Polyneuritis

What is Polyneuritis?

This striking and fairly common disorder means the nerve fibres degenerate from the periphery inwards. It may be due to chemical poisons and drugs, to toxins from bacteria in the body, or as a result of disorders of metabolism.

Not nearly so common today, although it still does occur, is alcoholic neuritis. Although this was often associated with a vitamin B deficiency, it probably produced a metabolic disturbance that in turn gave rise to symptoms. Certain industrially used chemicals may cause it, such as arsenic and mercury, often used in agricultural sprays (although the exact relationship is often disputed).

Drugs used in treatment may be a cause. It may occur in diabetics (diabetic neuritis) due to metabolic disturbances that take place with this disease. Unfortunately, even when the diabetes is brought under good control, the neuritis frequently persists. It seems most likely that the ingested toxin is absorbed by the bloodstream and affects the local nerves immediately, rather than producing symptoms from some central (brain) cause.

Polyneuritis Symptoms

Often the first symptom is a “foot-drop” in each lower limb. Muscle weakness, numbness, pain, paraesthesia (altered sensations) or anaesthesia (loss of feeling) may occur. This may also take place in the hands. If left untreated, it may intensify, and spread (“glove and stocking” distribution, suggesting that the skin areas normally covered by such garments are the parts affected with sensory alterations).

There may be alterations in the sweat secretions, ageing alterations in the skin, nails and other tissues. The disorders occur in a symmetrical fashion (eg in both lower, then upper limbs), and they tend to occur at more distant parts then spread toward the body itself. Weakness, muscle wasting, the tendency to muscular contraction, loss of normal reflex function, are all typical. The doctor can usually make a rapid diagnosis, for the picture is generally uniform.

Polyneuritis Treatment

This is purely symptomatic. The doctor will try to find the cause, if one exists, and endeavour to correct this. For example, if it seems to be due to association of a chemical poison, or drug therapy, or alcoholism, then efforts to eliminate these must be made. A search will be made to eliminate diabetes as a cause (often this can be done simply by finding glucose in the urine, now readily indicated by dip sticks in a few seconds).

Vitamin B preparations are often used in abundance. However, although these may improve the general feeling of the patient, unless there is a specific need for them, they are of no proven value. In vitamin B deficiency due to alcoholism (and resulting beri-beri), it can assist considerably. However, psychologically the use of this product can help.

General nutrition must be given attention. Relief of pain by suitable analgesics and physiotherapy in certain cases, especially where there is a risk of muscle contracture, may help considerably. Some forms of relapsing neuritis are assisted by cortisone products. Recovery often takes place, but residual aftermath involving neurotic pain, muscle contractures and wasting may present long term problems.