Idiopathic Polyneuropathy

Idiopathic sensory-motor polyneuropathy is an illness where sensory and motor nerves of the peripheral nervous system are affected and no obvious underlying etiology is found. In many respects, the symptoms are very similar to diabetic polyneuropathy.

Symptoms

In idiopathic sensory-motor polyneuropathy, the patients may experience unusual sensations (paresthesias), numbness and pain in their hands and feet. In addition, there may be weakness of the muscles in the feet and hands. As the disease progresses, patients may experience balance problems and have difficulty walking on uneven surfaces or in the dark. In a small minority of the patients, the autonomic nervous system may also be involved and the patients may experience persistent nausea, vomiting, diarrhea, constipation, incontinence, sweating abnormalities or sexual dysfunction.

Diagnosis

Diagnosis of idiopathic sensory-motor polyneuropathy is based on history, clinical examination and supporting laboratory investigations. These include electromyography with nerve conduction studies, skin biopsies to evaluate cutaneous nerve innervation, and nerve and muscle biopsies for histopathological evaluation.

Treatment

Treatment of idiopathic sensory-motor polyneuropathy depends on controlling neuropathic pain, which can be treated with anti-seizure medications, antidepressants, or analgesics including opiate drugs. In severe painful conditions, patients may be referred to the Blaustein Chronic Pain Clinic for a multidisciplinary approach to pain management. Patients with balance problems often benefit from ‘gait’ training through physical therapy. Patients who have foot drop due to weakness in their ankles may benefit from orthotics.

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