Syndrome Affecting Hands and Feet: Polyneuropathy

By | 17 February 2021

If you have complaints such as burning, chills, numbness, and even cramps in your hands and feet, especially at night, you may suspect polyneuropathy syndrome caused by a problem in the nerve fibers. Polyneuropathy is a picture that occurs as a result of damage to many peripheral nerves for various reasons and its incidence increases with age.

The name of the neural network carries impulses to our limbs and organs, except for the central nervous system such as the peripheral nervous system, brain, and spinal cord. This system; consists of three types of nerve fibers, each with its own function. While sensory fibers provide the transmission of sensations such as touch and pain to the central nervous system, motor fibers enable us to move by transmitting the stimuli from the center to our muscles. Autonomic fibers regulate the functions of tissues and organs such as blood pressure and bowel movements. He says that polyneuropathy is the most common of the conditions affecting the peripheral nerves and affects the longest nerves first. Therefore, symptoms are initially seen in the feet.

Symptoms differ in polyneuropathy according to the affected nerve fiber. The most common symptoms; Numbness, tingling, burning or chills in hands and feet, stabbing, sharp pains, loss of balance and coordination, especially weakness in feet. Cramps can also be experienced. When autonomic fibers are affected, constipation, diarrhea attacks, difficulty in controlling the bladder, impotence (hardening problem), changes in heart rhythm, orthostatic hypotension (low blood pressure that occurs when standing up), decreased sweating and difficulty in sensing temperature changes can be seen.

Diabetes patients are in the first place
Symptoms first start in the feet, especially the soles and toes. As polyneuropathy progresses, it spreads to the hands and legs. Symptoms are usually continuous but may fluctuate, especially in the evening. Acute polyneuropathies occur for infectious and toxic reasons, while chronic polyneuropathies are more common. The incidence varies between 24 and 80 per 1000, and its incidence increases with age. It is thought that one in 10 people aged fifty-five and older has different levels of polyneuropathy. Approximately half of those with long-term diabetes can also have polyneuropathy.

Its progression can be prevented
If polyneuropathy is diagnosed early, the factor that causes nerve damage can be detected and controlled, thus preventing the progression of the nerve damage and protecting it from other symptoms that may occur. The presence of polyneuropathy is detected by EMG (electromyography) examination. EMG gives us information about which peripheral nerves and which fibers are affected, whether there is damage in the body of the nerve or in the sheath that surrounds it, and allows the nerve to transmit rapidly. According to the EMG findings, it is tried to understand whether it is an acute process or a chronic polyneuropathy. Again, in the presence of EMG and clinical findings, it is tried to determine whether it is genetic or not. After the diagnosis of polyneuropathy, the diseases that may cause it is investigated. For this, blood tests are done first. If necessary, further examinations such as electrophoresis, chest radiography, abdominal ultrasound, tumor markers are requested.

Reasons
Diabetes is the most common cause of polyneuropathy. Also, various causes such as hypothyroidism, alcohol use, chemotherapy drugs, cancer, infections, liver or kidney failure, vitamin B1 or B12 deficiency, heavy metal poisoning can be seen.

Treatment depending on the cause
The treatment of polyneuropathy is basically the treatment of the underlying disease or the cause of the nerve damage. Drugs that suppress the immune system such as cortisone can also be used depending on the situation. If the picture develops due to diabetes, controlling blood sugar is the most important step. Another point in the treatment is to eliminate the patient’s complaints. If there are complaints such as pain, numbness, burning, appropriate medication is arranged and the patient is relieved. Physiotherapy can be applied for weakness and balance disorder.

Long-term medication
While some complete recovery is achieved depending on the underlying cause, in some polyneuropathies, well-being can be preserved with long-term medication. In another group of polyneuropathy, progress may continue over time, wounds may occur in the feet in those with severe sensory impairment, and some genetic polyneuropathies may develop deformities and curvature in the spine over time, especially in the feet.

Right address neurologist
If you have complaints such as chills, burning, numbness in the hands and feet, especially at night, all these may be signs of polyneuropathy syndrome. EMG examination should be done by consulting with a neurologist, it should be determined whether there is any nerve damage and a path should be drawn accordingly. Some acute polyneuropathies can be life-threatening; In such sudden or new complaints, it is very important to consult a neurologist immediately.