Polyneuropathy: forms and symptoms
This acute form of polyneuropathy is probably due to an overreaction of the immune system, which is directed against the body’s own nervous system. The disease occurs in approximately 1.7 cases per 100,000 inhabitants per year. Almost exclusively, motor nerve fibres are affected, so that, as a result of the symptoms, suddenly occurring muscular paralyzes is in the foreground.
Polyneuroradiculitis: loss of muscle reflexes
The paralyzes mainly concentrate on the pelvic belt and shoulder area and are less pronounced on the hand and foot muscles. In severe cases, facial, eye, pharynx and trunk muscles may also be affected. Typically, there is a complete loss of muscle reflexes. Emotional disturbances are clearly in the background compared with the phenomena on the part of the muscle system.
Course of polyneuritis
Polyneuritis Guillain-Barré belongs to the category of polyneuropathies, which are associated with damage to the nerve insulation layer. Accordingly, it can also be distinguished from other forms of polyneuropathy due to the markedly reduced conduction velocities of the peripheral nerves.
In the course of the disease, an acute form, with a favourable tendency to cure, is distinguished from a chronic form with a poorer prognosis. However, even in the case of the acute form, the possibility exists of fatal complications due to respiratory paralysis or severe cardiac arrhythmias. Overall, the spectrum of possible manifestations ranges from only minor symptoms with slight fatigue and uncharacteristic insensitivity to a seemingly isolated paralysis of a muscle, for example, on the leg up to suddenly “ascending” paralyzes of the whole body from the legs.
Approximately 30 percent of all neuropathies are diabetes due (diabetes mellitus), wherein the polyneuropathy is sometimes only a subordinate symptom, in individual cases, however, may dominate the clinical picture. The basis for nerve damage is chronic vascular changes and circulatory disorders.
In the case of the sensory forms of diabetic polyneuropathy, symptoms of the legs are predominant in the symptoms, ranging from sensationlessness to the image of the “burning soles of the feet”. In addition, painful muscle cramps in the upper and lower limbs or generally dull, lying in the increased pain in the lumbar, groin and thigh areas can be added.
In the case of motor nerve fibres, paralysis of the pelvic and shoulder-belt musculature, sometimes of the hands and feet, may occur. We find all the severity of early fatigue of the muscles, to severe paralysis with muscle contractions. In some cases, the facial and eye muscles may also be affected.
If the polyneuropathy also affects fibres of the vegetative nervous system, disturbances of the sweat secretion, as well as the cardiac circulatory function, can result. The extent of diabetic polyneuropathy is often not directly related to the severity of the disease. The course of the disease is either creeping with a gradual increase in the symptoms or acute, especially in those forms associated with muscular paralysis in the pelvic region.
The alcohol-induced polyneuropathy is either an expression of the direct toxic effect of the alcohol on nervous tissue or the consequence of deficiency and malnutrition, which is often found in alcoholics. The complaints range from only slight emotional disturbances or dysfunctions predominantly on the feet and legs to more severe pain, calf cramps and, in some cases, also muscle paralysis.
Particularly characteristic of the alcohol polyneuropathy is the paralysis of the peroneal nerve, which runs on the outer side of the lower limb and is responsible for the extensor muscle of the forefoot. As a result, forefoot and toes can no longer be actively raised, which usually leads to a one-sided conspicuous pattern. In the case of severe alcohol abstinence, normalization of dietary habits, and above all the vitamin intake (vitamin B1), the neurological deficits and symptoms of alcohol polyneuropathy usually recede completely or in part.
A special form of polyneuropathy occurs in chronic lead poisoning. Particularly with workers in accumulator factories or persons who come into contact with paints or lead-containing paints professionally or privately, there is the risk of ingesting toxic amounts of lead by inhalation or via the gastrointestinal tract. In chronic poisoning, patients complain of:
- a headache
- intestinal colic
Your skin is pale to greyish-yellow.
Polyneuropathy is characterized by a paralysis of the stretching musculature on the hands, and more often by the legs. However, it may also lead to paralysis and muscle wasting in the area of the thumb and small finger balls or functional disorders in the area of those muscles which are responsible for spreading the fingers and toes. The sensitivity is usually less disturbed than the motor, pain does not occur. Hearing loss and visual disturbances can also be symptoms of a lead polyneuropathy.
The nerve damage is reversible after excretion of the overconcentration of lead and leaves only small functional restrictions on the musculature.
Thallium poisoning occurs mainly after oral intake of certain rat or mouse poisons. General symptoms of the poisoning are insomnia, increased salivary flow, heart rash and hair loss. The resulting polyneuropathy is accompanied by dyslexia and sometimes severe pain in the feet and hands.
Very characteristic is an insensitivity of the soles of the feet, whereby even the slightest touch can cause unbearable pain. In addition, the pelvic region may experience decreasing paralysis as well as muscle weakness and emotions in the facial region. Even after excretion of the thallium from the body, the neurological failures of the thallium polyneuropathy may persist.
The rare arsenic poisoning can also damage the peripheral nervous system in the sense of a polyneuropathy. Analogous to the thallium poisoning, there are unpleasant emotions and pain in the hands and feet. In contrast to thallium polyneuropathy, the symptoms of paralysis are more concentrated on the hand and foot region than on the pelvic and shoulder girdles. A complete reconstruction of the neurological failures is usually not.
Polyneuropathy in immune diseases of the vascular system
Particularly a special form of the immune-conditioned vascular diseases, the panarteriitis nodosa, often occurs in combination with polyneuropathy. Like all other organ symptoms of the disease, polyneuropathy is the expression of circulatory disorders in the peripheral nervous system. The first symptom is often sensitive reactions such as violent muscle and nerve pain. As a result, muscle paralysis and muscular atrophy occur.
Polyneuropathy in rheumatoid arthritis
In the course of rheumatoid arthritis, symptoms can also arise, which are primarily due to disturbances in the blood flow of the peripheral nervous system. The complaints range from sensory or motor deficiencies in the supply area of individual nerves (for example, in the hands) via isolated sensory disturbances of the fingers without the involvement of the thumb up to acute occurring pain and insensitivity to the legs with subsequent paralysis phenomena.
The prognosis of this polyneuropathy is less favourable in combination with the infestation of the sensitive and motor nervous system than in the case of pure emotional disturbances.