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What Is Progressive Polyneuropathy?

The central nervous system (CNS) comprises the brain and spinal cord; the peripheral nervous system (PNS) consists of the neural pathways running between the CNS and the organs and limbs of the body. The PNS contains both motor (movement) and sensory neurons or nerve fibers; neuropathy is the disruption of nerve impulses within the PNS. Progressive polyneuropathy describes a group of conditions in which disruption of the PNS exists in multiple sites, and the disease is chronic with symptoms that gradually worsen over time.

  1. Symptoms

    • The symptoms of polyneuropathy often include painful sensations such as burning or a pins-and-needles feeling in the hands and feet, according to the Merck Manuals. Other symptoms could be a loss of sensation such that a person no longer feels temperature or pain; in this instance the patient is at risk of injury and infection to the affected areas. Other symptoms such as bladder or bowel incontinence, fluctuating blood pressure and sexual dysfunction may occur. In late-stage progressive polyneuropathy, respiratory failure can result due to the destruction of nerve function to the muscles that control breathing.

    Diagnosis

    • Health-care professionals may suspect progressive polyneuropathy by the existence of multiple, declining symptoms, and various procedures may be ordered to confirm a diagnosis. One such procedure is electromyography, a test that looks at the electrical activity in muscles affected by symptoms. Another is nerve conduction studies, in which the speed of transmission of nerve impulses in symptomatic nerve fibers is measured.

    Causes

    • Progressive or chronic polyneuropathy can be initiated secondarily to other health issues. Diabetes, alcoholism, anemia, cancer, vitamin B12 deficiency, liver failure and renal failure are all conditions that can bring about progressive polyneuropathy, according to Merck Manuals. In the absence of other disease states, the cause of progressive polyneuropathy is often unknown.

    Treatments

    • Treatment of neuropathies will vary depending on the cause. For example, if diabetes is the cause, carefully controlling the patient's blood sugar has been shown to slow down progression. Surgical removal of cancers pressed against nerves can relieve some symptoms. In instances where a cause is unknown, pain relievers, anesthetics and antidepressant medications can be helpful in relieving pain symptoms. Physical therapy is employed to help with muscle weakness, stiffness and contraction.

    Acute Polyneuropathy

    • There are other polyneuropathies of the PNS in which the onset is sudden; this is known as acute or idiopathic polyneuropathy. In these instances symptoms can take from several hours to four weeks to reach their maximum effect; after which they will begin to slowly improve. These diseases are not progressive and so their effects will not be permanent. The Center for Peripheral Neuropathy lists many causes for acute polyneuropathies, including: vitamin deficiencies, infections, heavy metal exposure, side effects of some pharmaceuticals, and an autoimmune reaction such as Guillain-Barré Syndrome.

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