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Sommer C
; Geber C
; Young P
; Forst R
; Birklein F
; Schoser B
Dtsch Arztebl Int
2018[Feb]; 115
(6
): 83-90
PMID29478436
show ga
BACKGROUND: Polyneuropathies (peripheral neuropathies) are the most common type
of disorder of the peripheral nervous system in adults, and specifically in the
elderly, with an estimated prevalence of 5-8%, depending on age. The options for
treatment depend on the cause, which should therefore be identified as precisely
as possible by an appropriate diagnostic evaluation. METHODS: This review is
based on the current guidelines and on large-scale cohort studies and randomized,
controlled trials published from 2000 to 2017, with an emphasis on non-hereditary
types of polyneuropathy, that were retrieved by a selective search in PubMed.
RESULTS: Diabetes is the most common cause of polyneuropathy in Europe and North
America. Alcohol-associated polyneuropathy has a prevalence of 22-66% among
persons with chronic alcoholism. Because of the increasing prevalence of
malignant disease and the use of new chemotherapeutic drugs, chemotherapy-induced
neuropathies (CIN) have gained in clinical importance; their prevalence is often
stated to be 30-40%, with high variation depending on the drug(s) and treatment
regimen used. Polyneuropathy can also arise from genetic causes or as a
consequence of vitamin deficiency or overdose, exposure to toxic substances and
drugs, and a variety of immunological processes. About half of all cases of
polyneu - ropathy are associated with pain. Neuropathic pain can be treated
symptomatically with medication. Exercise, physiotherapy, and ergotherapy can
also be beneficial, depending on the patient's symptoms and functional deficits.
CONCLUSION: A timely diagnosis of the cause of polyneuropathy is a prerequisite
for the initiation of appropriate specific treatment. Patients with severe
neuropathy of unidentified cause should be referred to a specialized center for a
thorough diagnostic evaluation.
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