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European Journal of Epidemiology Jan 2016Polyneuropathy is a disabling condition of the peripheral nerves, characterized by symmetrical distal numbness and paresthesia, often accompanied with pain and weakness.... (Review)
Review
Polyneuropathy is a disabling condition of the peripheral nerves, characterized by symmetrical distal numbness and paresthesia, often accompanied with pain and weakness. Although the disease is often encountered in neurological clinics and is well known by physicians, incidence and prevalence rates are not well known. We searched EMBASE, Medline, Web-of-science, Cochrane, PubMed Publisher, and Google Scholar, for population-based studies investigating the prevalence of polyneuropathy and its risk factors. Out of 5119 papers, we identified 29 eligible studies, consisting of 11 door-to-door survey studies, 7 case-control studies and 11 cohort/database studies. Prevalence of polyneuropathy across these studies varies substantially. This can partly be explained by differences in assessment protocols and study populations. The overall prevalence of polyneuropathy in the general population seems around 1% and rises to up to 7% in the elderly. Polyneuropathy seemed more common in Western countries than in developing countries and there are indications that females are more often affected than males. Risk factor profiles differ across countries. In developing countries communicable diseases, like leprosy, are more common causes of neuropathy, whereas in Western countries especially diabetes, alcohol overconsumption, cytostatic drugs and cardiovascular disease are more commonly associated with polyneuropathy. In all studies a substantial proportion of polyneuropathy cases (20-30%) remains idiopathic. Most of these studies have been performed over 15 years ago. More recent evidence suggests that the prevalence of polyneuropathy in the general population has increased over the years. Future research is necessary to confirm this increase in prevalence and to identify new and potentially modifiable risk factors.
Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Chronic Disease; Female; Humans; Incidence; Male; Polyneuropathies; Prevalence; Risk Factors; Sex Factors
PubMed: 26700499
DOI: 10.1007/s10654-015-0094-6 -
Journal of Neurology Oct 2016Chronic idiopathic axonal polyneuropathy (CIAP) is a term describing neuropathies with both sensory and motor involvement in a length dependant distribution where... (Review)
Review
Chronic idiopathic axonal polyneuropathy (CIAP) is a term describing neuropathies with both sensory and motor involvement in a length dependant distribution where neurophysiology reveals axonal damage, neuropathy onset is insidious and shows slow or no progression of the disease over at least 6 months with no aetiology being identified despite appropriate investigations. This entity merits further consideration given how common it is, the absence of clarity regarding aetiopathogenesis, natural history and therapies. A systematic computer-based literature search was conducted on PubMed database. We used two Medical Subject Headings terms in title. Term A was "axonal", "cryptogenic", "idiopathic" or "unknown" and Term B was "neuropathy" or "polyneuropathy". This search strategy resulted in the identification of 658 articles. After eligibility assessment, 48 papers were used for this review. CIAP is usually diagnosed in the sixth decade of life and it is more prevalent in males (ratio 3:2). It is usually slowly progressive. Some data support a potential role of autoimmunity in CIAP and further larger prospective studies are required to address such potential link and any treatment implications. CIAP is a common type of polyneuropathy but the least studied. Increasing awareness and research into this entity may result in better understanding and in the development of treatment strategies.
Topics: Axons; Chronic Disease; Humans; Polyneuropathies
PubMed: 26961897
DOI: 10.1007/s00415-016-8082-7 -
BMJ (Clinical Research Ed.) May 2019Sensory polyneuropathies, which are caused by dysfunction of peripheral sensory nerve fibers, are a heterogeneous group of disorders that range from the common diabetic... (Review)
Review
Sensory polyneuropathies, which are caused by dysfunction of peripheral sensory nerve fibers, are a heterogeneous group of disorders that range from the common diabetic neuropathy to the rare sensory neuronopathies. The presenting symptoms, acuity, time course, severity, and subsequent morbidity vary and depend on the type of fiber that is affected and the underlying cause. Damage to small thinly myelinated and unmyelinated nerve fibers results in neuropathic pain, whereas damage to large myelinated sensory afferents results in proprioceptive deficits and ataxia. The causes of these disorders are diverse and include metabolic, toxic, infectious, inflammatory, autoimmune, and genetic conditions. Idiopathic sensory polyneuropathies are common although they should be considered a diagnosis of exclusion. The diagnostic evaluation involves electrophysiologic testing including nerve conduction studies, histopathologic analysis of nerve tissue, serum studies, and sometimes autonomic testing and cerebrospinal fluid analysis. The treatment of these diseases depends on the underlying cause and may include immunotherapy, mitigation of risk factors, symptomatic treatment, and gene therapy, such as the recently developed RNA interference and antisense oligonucleotide therapies for transthyretin familial amyloid polyneuropathy. Many of these disorders have no directed treatment, in which case management remains symptomatic and supportive. More research is needed into the underlying pathophysiology of nerve damage in these polyneuropathies to guide advances in treatment.
