Table of ContentsView AllTable of ContentsTypesCausesSymptomsRisk FactorsDiagnosisTreatmentOutlookFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Types
Causes
Symptoms
Risk Factors
Diagnosis
Treatment
Outlook
Frequently Asked Questions
The types of conditions that cause polyneuropathy often harmperipheral nervesthroughout the body, causing symptoms such as pain, decreased sensation, and weakness. Treatments can include medication to prevent nerve damage, physical therapy, and pain medications.
Depending on how soon it is diagnosed and treated, the nerve damage of polyneuropathy can often be slowed down with treatment. This article will explore the types of polyneuropathy, causes, associated conditions, risk factors, symptoms, diagnosis, and treatment.
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Polyneuropathy Types
Polyneuropathies are either acute or chronic. Acute polyneuropathies develop over the course of days or weeks and can cause serious health risks. Chronic polyneuropathies might not always cause noticeable symptoms at first, but they can be distressing and irreversible when they finally are experienced.
They can be described as:
Polyneuropathy Causes
Polyneuropathy affects the peripheral nerves, which are the nerves that control the movement of the arms and legs. It occurs due to peripheral nerve damage ordemyelination—damage to the myelin sheath—of the peripheral nerves.Myelinis a fatty covering that helps insulate nerves, allowing them to function efficiently.
Sometimes, demyelination can be reversible because the body naturally regenerates myelin. Nerve damage is not reversible because nerves do not heal. Generally, peripheral nerve demyelination occurs before nerve damage, but this is not always the case.
The different causes of polyneuropathy include:
Diabetic neuropathy: High blood glucose can cause changes in the body that lead to nerve damage, potentially affecting the nerves in the distal (farthest from the center of the body) extremities and nerves of thegastrointestinal system.
Neuropathy of chronic illness: Many people who have serious illnesses, like heart disease,kidney disease, gastrointestinal disease, or lung disease, may develop polyneuropathy that progresses slowly. Factors like nutritional deficiencies, chronic oxygen deprivation, and taking multiple medications can all contribute to this.
ICU neuropathy: Also called critical illness neuropathy, this condition can develop rapidly. It is associated with several contributing factors, including malnutrition, inflammation, metabolic abnormalities, infections, and medication toxicity.
Metabolic neuropathy: Metabolic changes, such as low or high sodium, potassium, magnesium, or calcium levels, may affect the way the nerves function, leading to symptoms of polyneuropathy.
Medication: Some medications, especially chemotherapy, are associated with this side effect. Some medications directly attack the nerves, and some may cause nutritional or metabolic effects that lead to nerve damage.
One such paraneoplastic syndrome is calledpolyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS syndrome).
Thyroid disease: Bothhypothyroidism (low thyroid hormone function) and hyperthyroidism (excessive thyroid hormone function)have been associated with polyneuropathy.
Inflammatory: Inflammation that may damage nerves can occur in association with medical conditions, such as diabetes.And inflammation can also occur in response to infections or without another identifiable cause.
Autoimmune: Autoimmune disease, such assystemic lupus erythematosus (SLE), may be associated with an increased likelihood of polyneuropathy.
Infections: Sometimes viral infections, including human immunodeficiency virus (HIV) infection, can cause polyneuropathy.
People who have GBS need intensive medical care, which includes immune suppression therapy and possibly respiratory support.Miller Fisher syndromeis a subtype of GBS.
Chronic inflammatory demyelinating polyneuropathy (CIDP): This condition is similar to GBS, but it is recurrent and chronic. The weakness of CIDP is not usually as severe as the weakness of GBS. Treatment can involve immune suppression therapy.
Compressive: Sometimes physical pressure can cause damage to multiple nerves. This may occur as a result of things like spine disease or inflammation.
The symptoms of polyneuropathy affect more than one limb (arm or leg). Generally, distal nerves, which are located in the fingers, toes, hands, and feet, are involved more severely than proximal nerves of the upper arms and thighs. The effects are usually almost symmetrical.
