Sensorimotor polyneuropathy
Polyneuropathy - sensorimotorSensorimotor polyneuropathy is a condition that causes a decreased ability to move and feel (sensation) because of nerve damage.
Causes
Neuropathy means a disease of, or damage to nerves. When it occurs outside of the central nervous system (CNS), that is, the brain and spinal cord, it is called a peripheral neuropathy. Mononeuropathy means one nerve is involved. Polyneuropathy means that many nerves in different parts of the body are involved.
Neuropathy can affect nerves that provide feeling (sensory neuropathy) or cause movement (motor neuropathy). It can also affect both, in which case it is called a sensorimotor neuropathy.
Sensorimotor polyneuropathy is a bodywide (systemic) process that damages nerve cells, nerve fibers (axons), and nerve coverings (myelin sheath). Damage to the covering of the nerve cell causes nerve signals to slow or stop. Damage to the nerve fiber or entire nerve cell can make the nerve stop working. Some neuropathies develop over years, while others can start and get severe within hours to days.
Myelin
Myelin is an insulating layer, or sheath that forms around nerves, including those in the brain and spinal cord. It is made up of protein and fatty ...
Read Article Now Book Mark ArticleNerve damage can be caused by:
- Autoimmune (when the body attacks itself) disorders
- Conditions that put pressure on nerves
- Decreased blood flow to the nerve
- Diseases that destroy the glue (connective tissue) that holds cells and tissues together
- Swelling (inflammation) of the nerves
Some diseases lead to polyneuropathy that is mainly sensory or mainly motor. Possible causes of sensorimotor polyneuropathy include:
- Alcoholic neuropathy
Alcoholic neuropathy
Alcoholic neuropathy is damage to the nerves that results from excessive drinking of alcohol.
Read Article Now Book Mark Article - Amyloid polyneuropathy
- Autoimmune disorders, such as Sjögren syndrome
- Cancer (called a paraneoplastic neuropathy)
- Long-term (chronic) inflammatory neuropathy
- Diabetic neuropathy
Diabetic neuropathy
Nerve damage that occurs in people with diabetes is called diabetic neuropathy. This condition is a complication of diabetes.
Read Article Now Book Mark Article - Drug-related neuropathy, including chemotherapy
Drug-related neuropathy
Neuropathy is injury to one or more peripheral nerves. These are nerves that are not in the brain or spinal cord. Neuropathy secondary to drugs cau...
Read Article Now Book Mark Article - Guillain-Barré syndrome
Guillain-Barré syndrome
Guillain-Barré syndrome (GBS) is a serious health problem that occurs when the body's defense (immune) system mistakenly attacks part of the peripher...
Read Article Now Book Mark Article - Hereditary neuropathy
- HIV/AIDS
- Low thyroid
- Parkinson disease
- Vitamin deficiency (vitamins B12, B1, and E)
Vitamins B12
Vitamin B12 is a water-soluble vitamin. Water-soluble vitamins dissolve in water. After the body uses these vitamins, leftover amounts leave the bo...
Read Article Now Book Mark ArticleB1
Thiamin is one of the B vitamins. The B vitamins are a group of water-soluble vitamins that are part of many of the chemical reactions in the body....
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Symptoms
Symptoms may include any of the following:
- Decreased feeling in any area of the body
- Difficulty swallowing or breathing
- Difficulty using the arms or hands
- Difficulty using the legs or feet
- Difficulty walking
Difficulty walking
Walking abnormalities can be caused by many different types of problems. Problems with the joints, (such as arthritis), bones (such as deformities),...
Read Article Now Book Mark Article - Pain, burning, tingling, or abnormal feeling in any area of the body (called neuralgia)
Neuralgia
Neuralgia is a sharp, shocking pain that follows the path of a nerve and is due to irritation or damage to the nerve. Common neuralgias include:Posth...
Read Article Now Book Mark Article - Weakness of the face, arms, or legs, or any area of the body
- Occasional falls due to lack of balance and not feeling the ground under your feet
Symptoms may develop quickly (as in Guillain-Barré syndrome) or slowly over weeks to years. Symptoms usually occur on both sides of the body. Most often, they start at the ends of the toes first.
Exams and Tests
The health care provider will examine you and ask about your symptoms. An exam may show:
- Decreased feeling (may affect touch, pain, vibration, or position sensation)
- Diminished reflexes (most commonly the ankle)
- Muscle atrophy
Muscle atrophy
Muscle atrophy is the wasting (thinning) or loss of muscle tissue.
Read Article Now Book Mark Article - Muscle twitches
Muscle twitches
Muscle twitches are fine movements of a small area of muscle.
Read Article Now Book Mark Article - Muscle weakness
- Paralysis
Paralysis
Muscle function loss is when a muscle does not work or move normally. The medical term for complete loss of muscle function is paralysis.
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Tests may include:
- Biopsy of the affected nerves
Biopsy
A biopsy is the removal of a small piece of tissue for laboratory examination.
