Polyneuropathy - sensorimotor

Definition

Sensorimotor polyneuropathy is a decrease in movement or sensation (ability to feel something).

Alternative Names

Causes

Polyneuropathy means disease of nerves. Sensorimotor polyneuropathy is damage to nerves other than the brain or spinal cord. Such nerve damage is called peripheral neuropathy.

Sensorimotor polyneuropathy is a systemic (body-wide) process that damages nerve cells, nerve fibers (axons), and nerve coverings (myelin sheath). Damage to the covering of the nerve cell causes nerve signals to slow down. Damage to the nerve fiber or entire nerve cell can make the nerve stop working.

Nerve damage can be caused by inflammation, decreased blood flow, any condition that puts pressure on nerves, and diseases that destroy the glue (connective tissue) that holds cells and tissues together.  

Possible causes of sensorimotor polyneuropathy include:

• Alcoholic neuropathy  
• Diabetic neuropathy
• Chronic inflammatory neuropathy
• Guillain-Barre syndrome
• Drug-related neuropathy

Symptoms

• Weakness of any area of the body, facial weakness, or weakness of the arms or legs
• Difficulty walking
• Difficulty using the legs or feet
• Difficulty using the arms or hands (legs and feet usually affected first)
• Difficulty swallowing
• Decreased sensation of any area of the body
• Pain, burning, tingling, or abnormal sensation of any area of the body
• Numbness, loss of sensation in the arms or legs

Symptoms may develop gradually over weeks to years and usually occur on both sides of the body.

Exams and Tests

A neuromuscular exam shows sensation and movement problems. Muscle weakness and sensation changes slow get worse over time. Sensation problems usually occur on both sides of the body.

An exam may show:

• Little or no reflexes
• Muscle weakness 
• Paralysis  
• Muscle twitch (fasciculations)
• Muscle atrophy

An EMG (a test of electrical activity in muscles) may show the type of peripheral nerve injury and how bad it is. Nerve conduction tests may reveal damage to nerve coverings or fibers. 

Other tests may include x-rays, scans, and blood tests.

Treatment

The goals of treatment include finding the cause, controlling the symptoms, and promoting a patient's self-care and independence.

The cause should be identified and treated whenever possible.

This may include controlling blood sugar levels  , not drinking alcohol, and taking daily nutritional supplements.

If medications (such as some treatments for HIV) are causing the problem, they should be changed, if possible.

PROMOTING SELF-CARE AND INDEPENDENCE

Physical therapy, vocational therapy, occupational therapy, and orthopedic interventions may be recommended.

Exercises and retraining may increase muscle strength and control. Wheelchairs, braces, or splints may provide mobility or support.

CONTROL OF SYMPTOMS

Safety is an important consideration for people with neuropathy. Lack of muscle control and decreased sensation may increase the risk of falls or other injuries.

If a person has movement difficulties, safety measures, such as the use of railings and removal of obstacles (including loose rugs that may slip on the floor), should be considered.

Safety measures for people experiencing difficulty with sensation include the use of adequate lighting (leave lights on at night), testing of water temperature before bathing, and use of protective shoes (such as those with closed toes and low heels).

People with decreased sensation should check their feet (or other affected area) frequently for bruises, open skin areas, or other injuries, which may go unnoticed and become severely infected.

Shoes should be checked inside frequently for grit or rough spots that may injure the feet. Patients with sensorimotor neuropathy should visit a podiatrist (foot doctor) to reduce the risk of injury to the feet.

People with neuropathy are prone to new nerve injury at pressure points (such as knees and elbows). They should avoid leaning on the elbows, crossing the knees, or being in other positions that put prolonged pressure on body areas.

Over-the-counter and prescription pain-relievers may be needed to control pain (neuralgia). Anticonvulsants (phenytoin, carbamazepine, neurontin) or tricyclic antidepressants may be used to reduce the stabbing pains that some people experience. 

Whenever possible, pain medication use should be avoided or used only when necessary.  Proper body positioning or keeping bed linens off a tender body part may help control pain.

Outlook (Prognosis)

A full recovery from peripheral neuropathy is possible if the cause of the sensorimotor polyneuropathy can be identified and successfully treated, and if the damage does not affect the entire nerve cell.

The extent of the disability varies from no disability to a partial or complete loss of movement, function, or sensation. Nerve pain may be quite uncomfortable and may persist for a long time.

Occasionally sensorimotor polyneuropathy causes severe, life-threatening symptoms.

Possible Complications

• Partial or complete loss of movement
• Partial or complete loss of control of movement
• Partial or complete loss of sensation
• Difficulty swallowing
• Recurrent or unnoticed injury to any part of the body
• Deformity

When to Contact a Medical Professional

Call your health care provider if loss of movement or sensation of a part of the body occurs. Early diagnosis and treatment increase the chance of controlling the symptoms.

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