Polyneuropathy is one of the most severe neurological disorders. Characterized by multiple lesions of peripheral nerves. When the first symptoms of the disease appear, you should immediately consult a doctor to receive surgical treatment aimed at weakening or eliminating the cause of the pathology.
Neuropathy is a disease that occurs due to dysfunction of a nerve. Neuropathy of the lower extremities, symptoms and treatment, which may vary, can only be detected by an experienced doctor.
What is polyneuropathy of the lower extremities
The name of the disease is translated from Greek as “disease of many nerves,” and this translation fully conveys the essence of polyneuropathy of the lower extremities. In this case, almost all endings of the peripheral nervous system are affected.
There are several forms of the disease:
- Sensory polyneuropathy of the lower extremities. It manifests itself to a greater extent as a sensitivity disorder in the affected area, for example, numbness, a tingling or pins and needles sensation, a burning sensation. Treatment consists of controlling sensory symptoms with medications. Distal sensory polyneuropathy of the lower extremities brings a lot of inconvenience to the victim, since initially suspecting the disease is quite problematic, but the longer treatment is delayed, the more difficult it will be.
- Motor. The main symptom is muscle weakness to the point of complete inability to move arms or legs. This can very quickly lead to muscle atrophy.
- Sensorimotor. Combines symptoms of sensory and motor polyneuropathy. In most cases, this form is diagnosed.
- Vegetative. It differs in that in the foreground there are symptoms of damage to vegetative fibers. Direct symptoms include paleness of the skin, increased sweating, dizziness, disruption of the gastrointestinal tract, constipation, and tachycardia. Autonomic disorders signal several problems at once, so it is imperative to consult a doctor.
- Mixed. This form is diagnosed if all of the above symptoms are observed.
Expert opinion
Author: Alexey Vladimirovich Vasiliev
Neurologist, Head of the Research Center for Motor Neuron Disease/ALS, Candidate of Medical Sciences
Polyneuropathy is a complex disease characterized by atrophy of nerve fibers as a result of disturbances in the functioning of the peripheral nervous system. The pathology affects the upper and lower extremities and is accompanied by impaired sensitivity of the integumentary tissues, muscle performance, and deterioration of blood circulation.
Polyneuropathy is divided into 2 types:
- Primary is deadly, can be observed in any healthy person, progresses very quickly, and often ends in Landry’s paralysis.
- Secondary develops as a result of metabolic disorders and is a consequence of diabetes mellitus, vitamin deficiency in the body, general intoxication, infections, and injuries.
Symptoms of polyneuropathy of the lower extremities are pronounced. Initially, a person feels weakness in the legs, a feeling of numbness of the feet appears, gradually spreading to the entire limb. Some patients complain of burning and pain, tingling in the legs; in advanced cases, there is an unsteady gait and dysfunction of motor skills. Depending on the severity of the condition, symptoms such as dark circles under the eyes, dizziness, weakness, and tremors may appear. Doctors at the Yusupov Clinic will examine the patient, based on comprehensive diagnostics, identify an accurate diagnosis, and prescribe treatment in accordance with the general condition and side symptoms of the disease.
Kinds
Polyneuropathy is divided into several types depending on the type of fibers affected:
- sensory: the nerves that provide sensitivity are affected;
- motor: disturbances in the functioning of motor nerves are detected;
- motor-sensory: mixed form, in which motor disorders predominate;
- sensory-motor: mixed neuropathy, in which sensitivity disturbances are more pronounced;
- vegetative: first place comes to disturbances in the functioning of internal organs, changes in vascular tone and associated trophic disorders.
Significant differences in symptoms are noticeable only in the initial stages of the disease. Subsequently, all nerve fibers are involved in the pathological process, and the manifestations become mixed.
