Polyneuropathy
Basics
Description
Description
- A peripheral nerve disorder in which many nerves throughout the body malfunction simultaneously
- Typically affects distal nerves most prominently
- Acute polyneuropathy causes:
- Infectious:
- Toxin-producing bacteria
- Viruses
- Autoimmune:
- Guillain–Barré
- Toxic (heavy metals):
- Lead
- Mercury
- Drugs:
- Anticonvulsants (phenytoin)
- Antibiotics (chloramphenicol, nitrofurantoin, sulfonamides)
- Chemotherapy (vinblastine, vincristine)
- Sedatives (hexobarbital and barbital)
- Cancer:
- Multiple myeloma
- Infectious:
- Chronic polyneuropathy causes:
- Diabetes (most common)
- Alcohol abuse
- Nutritional deficiencies:
- Thiamine
- B12
- HIV
- Hypothyroidism
- Liver failure
- Kidney failure
- Lung cancer
- Chronic inflammatory demyelinating polyneuropathy (CIDM)
Epidemiology
Incidence and Prevalence EstimatesEpidemiology
- In the U.S., the prevalence of polyneuropathy is ∼2% in the general population
- It is 8% in patients >55 yr of age
- The most common cause in the U.S. is diabetes and it occurs in ∼50% of diabetics on insulin
Etiology
Etiology
- Myelin dysfunction:
- Parainfectious immune response triggered by antigens that cross-react with antigens in the peripheral nervous system:
- Encapsulated bacteria:
- Campylobacter sp.
- Diphtheria
- Viruses:
- Enteric
- Influenza viruses
- HIV
- Vaccines:
- Influenza
- Encapsulated bacteria:
- Guillain–Barré syndrome:
- Acute onset due to myelin dysfunction
- Rapidly progressive weakness and may lead to respiratory failure
- CIDM:
- Chronic illness of myelin dysfunction
- Symptoms may recur or progress over months and years
- Parainfectious immune response triggered by antigens that cross-react with antigens in the peripheral nervous system:
- Vasa nervosum compromise:
- Vascular supply to nerves compromised leading to nerve infarction
- Causes:
- Chronic atherosclerosis
- Vasculitis
- Infections
- Hypercoagulable states
- Axonopathy
- Primary dysfunction of the axon
- Most often the result of toxic–metabolic disorders:
- Diabetes
- Nutritional deficiencies
- Drugs/chemicals
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Citation
Schaider, Jeffrey J., et al., editors. "Polyneuropathy." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307632/all/Polyneuropathy.
Polyneuropathy. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307632/all/Polyneuropathy. Accessed December 10, 2024.
Polyneuropathy. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307632/all/Polyneuropathy
Polyneuropathy [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 December 10]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307632/all/Polyneuropathy.
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