Polyneuropathy: forms and symptoms

Polyneuropathy can have a wide variety of causes. For example, various diseases, such as diabetes mellitus, can trigger the disease of the peripheral nervous system, but also poisoning, for example, from alcohol. Depending on the form, polyneuropathy manifests itself through different symptoms. In the following, we will show you what forms and signs are typical of them.

Polyneuroradikulitis Typ Guillain-Barré

This acute form of polyneuropathy is probably based on an overreaction of the immune system directed against the body’s nerve tissue. The disease occurs in approximately 1.7 cases per 100,000 inhabitants per year. Motor nerve fibres are almost exclusively affected, so suddenly occurring muscle paralysis is the main symptom.

 

Polyneuroradiculitis: Loss of muscle reflexes

The paralysis is primarily concentrated in the pelvic girdle and shoulder area and is less pronounced in the muscles of the hands and feet. In more severe individual cases, the muscles of the face, eyes, throat and trunk can also be affected. Typically, there is a complete loss of muscle reflexes. Sensory disturbances recede into the background compared to the phenomena on the part of the muscular system.

The course of Guillain-Barré polyneuritis

Guillain-Barré polyneuritis belongs to the category of polyneuropathies associated with damage to the nerve insulation layer. Accordingly, it can also be differentiated from other forms of polyneuropathy due to the significantly reduced conduction velocities of the peripheral nerves.

About the course of the disease, an acute form, usually with a favourable healing tendency, is distinguished from a chronic form with a poorer prognosis. But even in the acute form, there is the possibility of fatal complications due to respiratory paralysis or severe cardiac arrhythmia.

Overall, the spectrum of possible manifestations ranges from only minor symptoms with easy fatigue and uncharacteristic abnormal sensations to an isolated paralysis of a muscle, for example, in the leg, to paralysis of the whole body suddenly “rising” from the legs.

 

Diabetic Polyneuropathy

Approximately 30 per cent of all polyneuropathies are due to diabetes (diabetes mellitus), whereby polyneuropathy is sometimes only a minor symptom, but in individual cases, it can also dominate the symptoms. Nerve damage is based on chronic vascular changes and circulatory disorders.

In the sensory forms of diabetic polyneuropathy, the symptoms are primarily sensory disturbances in the legs, ranging from numbness to “burning soles of the feet”. In addition, painful muscle cramps in the upper and lower leg or general dull pain in the lumbar, groin and thigh area that is increased when lying down can also occur.

If motor nerve fibres are affected, paralysis of the pelvic and shoulder girdle muscles, and sometimes the hands and feet, can also occur. All degrees of severity can be found, from early fatigue of the muscles to severe paralysis with muscle cramps. In some cases, the muscles of the face and eyes can also be affected.

If polyneuropathy also affects the vegetative nervous system fibres, perspiration and cardiovascular function disturbances can result. The extent of diabetic polyneuropathy is often not directly related to the severity of the diabetes. The course of the disease is either insidious with a very gradual increase in symptoms or acute, especially in those forms that are associated with muscle paralysis in the pelvic girdle area.

Alcoholic polyneuropathy

Alcohol-related polyneuropathy is either an expression of the direct toxic effect of alcohol on nerve tissue or a consequence of malnutrition and undernourishment, which often occurs in alcoholics. The symptoms range from slight sensory disturbances or abnormal sensations, mainly in the feet and legs, to severe pain, calf cramps and sometimes muscle paralysis.

Paralysis of the peroneal nerve, which runs on the outside of the lower leg and is responsible for the extensor muscles of the forefoot, is particularly characteristic of alcohol polyneuropathy. As a result, the forefoot and toes can no longer be actively lifted, which usually leads to a one-sided conspicuous gait pattern.

With strict abstinence from alcohol, normalization of eating habits, and, above all, the intake of vitamins ( vitamin B1 ), the neurological deficits and symptoms of alcohol polyneuropathy usually regress entirely or partially.

lead polyneuropathy

A unique form of polyneuropathy occurs in chronic lead poisoning. There is a particular risk of workers in accumulator factories or people who come into professional or private contact with red lead or paints containing lead, inhaling or inhaling toxic amounts of lead through the gastrointestinal tract. With chronic poisoning, patients complain of:

• headache
• loss of appetite
• fatigue
• intestinal constipation
• Intestinal colic

Your skin is pale to yellowish grey.

The polyneuropathy is characterized by paralysis of the extensor muscles in the hands and, more rarely, in the legs. Under certain circumstances, however, paralysis and muscle atrophy in the area of ​​the thumb and ball of the little finger or functional disorders in those muscles responsible for spreading the fingers and toes can also occur. Sensitivity is usually less disturbed than motor function, and no pain exists. Hearing loss and vision problems can also be symptoms of lead polyneuropathy.

The nerve damage is reversible after eliminating the overconcentration of lead and leaves only minor functional limitations in the muscles.

 

Thallium-Polyneuropathie

Thallium poisoning mainly occurs after ingestion of specific rat or mouse poisons. General symptoms of poisoning include insomnia, increased salivation, tachycardia, and hair loss. The resulting polyneuropathy is accompanied by paraesthesia and sometimes severe pain in the feet and hands.

Hypersensitivity of the soles of the feet is very characteristic, with even the slightest touch triggering unbearable pain. In addition, paralysis descending from the pelvic girdle area mus,cle weakness, and sensory disturbances in the facial area can occur. Even after the thallium has been eliminated from the body, the neurological deficits of thallium polyneuropathy can partially persist.

Arsenic polyneuropathy

The rare arsenic poisoning can also damage the peripheral nervous system in the sense of polyneuropathy. Like thallium poisoning, there are unpleasant sensations and pain in the hands and feet. However, in contrast to thallium polyneuropathy, the symptoms of paralysis are more concentrated in the hand and foot region than in the pelvis and shoulder girdle. A complete regression of the neurological deficits usually does not occur.

Polyneuropathy in immune disorders of the vascular system

A unique form of immune-related vascular disease, panarteritis nodosa, often occurs in combination with polyneuropathy. Like all other organ symptoms of the disease, polyneuropathy can be explained as an expression of circulatory disorders in the peripheral nervous system. The first symptoms are often sensory irritations such as severe muscle and nerve pain. As the disease progresses, muscle paralysis and muscle atrophy occur.

 

Polyneuropathy in rheumatoid arthritis

During rheumatoid arthritis, symptoms can also appear primarily due to disturbances in the blood flow to the peripheral nervous system. The symptoms range from sensory or motor failures in the supply area of ​​individual nerves (e.g. on the hands) to isolated sensory disturbances in the fingers without thumb involvement to acute pain and discomfort in the legs with subsequent symptoms of paralysis.

The prognosis of this polyneuropathy is less favourable in the combined involvement of the sensory and motor nervous systems than in the case of pure sensory disturbances.