There are other types of classification of the disease:
- depending on the cause: alcoholic, diabetic, idiopathic, etc.;
- depending on the location of the lesion: polyneuropathy of the upper or lower extremities;
- depending on the type of course: acute, subacute, chronic;
- depending on the mechanism of occurrence: demyelinating (the sheath covering the nerve fibers is destroyed), axonal (formed by the death of nerve processes - axons), axonal-demyelinating.
Causes of polyneuropathy of the lower extremities
The causes of polyneuropathy of the lower extremities of various types are similar. The following points may lead to development:
- Diabetes. It is the most common cause of the disease, as it disrupts the proper functioning of the vessels that feed the nerves, thereby causing a deviation in the myelin sheath of the nerve fibers. With diabetes, the legs are most often affected.
- Severe deficiency of any of the B vitamins. The work of the nervous system is based on them, and therefore their long-term lack can lead to the development of the disease.
- Exposure to toxic substances on the body. Toxins include chemical toxic substances, alcoholic beverages, as well as intoxication due to various infectious diseases: diphtheria, human immunodeficiency virus, herpes. When the body is poisoned with carbon monoxide or arsenic, distal polyneuropathy can develop in just a few days, and with alcoholism and infections a longer development is typical.
- Traumatization. Nerve fibers are damaged by injury or surgery. The first include compression of the nerves, which is characteristic of spinal diseases such as herniated intervertebral discs and osteochondrosis.
- Guillain-Barre syndrome. Autoimmune disease often develops in the human body after infectious pathologies.
- Hereditary predisposition. Researchers have proven that certain disorders in proper metabolism that lead to polyneuropathy are transmitted genetically.
In rare cases, pathology occurs in pregnant women who seem to be absolutely healthy. The disease can manifest itself at any time - both in the first and third trimester. Scientists agree that the cause is precisely a deficiency of B vitamins, prolonged toxicosis and an unpredictable reaction of the pregnant woman’s immune system to the fetus.
Why do legs go numb with neurosis?
Leg neurosis is a consequence of non-inflammatory damage to peripheral nerves. The disease causes degenerative and dystrophic changes in tissues. The impetus for its appearance is a strong nervous shock.
The risk group for the occurrence of pathology includes:
- persons who use toxic substances (alcohol-containing drinks, drugs);
- people with metabolic disorders, for example, malfunctions of the thyroid gland, diabetes mellitus, severe kidney pathologies;
- patients with a history of limb injuries;
- patients with diphtheria, chickenpox, HIV, and any other infections;
- people with autoimmune pathologies;
- clients with a family history.
The first signs of polyneuropathy of the lower extremities
The first symptoms are found mostly on the distal parts of the legs. First of all, the foot disease is affected, and then the symptoms of polyneuropathy of the lower extremities gradually spread upward, so it is important to start treatment on time.
Initially, patients experience discomfort:
- burning;
- tingling;
- "goosebumps";
- numbness.
Then pain appears, and it is possible even from a light touch. Additionally, there may be a disturbance in sensitivity in the area of damage to the nerve fibers - it can either decrease or increase.
Symptoms are complicated by muscle weakness. In extremely rare situations, restless legs syndrome occurs.
Due to improved blood circulation in the affected areas, tropical and vascular disorders occur over time on the victim’s skin, which manifest themselves in:
- worsening or hyperpigmentation;
- peeling;
- cracks;
- ulcers.
Vascular type disorders include excessive pallor of the skin and a feeling of cold in areas prone to the disease. Symptoms of polyneuropathy of the lower extremities cannot be seen in the photo, so you should listen to your feelings.
The procedure for diagnosing pathology
An experienced neurologist will easily make a presumptive diagnosis based on the symptoms described in the patient’s words and on existing objective signs - skin changes, impaired reflexes, etc.
