Multiple neuritis, peripheral neuritis, peripheral neuropathy, polyneuritis
What is this condition?
This disorder involves degeneration of peripheral nerves supplying the distal muscles of the extremities. It results in muscle weakness with sensory loss and atrophy as well as decreased or absent deep tendon reflexes. Although peripheral nerve degeneration can occur at any age, incidence is highest in men between ages 30 and 50.
Because onset is usually subtle, a person may compensate by overusing unaffected muscles; however, the disease may begin rapidly with severe infection and chronic alcohol intoxication. If the cause can be identified and eliminated, the prognosis is good.
What causes it?
- Causes of peripheral nerve degeneration include:
- Chronic intoxication (with ethyl alcohol, arsenic, lead, carbon disulfide, benzene, phosphorus, and sulfonamides)
- Infectious diseases (meningitis, diphtheria, syphilis, tuberculosis, pneumonia, and mumps)
- Metabolic and inflammatory disorders (gout, diabetes, rheumatoid arthritis, polyarteritis nodosa, and lupus)
- Nutritional disorders (beriberi and other vitamin deficiencies, and malnourishment).
What are its symptoms?
The signs and symptoms of peripheral nerve degeneration develop slowly, and the disease usually affects the motor and sensory nerve fibers. The condition typically produces flaccid paralysis, wasting, loss of reflexes, pain of varying intensity, loss of ability to perceive vibratory sensations, and numbness, tingling, increased sensitivity to pain or touch, or anesthesia in the hands and feet.
Deep-tendon reflexes are diminished or absent, and atrophied muscles are tender or hypersensitive to pressure or palpation. Footdrop may also be present. Skin manifestations include glossy red skin and decreased sweating. Many people with the disease have a history of clumsiness and complain of frequent vague sensations.
How is it diagnosed?
The person’s history and physical exam reveal characteristic distribution of motor and sensory deficits. Electromyography may show a delayed action potential if peripheral nerve degeneration impairs motor nerve function.
How is it treated?
Effective treatment consists of supportive measures to relieve pain, adequate bed rest, and physical therapy, as needed. Most important, however, the underlying cause must be identified and corrected. For instance, it’s essential to identify and remove the toxic agent, correct nutritional and vitamin deficiencies (the person needs a high-calorie diet rich in vitamins, especially the B-complex group), or counsel the person to avoid alcohol.
What can a person with peripheral nerve degeneration do?
- Rest frequently and avoid using the affected arm or leg. To avoid bed sores, use a foot cradle. To prevent contractures, use splints, boards, braces, or other orthopedic appliances
- After the pain subsides, passive range-of-motion exercises or massage may be beneficial. The doctor may recommend electrotherapy for nerve and muscle stimulation.