The symptoms also can involve nerves in the face. Sometimes, physical functions, digesting food and breathing, can be affected as well.
Symptoms of polyneuropathy can include:
ComplicationsSometimes complications of polyneuropathy can be serious. This may include severe difficulty walking, wounds,sores, injuries, or infections of the extremities.
Complications
Sometimes complications of polyneuropathy can be serious. This may include severe difficulty walking, wounds,sores, injuries, or infections of the extremities.
Certain underlying conditions are known to cause polyneuropathy. Uncontrolled diabetes and chronic alcohol overuse are the most common. Sometimes people who have well-controlled diabetes are at increased risk as well.
Some chemotherapeutics and other medications are known to cause this side effect. And living with inflammatory or autoimmune diseases can increase the risk as well.
Nutritional causes of polyneuropathy can be more likely in people who do not get enough nutrients in the diet. Additionally,malabsorptionissues due to digestive diseases or intestinal or stomach surgery can interfere with proper nutrient absorption.
The diagnosis of polyneuropathy involves a medical history, physical examination, sometimes electrical nerve tests or blood tests, and, rarely, a biopsy.
The key feature of a physical examination include diminished reflexes, which generally affect nerves farther from the center of the body.Decreased sensation is often also detected.
During the sensory portion of your physical examination, you can expect your healthcare provider to examine your ability to feel pain, light touch, position changes, temperature, and vibration. With polyneuropathy, one or more of these sensations is usually diminished in the fingers and toes. It may improve as the testing moves up the arms or legs.
You may also be slightly weak and have trouble walking. Sometimes, with chronic polyneuropathy, muscle tone is decreased, resulting in floppiness, and themuscles can be atrophied (shrunk)as well.
Diagnostic tests may include:
Differential DiagnosisSimilar conditions that will need to be ruled out include:Myopathy(muscle disease) usually causes proximal weakness (closer to the center of the body).Radiculopathyis spinal nerve compression. It can affect multiple nerves, usually proximally and distally.Claudicationis a type of leg pain with walking that usually occurs due to vascular disease orspine disease
Differential Diagnosis
Similar conditions that will need to be ruled out include:Myopathy(muscle disease) usually causes proximal weakness (closer to the center of the body).Radiculopathyis spinal nerve compression. It can affect multiple nerves, usually proximally and distally.Claudicationis a type of leg pain with walking that usually occurs due to vascular disease orspine disease
Similar conditions that will need to be ruled out include:
There are treatments for some of the discomfort and painful symptoms of polyneuropathy. Additionally, medical interventions can sometimes help prevent the condition from progressing. Most people who have polyneuropathy would benefit from exercise and physical therapy:
Often, physical therapy and exercises can help alleviate discomfort. This is also important to avoid atrophy and to maximize strength as much as possible.
Topical Creams for Neuropathy
Managing complications can improve overall health and outcome. This can include checking the extremities for visible signs of wounds or injuries on a daily basis and making sure that all wounds are clean and properly taken care of to prevent an infection.
Summary
Polyneuropathy is a medical condition that affects nerves throughout the body. This typically occurs due to a systemic (whole-body) illness like diabetes or alcohol-related disease. There are many causes of polyneuropathy, and diagnosis of the cause is important for preventing the progression of the nerve damage.
Polyneuropathy can cause pain, diminished sensation, and weakness. Treatments can alleviate discomfort but cannot repair sensory loss of weakness. Physical therapy and medical interventions can help maximize abilities and prevent complications.
Some types of polyneuropathies are curable. This includes Guillain-Barré syndrome or inflammatory polyneuropathy from immune-mediated diseases or infections.Most types of polyneuropathies are not curable if nerve damage has occurred, but symptoms of pain and discomfort can be alleviated with medication. Weakness and loss of sensation from nerve damage usually cannot be restored.
