Sensory polyneuropathy
Sensory polyneuropathy is a disease whose symptoms are caused by damage to axon neurons. This dangerous disease is very common in patients with diabetes mellitus. Just as in cases with other types of polyneuropathies, one of the decisive factors in the choice of treatment and its subsequent results is the timely detection of the disease.
Sensory polyneuropathy can appear due to various reasons, including due to serious autoimmune processes, intoxication, heredity and infections, while the most dangerous case is when this disease is inherited or acquired due to a particular genetic predisposition.
The main symptoms of this dangerous sensory polyneuropathy are loss of sensitivity, unreasonable sensations of burning, tingling and itching, a feeling of vibration in the limbs, and the patient begins to perceive worse heat and cold, temperature changes. With sensory polyneuropathy, negative symptoms of sensory impairment, a feeling of “gloves” and “socks”, a violation of the sensitivity of the lower abdomen are also possible.
Depending on what type of neurons are damaged, three main forms of sensory polyneuropathy can be distinguished: hyperalgesic form, atactic form and mixed form. With the atactic form of the disease, symptoms such as impaired coordination of movement, paresthesia, numbness, instability (especially with closed eyes) are noted. Muscle strength usually remains unchanged, however, when examined by a physician and checked for strength associated with loss of deep sensitivity, it can be significantly reduced.
The hyperalgesic form implies such symptoms as autonomic dysfunction, pain (most often burning or shooting), decreased pain sensitivity, decreased temperature sensitivity. The mixed form of sensory polyneuropathy includes symptoms characteristic of the aforementioned forms of the disease.
In sensory polyneuropathy, the main symptoms are most often asymmetric, especially at the very beginning of the disease. So, for example, this disease can begin with one leg, while the other will remain completely healthy for a long time, but as the disease progresses, the symptoms become more symmetrical. Often, in the early stages of the disease, not only the legs are affected, but also the upper limbs, and sometimes even the trunk and face. Symptoms can develop within a few days or 1 to 2 months.
Having reached a certain point, so to speak, the maximum, many symptoms most often stabilize for a long time. It often happens that the symptoms decrease, but most often, especially with a monophasic course of the disease, they remain at the same level, which is usually quite high, or continue to increase. In contrast to Guillain-Barré syndrome, sensory polyneuropathy is characterized by poor recovery of functions.
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Sensory impairment can range from mild numbness to deepest anesthesia with arthropathy and ulcers. In this disease, paresthesia and spontaneous unbearable pain are often observed. At the moment, no complete explanation has been found for this unique disease, which combines the absence of sensitivity to pain stimuli and severe spontaneous pain.
To diagnose sensory polyneuropathy, an anamnesis is required with a thorough identification of other diseases, dietary habits, a list of medications that the patient used, a description of heredity, previous infectious diseases that could affect the development of polyneuropathy, an assessment of the patient's workplace, in order to establish the fact of contact with toxic substances, ENMG results, as well as specific results of cutaneous nerve biopsy, etc.
To date, the treatment of sensory polyneuropathy is rather poorly developed. Corticosteroids, cytostatics, plasmapheresis and immunoglobulin are most commonly used in treatment, however, too often, treatment attempts are unsuccessful. Against the background of immunotherapy, there is a partial regression of symptoms and stabilization of the condition, but the reasons for this result are not fully understood, however, in any case, timely therapy plays the main role.
As well as in all other types of polyneuropathies, timely diagnosis and initiation of treatment contributes, if not recovery, then stabilization of the patient's condition. In the case of sensory polyneuropathy, if the disease is not found at an early stage, then, after a significant part of the neurons have died, it is impossible to carry out a significant recovery, however, one can hope to stop the progress of the disease and stabilize the patient's condition.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
