Polyneuropathie: diagnostiek en beleid

– A polyneuropathy is characterized by a symmetrical distribution of sensory or motor abnormalities, more pronounced distally than proximally and usually more evident in the lower than in the upper limbs.

– Polyneuropathies may be classified on the basis of (a) clinical picture: acutesubacutechronic, sensorymotorautonomous, axonal degenerationsegmental demyelinization, and (b) cause: metabolic disorder, deficiency, infection, auto(dys)immunity, hereditary and toxiciatrogenic polyneuropathy, with idiopathic polyneuropathy as the remaining group.

– Damaged nerves may recover as the result of spontaneous remyelinization and axonal regeneration.

– Treatment is particularly successful in immunomediated neuropathies. Withdrawal is often successful in intoxications and suppletion in deficiencies.

– Even if no treatment is possible, the diagnosis is important: the patient can be taught to accept his disease and the prognosis can be determined, in connection with possible handicaps.