Some types of polyneuropathies are curable. This includes Guillain-Barré syndrome or inflammatory polyneuropathy from immune-mediated diseases or infections.
Most types of polyneuropathies are not curable if nerve damage has occurred, but symptoms of pain and discomfort can be alleviated with medication. Weakness and loss of sensation from nerve damage usually cannot be restored.
In general, polyneuropathy is a chronic progressive condition that typically is not fatal, and you can live with it for many years.Guillain-Barré syndrome is a type of acutely progressive polyneuropathy that can be fatal because it affects the muscles that control breathing. With anti-inflammatory treatment and respiratory support, most people can recover from this condition.Learn MoreTreatment and recovery of GBS
In general, polyneuropathy is a chronic progressive condition that typically is not fatal, and you can live with it for many years.Guillain-Barré syndrome is a type of acutely progressive polyneuropathy that can be fatal because it affects the muscles that control breathing. With anti-inflammatory treatment and respiratory support, most people can recover from this condition.
In general, polyneuropathy is a chronic progressive condition that typically is not fatal, and you can live with it for many years.
Guillain-Barré syndrome is a type of acutely progressive polyneuropathy that can be fatal because it affects the muscles that control breathing. With anti-inflammatory treatment and respiratory support, most people can recover from this condition.
Learn MoreTreatment and recovery of GBS
Some of the symptoms of neuropathy—pain, discomfort, sensations of tingling and burning—may be more noticeable at night when you are trying to sleep.
4 Neuropathy Types and How to Treat Them
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Asadi S, Aminianfar A, Shiva F, Asadi S, Yarizadeh H, Qorbani M, Mirzaei K.Association between dietary inflammatory index scores and diabetes sensorimotor polyneuropathy in patients with type 2 diabetes mellitus: A case-control study.Evid Based Complement Alternat Med.2022;2022:2661649. doi:10.1155/2022/2661649Bell DSH.Metformin-induced vitamin B12 deficiency can cause or worsen distal symmetrical, autonomic and cardiac neuropathy in the patient with diabetes.Diabetes Obes Metab.2022 May 2. doi:10.1111/dom.14734Isfort M, McVerry BJ, Shutter L, Kim M, Lacomis D.Perceived utility of electrodiagnostic testing in critical illness myopathy and polyneuropathy: A survey of intensive care unit providers.Muscle Nerve.2022 Apr 25. doi:10.1002/mus.27561Kim YR.Update on the POEMS syndrome.Blood Res. 2022;57(S1):27-31. doi:10.5045/br.2022.2022001Huang Y, Ying Z, Chen Z, et al.Thyroid hormone level is associated with the frequency and severity of Guillain-Barré syndrome.Int J Neurosci.2017;127(10):893-899. doi:10.1080/00207454.2016.1278541van Veen R, Wieske L, Lucke I, et al.Assessing deterioration using impairment and functional outcome measures in chronic inflammatory demyelinating polyneuropathy: a post-hoc analysis of the IOC trial.J Peripher Nerv Syst.2022 May 4. doi:10.1111/jns.12497
