Diabetic polyneuropathy
Clinic
Diabetic polyneuropathy, the most common form of polyneuropathy, is usually the result of long-term elevated blood sugar levels and often occurs in the form of pain, tingling or numbness in the feet and legs. In severe cases, the disease can spread to the hands and other areas. The pain is usually burning, stabbing or described as persistent numbness, which becomes more intense at night in particular.
Diagnosis
Diagnosis is based on a comprehensive neurological examination, often supplemented by electroneurographic tests that measure the speed and quality of nerve conduction. Laboratory tests to determine blood glucose and HbA1c help to classify the severity of the diabetes and to strive for the best possible blood glucose control.
Therapy
The focus is on blood sugar control to prevent the progression of nerve damage. Painkillers such as antidepressants (e.g. duloxetine or amitryptiline) and anticonvulsants (e.g. pregabalin) have a targeted effect against neuropathic pain. TENS and capsaicin creams can provide additional relief. In advanced cases, where pain control is persistently inadequate, treatment with neurostimulators can be discussed.
Alcoholic polyneuropathy
Clinic
Polyneuropathy caused by chronic alcohol abuse often manifests itself in weakness, numbness and pain, primarily in the legs. Those affected also suffer from motor impairments and an increased risk of injury due to reduced sensitivity to pain.
Diagnosis
A thorough medical history and neurological examination are essential to differentiate alcoholic polyneuropathy from other causes. Electromyography (EMG) and vitamin B levels in the blood can provide information about the extent and cause of the nerve damage.
Therapy
In addition to complete abstinence from alcohol, vitamin B supplements (especially B1 and B12) support nerve regeneration. Anticonvulsants and TENS can be used for pain therapy to alleviate the symptoms.
Idiopathic or unexplained polyneuropathy
Clinic
Idiopathic polyneuropathy occurs without a clearly identifiable cause and usually leads to sensations of pain and numbness in the extremities. Patients often describe a tingling or burning sensation that occurs mainly in the feet.
Diagnosis
The diagnosis is made by exclusion. After a comprehensive neurological examination, tests to determine nerve conduction velocities and laboratory tests are carried out to rule out other causes.
Therapy
Treatment is aimed at relieving pain, as the cause often remains unclear. A combination of antidepressants, anticonvulsants and TENS is often used to alleviate symptoms and improve quality of life.
Polyneuropathy after chemotherapy
Clinic
This form of polyneuropathy often develops after certain chemotherapies and is accompanied by painful sensations and muscle weakness. The symptoms can already occur during treatment and can worsen over a period of months.
Diagnosis
Diagnosis is based on medical history, neurological examination and documentation of symptoms occurring during chemotherapy. Electroneurographic tests can determine the extent of nerve damage.
Therapy
Symptom-relieving painkillers such as pregabalin and gabapentin are often used. Physiotherapy can also help to maintain mobility. Preventive measures such as the use of cooling during chemotherapy are increasingly being researched.
Conclusion
Painful polyneuropathy manifests itself in various forms and degrees of severity. Early diagnosis and individual treatment are crucial to alleviate the symptoms and improve the quality of life of those affected.