Topics: Complementary Therapies; Genetic Therapy; Humans; Immunotherapy; Meta-Analysis as Topic; Nerve Fibers, Myelinated; Nerve Fibers, Unmyelinated; Neurologic Examination; Observational Studies as Topic; Polyneuropathies; Randomized Controlled Trials as Topic; Risk Reduction Behavior; Sensory Thresholds
PubMed: 31068323
DOI: 10.1136/bmj.l1108 -
Continuum (Minneapolis, Minn.) Oct 2017Immune axonal polyneuropathy is caused by a diverse group of disorders that share similar presentations and treatment regimens. This article focuses on the clinical... (Review)
Review
PURPOSE OF REVIEW
Immune axonal polyneuropathy is caused by a diverse group of disorders that share similar presentations and treatment regimens. This article focuses on the clinical findings, evaluation, and management of immune-mediated causes of axonal polyneuropathy, focusing primarily on large fiber sensorimotor polyneuropathy.
RECENT FINDINGS
Specific characteristics of an immune-mediated polyneuropathy have been incorporated in a new diagnostic screening tool that is highly sensitive and can easily be used in the outpatient clinic setting. New insights into autoantibodies may help identify the presence of an underlying autoimmune or paraneoplastic disease as the cause of a polyneuropathy.
SUMMARY
This article provides readers with further understanding into the autoimmune causes of axonal polyneuropathy and will help the clinician recognize key clinical features that may lead to timely diagnosis and treatment.
Topics: Autoantibodies; Diagnostic Techniques, Neurological; Humans; Polyneuropathies
PubMed: 28968368
DOI: 10.1212/CON.0000000000000523 -
Neurologic Clinics Nov 2021This article focuses on principles of nerve conduction studies and needle electromyography applied to the electrodiagnosis of polyneuropathy. The components of the... (Review)
Review
This article focuses on principles of nerve conduction studies and needle electromyography applied to the electrodiagnosis of polyneuropathy. The components of the electrodiagnostic evaluation of polyneuropathy and the electrophysiological characteristics of axonal and demyelinating neuropathies and nodo-paranodopathies are reviewed.
Topics: Axons; Electrodiagnosis; Electromyography; Humans; Neural Conduction; Polyneuropathies
PubMed: 34602212
DOI: 10.1016/j.ncl.2021.06.012 -
Der Internist Mar 2020Approximately one of three people with diabetes is affected by distal symmetric sensorimotor polyneuropathy (DSPN) which is associated with marked impairment in quality... (Review)
Review
Approximately one of three people with diabetes is affected by distal symmetric sensorimotor polyneuropathy (DSPN) which is associated with marked impairment in quality of life due to partly excruciating neuropathic pain on the one hand and painless foot ulcers on the other hand. The prevalence of painful DSPN may reach up to one quarter of patients with diabetes, while DSPN may be asymptomatic in up to half of the patients affected. Regrettably, DSPN still remains underdiagnosed. Typical neuropathic symptoms include pain, paresthesias and numbness particularly in the feet and calves. The management of DSPN includes three cornerstones: (1) lifestyle modification, causal treatment aimed at near-normoglycemia and multifactorial cardiovascular risk intervention, (2) pathogenesis-derived treatment and (3) symptomatic treatment of neuropathic pain. Multimodal pain treatment should not only aim at pain relief, but also allow for improvement in quality of sleep, mobility, and general quality of life.