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- Electrical test of the muscles (EMG)
EMG
Electromyography (EMG) is a test that checks the health of the muscles and the nerves that control the muscles.
Read Article Now Book Mark Article - Electrical test of nerve conduction
Nerve conduction
Nerve conduction velocity (NCV) is a test to see how fast electrical signals move through a nerve. This test is done along with electromyography (EM...
Read Article Now Book Mark Article - X-rays or other imaging tests, such as MRI
- Genetic testing
- Spinal fluid testing (lumbar puncture/spinal tap)
Treatment
Goals of treatment include:
- Finding the cause
- Controlling the symptoms
- Promoting a person's self-care and independence
Depending on the cause, treatment may include:
- Changing medicines, if they are causing the problem
- Controlling blood sugar level, when the neuropathy is from diabetes
- Not drinking alcohol
- Taking daily nutritional supplements
- Medicines to treat the underlying cause of the polyneuropathy
PROMOTING SELF-CARE AND INDEPENDENCE
- Exercises and retraining to maximize function of the damaged nerves
- Job (vocational) therapy
- Occupational therapy
- Orthopedic treatments
- Physical therapy
- Wheelchairs, braces, or splints
CONTROL OF SYMPTOMS
Safety is important for people with neuropathy. Lack of muscle control and decreased sensation can increase the risk of falls or other injuries.
If you have movement difficulties, these measures can help keep you safe:
- Leave lights on.
- Remove obstacles (such as loose rugs that may slip on the floor).
- Test water temperature before bathing.
- Use railings.
- Wear protective shoes (such as those with closed toes and low heels).
- Wear shoes that have non-slippery soles.
- Have a therapist assess your need for an assistive device such as a cane or walker.
Other tips include:
- Check your feet (or other affected area) daily for bruises, open skin areas, or other injuries,which you may not notice that can become infected.
- Check the inside of shoes often for grit or rough spots that may injure your feet.
- Visit a foot doctor (podiatrist) to assess and reduce the risk of injury to your feet.
- Avoid leaning on your elbows, crossing your knees, or being in other positions that put prolonged pressure on certain body areas.
Medicines used to treat the symptoms of this condition:
- Over-the-counter and prescription pain relievers to reduce stabbing pain (neuralgia)
Neuralgia
Neuralgia is a sharp, shocking pain that follows the path of a nerve and is due to irritation or damage to the nerve. Common neuralgias include:Posth...
Read Article Now Book Mark Article - Anticonvulsants or antidepressants
- Lotions, creams, or medicated patches
Other treatments may be directed against your immune system to stop an autoimmune attack:
- Steroids and other immunosuppressants
- Plasma pheresis (plasma exchange)
- Intravenous immunoglobulin (IVIg)
Use pain medicine only when necessary. Keeping your body in the proper position or keeping bed linens off a tender body part may help control pain.
Support Groups
These groups can provide more information about neuropathy.
- Neuropathy Action Foundation -- www.neuropathyaction.org
- The Foundation for Peripheral Neuropathy -- www.foundationforpn.org
Outlook (Prognosis)
In some cases, you can fully recover from peripheral neuropathy if your provider can find the cause and successfully treat it, and if the damage does not affect the entire nerve cell.
The amount of disability varies. Some people have no disability. Others have partial or complete loss of movement, function, or feeling. Nerve pain may be uncomfortable and may last for a long time.
In some cases, sensorimotor polyneuropathy causes severe, life-threatening symptoms.
Possible Complications
Problems that may result include:
- Deformity
- Injury to feet (caused by bad shoes or hot water when stepping into the bathtub)
- Numbness
- Pain
- Trouble walking
- Weakness
- Difficulty breathing or swallowing (in severe cases)
- Falls due to lack of balance
When to Contact a Medical Professional
Contact your provider if you have loss of movement or feeling in a part of your body. Early diagnosis and treatment increase the chance of controlling the symptoms.
References
Craig A. Neuropathies. In: Cifu DX, ed. Braddom's Physical Medicine & Rehabilitation. 6th ed. Philadelphia, PA: Elsevier; 2020: chap 41.
Endrizzi SA, Rathmell JP, Hurley RW. Painful peripheral neuropathies. In: Benzon HT, Raja SN, Liu SS, Fishman SM, Cohen SP, eds. Essentials of Pain Medicine. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 32.
Katirji B. Disorders of peripheral nerves. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 106.
Central nervous system and peripheral nervous system - illustration
The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.
Central nervous system and peripheral nervous system
illustration
Nervous system - illustration
The central nervous system is comprised of the brain and spinal cord. The peripheral nervous system includes all peripheral nerves.
Nervous system
illustration
Central nervous system and peripheral nervous system - illustration
The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.
Central nervous system and peripheral nervous system
illustration
Nervous system - illustration
The central nervous system is comprised of the brain and spinal cord. The peripheral nervous system includes all peripheral nerves.
Nervous system
illustration
Review Date: 11/9/2021
Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.