Diagnostic methods are very diverse, here are some of them:
| Methodology | What does it show |
| Electroneuromyography | Determination of the source of damage to the nervous system - roots, nerve processes, neuron bodies, membranes, etc. |
| General, biochemical blood test | Inflammatory, infectious process, presence of autoimmune changes |
| Blood sugar test | Development of diabetes mellitus |
| X-ray of the spine | Pathologies of the spinal column |
| Spinal tap | Presence of antibodies to own nerve fibers in the spinal cord |
The main method for diagnosing problems with nerve fibers remains the simple technique of electroneuromyography - it helps to clarify the diagnosis.
Symptoms of polyneuropathy of the lower extremities
The causes of polyneuropathy of the lower extremities are different, but the symptoms are always similar. They are expressed as follows:
- muscle weakness;
- decreased sensitivity, which may disappear altogether;
- lack of reflexes;
- burning;
- swelling;
- trembling fingers;
- increased sweating;
- cardiopalmus;
- lack of coordination;
- respiratory dysfunction;
- difficulty with balance;
- slow healing of wounds.
Symptoms can vary in severity. Therefore, the disease can develop either over years or in a matter of days.
Diagnosis of polyneuropathy of the lower extremities
The presence of polyneuropathy can be determined without special tests, based on the symptoms and first signs. It is necessary to conduct special tests to identify the cause of the disease. Due to the abundance of symptoms, diagnosis can be difficult. In this case, a number of instrumental and laboratory studies will be required.
Initially, consultation with a neurologist is necessary. The doctor should examine the affected areas and check reflexes. If polyneuropathy is suspected, you must do the following:
- general blood analysis;
- check blood and urine sugar levels to rule out or confirm the presence of diabetes;
- biochemical analysis for indicators such as creatinine, urea, total protein, liver enzymes, vitamin B12 levels.
Sometimes a nerve biopsy may be necessary.
Electroneuromyography is also additionally prescribed. Neurophysiological research helps to find out how quickly the signal reaches the nerve endings. Carrying out is necessary regardless of clinical symptoms, as it helps to identify the speed of spread of excitation along the nerves. To assess the symmetry and level of the lesion, an EMG of the legs is required.
A history and physical examination can help determine the need for additional testing to determine the cause of the neuropathy.
Symptoms of neurotic disease
Many patients with neurosis complain of numbness and burning in their legs. Also possible:
- decreased sensitivity of the foot;
- uncomfortable feeling of “crawling goosebumps”;
- inability to sense temperature changes;
- muscle twitching;
- frequent seizures;
- lack of some basic reflexes;
- weakness of the calf muscle (can reach atrophy);
- unilateral sluggish paresis;
- progressive paralysis.
It is extremely important not to hush up the problem and not try to eliminate it with the help of folk recipes. There is no need to rely on massage either - it will not be possible to achieve complete recovery with its help. Therapy must be comprehensive.
Treatment of polyneuropathy of the lower extremities
A patient with polyneuropathy of the lower extremities needs to prepare for long and difficult complex treatment. Since it consists not only in relieving symptoms that poison life, but also in eradicating the root cause of the disease.
As a result, the nerve fiber is destroyed, and it will take a long time to restore it. The course of treatment begins with a direct impact on the factor that caused the polyneuropathy, that is, with the relief of the underlying disease or stabilization of the patient’s condition.
For example, if the cause of the disease is diabetes mellitus, then all efforts are initially aimed at reducing blood sugar levels; in case of an infectious type, drug therapy is aimed at fighting the infection, and if the root of the problem is hidden in a deficiency of B vitamins, then it is important to compensate for the deficiency in a timely manner. If the cause of polyneuropathy is disruption of the endocrine system, the doctor prescribes hormonal therapy. But vitamin therapy is more widely used in treatment.
Positive results are demonstrated by those drugs that are aimed at improving blood microcirculation, and therefore nourishing nerve fibers.
Physiotherapeutic techniques, such as electrophoresis, are actively used in treatment. If polyneuropathy of the lower extremities is accompanied by severe pain, the patient must be prescribed painkillers, locally and orally.
