What is it about ?
The prefix “poly” means “a lot”, and the term ” neuropathy »Refers to a disease of the nervous tissue (the nerves are responsible for controlling muscles and sensation). Polyneuropathy therefore means that nerves are affected in several places in the body.
We distinguish four major groups:
- Toxic neuropathies are caused by all kinds of toxins, such as alcohol, heavy metals (eg arsenic, lead, mercury, thallium, gold), solvents (eg hexane, acrylamide, carbon disulfide, organophosphates) and medications (eg cancer drugs, certain antibiotics, drugs for heart rhythm disturbances).
- Metabolic neuropathies are the result of metabolic disorders. The most well-known cause of metabolic neuropathy is diabetes, but kidney failure, certain vitamin deficiencies (especially vitamin B12), an underactive thyroid (hypothyroidism) and some cancers can also trigger the condition.
- Hereditary neuropathy (Charcot-Marie-Tooth disease) mostly affects the nerves in the ankle region.
- Polyneuropathies associated with immunological disorders (conditions that affect the immune system). The cause is an infection (for example Lyme borreliosis, AIDS, Meadow) or the production of antibodies affecting the nervous tissue per se (as in the case of Guillain-Barré syndrome and some systemic diseases).
In approximately 25% of cases, even after careful examination, the cause of the problem cannot be found.
What is their frequency?
In Belgium, a polyneuropathy is diagnosed in 1.91 men out of 1000 per year. For women, this proportion rises to 2.06 per 1,000.
How to recognize it?
Symptoms mostly occur in the arms and legs. The nerves regulate sensation (sensory nerves) and ensure the strength and mobility of muscles (motor nerves).
Because polyneuropathy is a disorder that affects either the sensory nerves only (sensory nerves), or only the movement nerves (motor nerves), or both types of nerves, symptoms can be both motor and sensory. The patient can therefore present sensory disturbances (sensory symptoms): numbness, tingling, changing sensation, hypersensitivity, irritation and even pain. The pain can vary from a shooting pain to a throbbing pain and needle sticking. Cramping, muscle atrophy, and muscle weakness are signs that may suggest damage to motor nerves. It is expressed through a decrease in strength and can even lead to paralysis.
In people with polyneuropathy that affects both types of nervous tissue, it is primarily the loss of fine motor skills that is noticeable at first. In this case, the person has difficulty picking up something small from the ground or getting a thread through a needle. Over time, large muscles also begin to break down. A good example of this muscular degradation is the “drop foot”: it is no longer possible to unroll the foot, which strikes against the ground. Due to the decrease in strength in the hands, the person is no longer able to open a bottle, for example.
How is the diagnosis made?
The diagnosis usually stems from the nature of the symptoms. But finding a cause is not easy. The doctor will start by asking you a series of questions: Do you have diabetes? Do you drink alcohol regularly? Do you come into contact with toxic substances at work? What medications do you take ? Are you on a special diet?
One will follow neurological examination. During this examination, the doctor tests your strength, your reflexes and your sensations.
Finally, a routine blood test is carried out with determination of blood sugar levels, kidney function and vitamin B12 content.
If all these exams do not clarify the problem, you will be referred to a neurologist for further examinations.
What can you do ?
Stop drinking alcohol. If you have diabetes, it is very important that your blood sugar levels are properly regulated. If necessary, your diet and medications should be adjusted. Vitamin B12 deficiency is common among convinced vegans. Vitamin B12 is found mostly in meat, eggs and dairy products. In the event of occupational exposure to toxic substances, you will have to temporarily stop your activities. Adopt workplace safety measures, such as wearing suitable clothing and a mask.
What can your doctor do?
Treatment depends on the underlying cause. Treatment should be optimized in case of diabetes. In case of vitamin B12 deficiency which cannot be controlled by diet, medication or monthly vitamin B12 injections may be prescribed. Neuralgia is treated with carbamazepine, gabapentin, or certain antidepressants. The dose is gradually increased. Unfortunately, neuralgia is a difficult type of pain to treat because there are not many medications that can really relieve it.
Want to know more?
www.mongeneraliste.be/maladies/nevrites-neuropathies-nerfs
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