Topics: Animals; Cattle; Diabetes Complications; Diabetes Mellitus; Diabetic Neuropathies; Humans; Neuralgia; Polyneuropathies; Prevalence; Quality of Life
PubMed: 32086529
DOI: 10.1007/s00108-020-00770-8 -
The Lancet. Neurology Oct 2011Critical illness polyneuropathy (CIP) and myopathy (CIM) are complications of critical illness that present with muscle weakness and failure to wean from the ventilator.... (Review)
Review
Critical illness polyneuropathy (CIP) and myopathy (CIM) are complications of critical illness that present with muscle weakness and failure to wean from the ventilator. In addition to prolonging mechanical ventilation and hospitalisation, CIP and CIM increase hospital mortality in patients who are critically ill and cause chronic disability in survivors of critical illness. Structural changes associated with CIP and CIM include axonal nerve degeneration, muscle myosin loss, and muscle necrosis. Functional changes can cause electrical inexcitability of nerves and muscles with reversible muscle weakness. Microvascular changes and cytopathic hypoxia might disrupt energy supply and use. An acquired sodium channelopathy causing reduced muscle membrane and nerve excitability is a possible unifying mechanism underlying CIP and CIM. The diagnosis of CIP, CIM, or combined CIP and CIM relies on clinical, electrophysiological, and muscle biopsy investigations. Control of hyperglycaemia might reduce the severity of these complications of critical illness, and early rehabilitation in the intensive care unit might improve the functional recovery and independence of patients.
Topics: Biopsy; Electrophysiology; Hospital Mortality; Humans; Muscle Weakness; Muscular Diseases; Paralysis; Polyneuropathies
PubMed: 21939902
DOI: 10.1016/S1474-4422(11)70178-8 -
Zeitschrift Fur Gerontologie Und... Jun 2017The peripheral nervous system is subject to changes during the ageing process, e. g. deep tendon reflexes decrease, as does proprioception. Polyneuropathies, on the... (Review)
Review
The peripheral nervous system is subject to changes during the ageing process, e. g. deep tendon reflexes decrease, as does proprioception. Polyneuropathies, on the other hand, need to be distinguished from age-related changes as independent diseases with etiologies similar to those at younger ages. Etiologies includes metabolic disorders, primary inflammatory polyneuropathies, and systemic disorders. Neuropathies associated with diabetes, malignancy, and monoclonal gammopathies appear to be more common in older patients. Using a systematic approach, it is possible to establish a specific diagnosis in the majority of cases. Since polyneuropathies contribute to reduced mobility in the elderly, an assessment of functional skills is mandatory. Polyneuropathy therapy is primarily based on the treatment of underlying conditions and neuropathic pain management. Physiotherapy and rehabilitation target pain relief and maintaining activities of daily living.
Topics: Aged; Aged, 80 and over; Evidence-Based Medicine; Female; Geriatric Assessment; Humans; Male; Middle Aged; Neuralgia; Pain Management; Pain Measurement; Polyneuropathies; Treatment Outcome
PubMed: 28455594
DOI: 10.1007/s00391-017-1233-3 -
Journal of Veterinary Internal Medicine 2023Suspected immune-mediated polyneuropathy has been increasingly reported in cats, especially in the last decade, but the condition remains poorly understood.
BACKGROUND
Suspected immune-mediated polyneuropathy has been increasingly reported in cats, especially in the last decade, but the condition remains poorly understood.
OBJECTIVES
Refine the clinical description and review the classification of this condition based on electrodiagnostic investigation and evaluate the benefit of corticosteroid treatment and L-carnitine supplementation.
ANIMALS
Fifty-five cats presented with signs of muscular weakness and electrodiagnostic findings consistent with polyneuropathy of unknown origin.
METHODS
Retrospective, multicenter study. Data from the medical records were reviewed. The owners were contacted by phone for follow-up at the time of the study.
RESULTS
The male-to-female ratio was 2.2. The median age of onset was 10 months, with 91% of affected cats being <3 years of age. Fourteen breeds were represented in the study. The electrodiagnostic findings supported purely motor axonal polyneuropathy. Histological findings from nerve biopsies were consistent with immune-mediated neuropathy in 87% of the tested cats. The overall prognosis for recovery was good to excellent, as all but 1 cat achieved clinical recovery, with 12% having mild sequelae and 28% having multiple episodes during their lifetime. The outcome was similar in cats with no treatment when compared with cats receiving corticosteroids or L-carnitine supplementation.
CONCLUSIONS AND CLINICAL IMPORTANCE
Immune-mediated motor axonal polyneuropathy should be considered in young cats with muscle weakness. This condition may be similar to acute motor axonal neuropathy in Guillain-Barré syndrome patients. Based on our results, diagnostic criteria have been proposed.
Topics: Cats; Male; Female; Animals; Retrospective Studies; Polyneuropathies; Guillain-Barre Syndrome; Prognosis; Disease Progression; Neural Conduction; Cat Diseases
PubMed: 37139643
DOI: 10.1111/jvim.16701 -
Deutsche Medizinische Wochenschrift... Oct 2002
Review
Topics: Clinical Trials as Topic; Humans; Neurologic Examination; Polyneuropathies
PubMed: 12373641
DOI: 10.1055/s-2002-34517