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Asadi S, Aminianfar A, Shiva F, Asadi S, Yarizadeh H, Qorbani M, Mirzaei K.Association between dietary inflammatory index scores and diabetes sensorimotor polyneuropathy in patients with type 2 diabetes mellitus: A case-control study.Evid Based Complement Alternat Med.2022;2022:2661649. doi:10.1155/2022/2661649Bell DSH.Metformin-induced vitamin B12 deficiency can cause or worsen distal symmetrical, autonomic and cardiac neuropathy in the patient with diabetes.Diabetes Obes Metab.2022 May 2. doi:10.1111/dom.14734Isfort M, McVerry BJ, Shutter L, Kim M, Lacomis D.Perceived utility of electrodiagnostic testing in critical illness myopathy and polyneuropathy: A survey of intensive care unit providers.Muscle Nerve.2022 Apr 25. doi:10.1002/mus.27561Kim YR.Update on the POEMS syndrome.Blood Res. 2022;57(S1):27-31. doi:10.5045/br.2022.2022001Huang Y, Ying Z, Chen Z, et al.Thyroid hormone level is associated with the frequency and severity of Guillain-Barré syndrome.Int J Neurosci.2017;127(10):893-899. doi:10.1080/00207454.2016.1278541van Veen R, Wieske L, Lucke I, et al.Assessing deterioration using impairment and functional outcome measures in chronic inflammatory demyelinating polyneuropathy: a post-hoc analysis of the IOC trial.J Peripher Nerv Syst.2022 May 4. doi:10.1111/jns.12497
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Asadi S, Aminianfar A, Shiva F, Asadi S, Yarizadeh H, Qorbani M, Mirzaei K.Association between dietary inflammatory index scores and diabetes sensorimotor polyneuropathy in patients with type 2 diabetes mellitus: A case-control study.Evid Based Complement Alternat Med.2022;2022:2661649. doi:10.1155/2022/2661649Bell DSH.Metformin-induced vitamin B12 deficiency can cause or worsen distal symmetrical, autonomic and cardiac neuropathy in the patient with diabetes.Diabetes Obes Metab.2022 May 2. doi:10.1111/dom.14734Isfort M, McVerry BJ, Shutter L, Kim M, Lacomis D.Perceived utility of electrodiagnostic testing in critical illness myopathy and polyneuropathy: A survey of intensive care unit providers.Muscle Nerve.2022 Apr 25. doi:10.1002/mus.27561Kim YR.Update on the POEMS syndrome.Blood Res. 2022;57(S1):27-31. doi:10.5045/br.2022.2022001Huang Y, Ying Z, Chen Z, et al.Thyroid hormone level is associated with the frequency and severity of Guillain-Barré syndrome.Int J Neurosci.2017;127(10):893-899. doi:10.1080/00207454.2016.1278541van Veen R, Wieske L, Lucke I, et al.Assessing deterioration using impairment and functional outcome measures in chronic inflammatory demyelinating polyneuropathy: a post-hoc analysis of the IOC trial.J Peripher Nerv Syst.2022 May 4. doi:10.1111/jns.12497
Asadi S, Aminianfar A, Shiva F, Asadi S, Yarizadeh H, Qorbani M, Mirzaei K.Association between dietary inflammatory index scores and diabetes sensorimotor polyneuropathy in patients with type 2 diabetes mellitus: A case-control study.Evid Based Complement Alternat Med.2022;2022:2661649. doi:10.1155/2022/2661649
Bell DSH.Metformin-induced vitamin B12 deficiency can cause or worsen distal symmetrical, autonomic and cardiac neuropathy in the patient with diabetes.Diabetes Obes Metab.2022 May 2. doi:10.1111/dom.14734
Isfort M, McVerry BJ, Shutter L, Kim M, Lacomis D.Perceived utility of electrodiagnostic testing in critical illness myopathy and polyneuropathy: A survey of intensive care unit providers.Muscle Nerve.2022 Apr 25. doi:10.1002/mus.27561
Kim YR.Update on the POEMS syndrome.Blood Res. 2022;57(S1):27-31. doi:10.5045/br.2022.2022001
Huang Y, Ying Z, Chen Z, et al.Thyroid hormone level is associated with the frequency and severity of Guillain-Barré syndrome.Int J Neurosci.2017;127(10):893-899. doi:10.1080/00207454.2016.1278541
van Veen R, Wieske L, Lucke I, et al.Assessing deterioration using impairment and functional outcome measures in chronic inflammatory demyelinating polyneuropathy: a post-hoc analysis of the IOC trial.J Peripher Nerv Syst.2022 May 4. doi:10.1111/jns.12497
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