Polyneuropathy - it starts with tingling and ends in pain
Polyneuropathy is a disorder of the peripheral nerves. The stimulus transmission functions poorly or not at all. At the beginning those affected complain of a tingling or numbness. Symptoms occur in the feet, rarely in the hands, but can also affect other parts of the body. In later stages, there is pain and a decrease in the feeling of touch, even extreme cold and heat cannot be felt.
In Austria diabetes mellitus is is usually the cause of polyneuropathy. The strength of nerve damage depends on age, disease duration and glycemic control.
In the Klinik Pirawarth polyneuropathy has been discovered both as the main ailment, but often as an additional finding in another underlying disease.
Exact research into causes
If polyneuropathy is suspected a clinical examination is performed with accurate medical history. Pre-existing conditions, type of sensory disturbances, motor dysfunction, and pain will be ascertained. In addition to the drug and alcohol history, a careful inspection of the feet is carried out. The initial laboratory findings should provide information about the fasting blood sugar and long-term blood sugar values, electrolytes, blood count, inflammatory parameters and renal and liver function values.
In the detailed neurological examination, the focus is on the scrutiny of muscle strength ratios, reflexes as well as the surface and deep sensibility. Further examinations are available such as NCS (nerve conduction study) and EMG (electromyography).
Mechanism-based pain management
The treatment of polyneuropathy is not easy. Once the cause of the disease has been clarified, we try to eliminate or reduce it.
If the polyneuropathy is due to an untreatable disease or the underlying cause is not clear, then only the symptoms can be treated.
"The drugs for neuropathic pain are not favorable for kidney function, so it depends on the exact setting of the pain therapy" describes Dr. Kulisev. "A big advantage at the Klinik Pirawarth is the time we have to coordinate this medication. Four weeks is an excellent time for the doctors team to be able to perform individual adjustments under continuous laboratory control.
Develop more intuition
With an accompanying physiotherapy and sports therapy it is attempted to compensate for motor deficits and increase muscle strength in neurological rehabilitation.
Additionall occupational therapy is prescribed for pronounced, sensory deficits. Sensitivity training is useful for disturbances of fine motor skills in the hands. Or a cell bath can also eliminate sensory disturbances. Mesh glove applications have a similar mode of action. Somatosensory areas of the brain can be electrically stimulated by the contra-lesional hand via the glove.
A stable glucose control is important for example in diabetes and neuropathy. Our own in-house dieticians take advantage while the guest is in the clinic to illustrate the relationship between disease and nutrition.
An issue Dr. Kulisev addresses to the referring physicians: "It is important to motivate the patient, but one should not promise too much! We can also not perform miracles! "However, there is a positive case example which Dr. Susanne Schutzenberger-Sitta fondly remembers:" A Russian patient was assigned to the Klinik Pirawarth by the Kaiser-Franz-Josef Hospital in Vienna - with a special form of polyneuropathy and in a wheelchair. Initially she was taken care of in the acute hospital and was lucky because the form of her disorder was treatable. It was emotional for all of us when she left again wearing her ballerina shoes".
Dear Colleagues! All of the assessment team at the Klinik Pirawarth is always open for questions and suggestions and for the exchange of information. We are at your disposal should you wish to discuss with us any special request regarding your patient.