Sensorimotor polyneuropathy

• Alternative Names

  Polyneuropathy - sensorimotor

• Causes, incidence, and risk factors

  Polyneuropathy means disease of nerves. Sensorimotor polyneuropathy is damage to nerves other than the brain or spinal cord. Such nerve damage is called peripheral neuropathy.

  Sensorimotor polyneuropathy is a body-wide (systemic) process that damages nerve cells, nerve fibers (axons), and nerve coverings (myelin sheath). Damage to the covering of the nerve cell causes nerve signals to slow down. Damage to the nerve fiber or entire nerve cell can make the nerve stop working.

  Nerve damage can be caused by:

  • Conditions that put pressure on nerves
  • Decreased blood flow
  • Diseases that destroy the glue (connective tissue) that holds cells and tissues together
  • Swelling (inflammation)

  Possible causes of sensorimotor polyneuropathy include:

  • Alcoholic neuropathy
  • Chronic inflammatory neuropathy
  • Diabetic neuropathy
  • Drug-related neuropathy
  • Guillain-Barre syndrome
  • Vitamin deficiency (vitamin B12 and others)
• Symptoms
  • Decreased feeling in any area of the body
  • Difficulty swallowing
  • Difficulty using the arms or hands
  • Difficulty using the legs or feet
  • Difficulty walking
  • Numbness, loss of feeling in the arms or legs
  • Pain, burning, tingling, or abnormal feeling in any area of the body
  • Weakness of the face, arms, or legs, or any area of the body

  Symptoms may develop slowly over weeks to years and usually occur on both sides of the body.

• Signs and tests

  An exam may show:

  • Little or no reflexes
  • Muscle atrophy
  • Muscle twitch (fasciculations)
  • Muscle weakness
  • Paralysis
  • Problems with movement and feeling (sensation)

  Tests may include:

  • A test of electrical activity in muscles (EMG)
  • Blood tests
  • Nerve conduction tests
  • X-rays
• Treatment

  The goals of treatment include:

  • Finding the cause
  • Controlling the symptoms
  • Promoting a patient's self-care and independence

  Treatment may include:

  • Changing medications (such as some treatments for HIV) if they are causing the problem
  • Controlling blood sugar levels
  • Not drinking alcohol
  • Taking daily nutritional supplements

  PROMOTING SELF-CARE AND INDEPENDENCE

  • Exercises and retraining
  • Job (vocational) therapy
  • Occupational therapy
  • Orthopedic treatments
  • Physical therapy
  • Wheelchairs, braces, or splints

  CONTROL OF SYMPTOMS

  Safety is an important consideration for people with neuropathy. Lack of muscle control and decreased sensation may increase the risk of falls or other injuries.

  If you have movement difficulties, consider the following safety measures:

  • Leave lights on.
  • Remove obstacles (such as loose rugs that may slip on the floor).
  • Test water temperature before bathing.
  • Use railings.
  • Wear protective shoes (such as those with closed toes and low heels).

  Other tips include:

  • Check your feet (or other affected area) often for bruises, open skin areas, or other injuries, which you may not notice and can become infected.
  • Check the inside of shoes often for grit or rough spots that may injure your feet.
  • Visit a foot doctor (podiatrist) to reduce the risk of injury to your feet.
  • Avoid leaning on your elbows, crossing your knees, or being in other positions that put prolonged pressure on certain body areas.

  Medications used to treat this condition:

  • Over-the-counter and prescription pain relievers to control pain (neuralgia)
  • Anticonvulsants (phenytoin, carbamazepine, neurontin) or tricyclic antidepressants to reduce stabbing pain

  Avoid pain medication whenever possible, or use it only when necessary. Keeping your body in the proper position or keeping bed linens off a tender body part may help control pain.

• Expectations (prognosis)

  You can fully recover from peripheral neuropathy if your health care provider can find the cause and successfully treat it, and if the damage does not affect the entire nerve cell.

  The amount of disability varies. Some people have no disability, while others have a partial or complete loss of movement, function, or feeling. Nerve pain may be uncomfortable and may last for a long time.

  Occasionally sensorimotor polyneuropathy causes severe, life-threatening symptoms.

• Complications
  • Deformity
  • Difficulty swallowing
  • Partial or total loss of movement or control over movement
  • Partial or total loss of feeling
  • Recurrent or unnoticed injury to any part of the body
• Calling your health care provider

  Call your health care provider if you have loss of movement or feeling in a part of your body. Early diagnosis and treatment increase the chance of controlling the symptoms.

Review Date: 2/13/2008

Reviewed By: Luc Jasmin, MD, PhD, Departments of Anatomy & Neurological Surgery, University of California, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.