It is impossible to completely insure yourself against the disease. But you can try to prevent it using simple precautions. That is, when working with toxic substances, it is imperative to use appropriate protective equipment, take any medications only after consultation and prescription of a doctor, and do not let infectious diseases take their course, preventing them from going into a chronic inflammatory period, when it will no longer be possible to cure the disease and all that remains is to treat it. exacerbations and relieve symptoms. The simplest measures to prevent problems are a balanced diet rich in vitamins, constant physical activity, and avoidance of alcoholic beverages.
Initially, treatment is aimed at eliminating the cause, and then maintenance therapy continues. It is necessary to discontinue medications and eliminate the effects on the body of toxic substances that caused the disease, adjust the diet, supplementing it with the necessary vitamins. Considering that only these measures slow down the course of the disease and reduce complaints, recovery progresses extremely slowly and may be incomplete.
If the cause cannot be stopped, all treatment is reduced to minimizing pain and disability. A rehabilitation specialist and physical therapist will recommend special orthopedic devices.
Tricyclic antidepressants and anticonvulsants are prescribed to relieve neuropathic pain such as burning or pins and needles. Medicines that affect the central nervous system are selected individually for each patient, depending on the state of the body and the patient’s psyche. It is strictly prohibited to prescribe medications on your own, so as not to cause even greater harm.
For demyelinating polyneuropathy of the legs, treatment based on immunomodulators is often used. Plasmapheresis or intravenous administration of immunoglobulins is recommended for acute inflammatory demyelination.
For chronic myelin dysfunction, plasma exchange or intravenous administration of immunoglobulin, corticosteroids or metabolic inhibitors is prescribed.
Of the entire list of vitamin preparations, preference is given to vitamins B1 and B12, which are also called thiamine and cyanocobalamin. The substances improve the level of transmission of excitation throughout the nerve fiber, which significantly reduces the manifestations of the disease, and also additionally protects the nerves from the effects of active radicals. They are prescribed over a long course in the form of injections administered intramuscularly.
Even if the treatment was successful and all or most of the nerve fibers were restored, it is too early to relax. It is necessary to carry out a long course of rehabilitation therapy, since with polyneuropathy, the muscles first suffer, losing tone. Therefore, long-term work aimed at restoring mobility is necessary; the help of several specialists may be required at once.
During rehabilitation after an illness, massage is mandatory. It repeatedly improves blood supply, restores mobility and elasticity to muscle tissue, and improves metabolic processes.
A similar effect is provided by various physiotherapeutic techniques. They also improve microcirculation, reduce pain and restore muscle cells. Physiotherapy for polyneuropathy of the lower extremities is most useful, so it is not recommended to neglect it.
In cases of severe injuries where complete recovery is not possible, the assistance of an occupational therapist may be required. Occupational therapy is action therapy. The specialist helps facilitate the patient’s process of adaptation to a state of limited movement, develops a new algorithm of movements necessary to perform everyday activities.
Due to the uniqueness of each case, the scheme of rehabilitation measures is developed individually and depends on the patient’s condition. Rehabilitation may include vitamin therapy, long-term work with psychologists, diet therapy and other techniques, depending on the specific situation.
Treatment of polyneuropathy of the lower extremities must begin immediately, without delay. As soon as alarming symptoms appear, you should consult a doctor - without timely treatment, there is a high risk of complications in the form of paralysis, disruption of the cardiovascular and respiratory systems. Timely treatment will help reduce the likelihood of complications to a minimum and maintain full functionality. Don’t forget about restorative therapy, it is this that will consolidate the effect obtained from the treatment.
Treatment of neuropathic pain
Treatment of neuropathic pain has many goals. The main goals are listed below.
- Reducing or eliminating the cause of pain. For example, your healthcare provider may try to reduce the size of a tumor that is putting pressure on a nerve.
- Pain relief.
- Maintaining your usual level of activity.
- Improving quality of life.
