Polyneuropathy: an Introduction
Polyneuropathy: all you want to know
In the Netherlands there are a suspected 400.000 patients that suffer from polyneuropathy. What is that? Neuropathy is a condition in which the peripheral nerves to the legs, feet, arms and hands lose some function. This condition nearly always starts with the functioning of the feet. The first thing you notice is less sensation in the feet, like you’re walking on sand or on clouds. The feeling is similar to wearing a sock or a glove, as if you can’t really feel your environment anymore. The change in feeling is almost always symmetrical, which means that both on the left and right side the sensation feels different from what you’re used to. Slowly the condition makes its way up, first only the feet and then the lower leg up to the knee. The hands usually follow a little liter in the process. Not only the sensation feels disturbed, the muscle strength can also decline.
On top of the sensory disorder, the accompanying pain can be inconvenient. It can be burning pain or mean sharp pain like walking on barbwire or nettles. This is what our patients have told us. When one nerve is affected we speak of mono-neuropathy (mono=one) and when several nerves are affected we use the term polyneuropathy.
Polyneuropathy: complaints and symptoms
Many different complaints and symptoms may appear: sensory and in terms of muscle strength. Sensory: numb feeling, tingling, changing sensations from touch and heat, pain and even disturbed balance. Muscle complaints include: cramp, decrease of muscle strength, strange tingling movements of the muscles and thinning of the muscles.
Definition of polyneuropathy
It’s good to give a condition a definition. We back-up the definition that has been established by a special work group in the Netherlands:
Polyneuropathy is a symmetrical condition of the peripheral nerves, which is characterized by sensory and/or motor abnormalities that are usually more present distal than proximal and more in the legs than in the arms. Per definition polyneuropathy always concerns several nerves.
Or: polyneuropathy is a condition of the long nerves that run through the arms and legs, equal on the left and right side, and includes both sensory complaints as well as decreased muscle function, specifically at the extremities of the legs and less so in the arms.
Causes of neuropathy: from love to sugar
There are all sorts of causes of neuropathy, ranging from vitamin B12 deficiency, vitamin B6 overdose, alcohol abuse, and diabetes till genetic conditions. There is also a romantic cause: the honeymoon palsy or the ‘paralysie des amoureux’ is a condition discovered by the French… When you wake up with a numb arm after a beautiful night because your lover fell asleep on your arm. Usually the treatment for this one is simple…
Treatment is easy and quick if neuropathy is caused by a vitamin deficiency or a chronic overdose of vitamins (too many supplements). Either you supplement the deficiency or you quit taking the excess.
If only it was always this simple. In most neuropathy cases treatment of the cause is quite challenging. The most common cause of neuropathy, diabetes, is hard to treat. You would think that when you treat the sugar problem the neuropathy would also get better, but this is not the case. The diabetic neuropathy is generally not treatable by optimally treating the sugar levels.
If we follow the classification of causes according to modern medicine, we get neuropathy due to:
- Deficiencies (for example vitamin deficiencies)
- Poisoning (for example an overdose of vitamins)
- Metabolic conditions (diabetes)
- Genetic conditions (HMSN 1 and 2 and Dejerine-Sottas disease)
- Infections (AIDS)
- Auto-immune disease and inflammatory neuropathy (Guillain-Barre)
- Unknown causes (CIAP)
After diabetic neuropathy, the so-called idiopathic neuropathy and CIAP, genetic neuropathy, inflammatory neuropathy and neuropathy due to alcohol abuse or medicine are the most common forms of neuropathy.
The most significant risk factors for neuropathy are: diabetes, alcoholism and use of medicine that are toxic to the nerves (like cancer medicine). Nearly half of all neuropathy patients have diabetes. That is why we will expand on this form of neuropathy first.
This form of neuropathy is the most common. The chance of diabetic polyneuropathy increases with the years of having diabetes, bad sugar regulation and the presence of other conditions like kidney or eye problems.
There are about 450.000 diabetes patients in the Netherlands. Approximately 20% of those have polyneuropathy, that’s nearly 100.000 patients! Diabetic neuropathy is characterized by slowly progressing, symmetrical loss of sensation and loss of muscle strength, sometimes with accompanying severe pain, which can be asymmetrical.
Neuropathy by anti-cancer medicine
Medicines that can cause so-called toxic polyneuropathy are anti-cancer medicines like vincristine, paclitaxel (Taxol®) and cisplatine. The more of these substances you get in to your body, the higher the chance of nerve damage.
Due to treatment with the anti-cancer medicine vincristine, paclitaxel and cisplatinum, many patients get neuropathy of sensory nature, sometimes (with vincristine and paclitaxel) including muscle weakness. The polyneuropathy arises quite soon after starting chemotherapy and increases with increased doses of these substances and is progressive. In case of cisplatinum, the abnormalities can still keep developing after quitting the treatment. Fortunately, in case of neuropathy due to anti-cancer medicine, treatment and recovery is generally possible. Sometimes the condition recovers spontaneously.
Pain in neuropathy
Pain can be present in different forms of neuropathy. Pain with diabetic neuropathy is most common. The condition doesn’t have to occur on both sides, but could be present only in one leg for example.
Treatment of painful neuropathy
There are many angles to treat painful neuropathy. Good results can often be achieved by combining regular medicine with lesser-known natural substances, like PeaPure.
On this website many stories of patients supporting the use of the natural compound PEA for neuropathic pain.