate nutrition in terms of vitamin E and especially vitamins B1, B6 and B12 can damage the nerves. This leads to neuropathy.
Injuries and Traumas
Peripheral nerve damage can be seen in post-traumatic injuries with repetitive movements such as writing.
Toxins
Exposure to chemicals such as arsenic and mercury, abuse of drugs and chemicals are also causes of polyneuropathy.
Hypothyroidism
Underactive thyroid glands, although rare, can cause damage to the peripheral nervous system.
How is polyneuropathy diagnosed?
The diagnosis of polyneuropathy is based primarily on the history of the patients. A detailed physical and neurological examination is also performed. Some tests are used to check muscle strength, reflexes, coordination and posture.
MRI and CT Scans
These imaging methods are used to identify factors such as tumors or hernias that may cause nerve damage.
Electro Diagnostic Tests
With these tests, electrical activity in both muscles and nerves can be measured. With the electromyography method used, it is possible to measure the nerve conduction velocity. These tests help to detect damage to the nerves.
Biopsies
A nerve or skin sample can be taken to detect abnormalities in the nerve or nerve endings.
Treatment of Polyneuropathy
In order to treat polyneuropathy, the causative disease must first be treated. In addition, vitamins and minerals that are deficient in the body due to nutrition are also supplemented.
Medication Therapy
The drugs used in the treatment of neuropathy differ according to the underlying cause. Medication is also used to alleviate the symptoms of polyneuropathy. The drug groups used in treatment are as follows.
- Painkillers
- Insulin-containing drugs if caused by hypothyroidism,
- TCA group antidepressants and duloxetine,
- SNRI drugs
- Some seizure medications,
Transcutaneous Electrical Nerve Stimulation
This treatment method, which sends a soft electric current into the skin, relieves the pain felt by the patients.
Plasma Exchange
It is a method used especially in polyneuropathy caused by autoimmune and inflammatory diseases. In this method, the patients' blood is removed from the body and cleansed of antibodies and protein. The blood is then returned to the body.
Immunoglobulin Therapy
It is one of the treatment methods used to control antibody and high protein levels and regulate the immune system.
Polyneuropathic Physical Therapy
Physical therapy methods are used to relieve muscle weakness and incoordination. In this way, these complaints of patients are reduced.
Treatment with Orthotics and Devices
Some medical devices such as splints, wheelchairs or braces provide relief, especially for the legs, arms and hands.
Complementary Therapies
Some methods such as meditation, acupuncture and massage relieve patients' pain.
Tips for Polyneuropathy Patients
- Caffeine consumption should be limited.
- It is necessary to avoid a stressful life.
- Daily walks and activities such as yoga and meditation help both muscles and patients to relax.
- Problems such as anxiety or depression need to be treated as soon as possible.
- Consuming foods that contain plenty of elements such as iron, calcium, folic acid and magnesium helps to strengthen muscles.
- If a vegetarian or vegan diet is followed, B12 supplements should be used.
- It is necessary to eat a diet rich in vitamins and minerals,
- A balanced diet is essential to strengthen the immune system,
- Alcohol and smoking should be stopped.
- Physical therapy sessions should be followed regularly and exercises should not be interrupted.