Treatment for neuropathic pain usually involves medications or nerve blocks.
medications;
Typically, patients take 1 or more medications to treat neuropathic pain. For example, the following:
- Anticonvulsant medications. If you are prescribed these medications, it does not mean you have a seizure disorder (such as epilepsy). These medications help calm the nerves that cause pain.
- Antidepressants. Just because you are prescribed these medications does not mean you are depressed or are being treated for depression. These medications help calm the nerves that cause pain.
- Opioids (strong prescription medicine used to relieve pain).
- Local anesthetics (medicines that numb the skin or a small area of the body).
- Steroid medications.
Your healthcare provider will tell you how and when to take your medications. You will be given information about your medications and possible side effects.
These medications are good for treating neuropathic pain, but may take up to 2 weeks to work. During the first few weeks, your doctor may increase your dose (amount of medicine you take). This will help you get enough medication to relieve pain. It is common practice to prescribe several different medications to find one or more options that are most suitable.
Nerve blocks
Nerve blocks may also be used to treat neuropathic pain. A nerve block is an injection (shot) of a steroid, local anesthetic, or other medicine directly into the nerve that is causing the pain. This stops the transmission of pain signals from the nerves to the brain. If you are prescribed a nerve block, this procedure will be performed by a pain management specialist.
to come back to the beginning
Prognosis of polyneuropathy of the lower extremities
The disease is very dangerous for humans, as it does not go away on its own. If you start polyneuropathy, the consequences will be sad.
It is worth remembering that prolonged muscle weakness often leads to a decrease in the tone of the body muscles and subsequently to complete muscle atrophy. In turn, this can lead to the appearance of ulcers on the skin.
In rare cases, polyneuropathy results in complete paralysis of the distal planes of the body and respiratory organs. This is deadly for humans. A progressive disease causes a lot of inconvenience to the victim, forcing him to build a new way of life, radically changing his usual way of life. Over time, patients lose the ability to move independently and care for themselves, which is fraught with feelings of increased anxiety and depression. In this case, the help of a qualified psychologist is urgently needed. Distal polyneuropathy of the lower extremities requires long-term rehabilitation even after recovery and relief of all symptoms.
Advantages of our clinic
The multidisciplinary clinic “Energy of Health” has experienced staff and the most modern equipment for diagnosing and treating various diseases. We provide each client with high quality medical services, which include:
- detailed examination to accurately determine the cause of complaints;
- consultations with narrow specialists directly in the clinic, as well as communication with foreign doctors if necessary;
- comprehensive treatment, selected in accordance with the indications and individual characteristics of the body;
- minor surgical operations directly in the clinic;
- own day hospital for maximum convenience;
- drawing up rehabilitation programs;
- affordable prices and services within the framework of voluntary health insurance.
Polyneuropathy is a dangerous complication of many conditions and diseases. You should not hope that the symptoms are limited to a simple tingling sensation; over time, the condition will worsen. Don’t delay seeing a doctor; sign up for a consultation with neurologists at the Energy of Health clinic.
Prevention of polyneuropathy of the lower extremities
In order to prevent a disease such as polyneuropathy of the lower parts of the body, it is necessary to stop drinking alcohol, regularly monitor blood and urine sugar levels, and when working with hazardous and toxic substances, it is imperative to use special personal protective equipment.
To avoid pain after relieving the disease, it is recommended:
- wear loose shoes that do not pinch your feet;
- do not take long walks over long distances;
- do not stand still for a long time without changing position;
- wash your feet in cool water.
Do not forget about physical therapy, designed to keep muscles in constant tone, preventing atrophy. Regular physical therapy for polyneuropathy will strengthen the body. It is worth leading a calm lifestyle, avoiding emotional stress, which can negatively affect the nervous system, eating right and listening to the state of the body in order to prevent the disease from returning.
Why contact us
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- anonymity;
- individual approach;
- high-precision diagnostics;
- effective treatment;
- successful rehabilitation;
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