Sensorimotor polyneuropathy is a condition that causes a decreased ability to move or feel (sensation) due to nerve damage.
Polyneuropathy - sensorimotor
Causes, incidence, and risk factors
Neuropathy means a disease of, or damage to nerves. When it occurs outside of the brain or spinal cord, it is called a peripheral neuropathy. Mononeuropathy means one nerve is involved. Polyneuropathy means that many nerves in different parts of the body are involved.
Neuropathy can affect nerves that provide feeling (sensory neuropathy) or cause movement (motor neuropathy). It can also affect both, in which case it is called a sensorimotor neuropathy.
Sensorimotor polyneuropathy is a body-wide (systemic) 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:
- Autoimmune (body-wide) disorders
- Conditions that put pressure on nerves
- Decreased blood flow to the nerve
- Diseases that destroy the glue (connective tissue) that holds cells and tissues together
- Swelling (inflammation) of the nerves
Some diseases lead to polyneuropathy that is mainly sensory or mainly motor. Possible causes of sensorimotor polyneuropathy include:
- Alcoholic neuropathy
- Cancer (called a paraneoplastic neuropathy)
- Chronic inflammatory neuropathy
- Diabetic neuropathy
- Drug-related neuropathy
- Guillain-Barre syndrome
- Hereditary neuropathy
- Vitamin deficiency (vitamins B12, B1, and E)
- Decreased feeling in any area of the body
- Difficulty swallowing
- Difficulty using the arms or hands
- Difficulty using the legs or feet
- Difficulty walking
- Pain, burning, tingling, or abnormal feeling in any area of the body (called neuralgia)
- Weakness of the face, arms, or legs, or any area of the body
Symptoms may develop quickly (as in Guillain-Barre syndrome) or slowly over weeks to years. Symptoms usually occur on both sides of the body. Most often, they start at the ends of the toes first.
Signs and tests
An exam may show:
- Decreased feeling (may affect touch, pain, vibration, or position sensation)
- Diminished reflexes (ankle most commonly)
- Muscle atrophy
- Muscle twitches (fasciculations)
- Muscle weakness
Tests may include:
- Blood tests
- Electrical test of the muscles (EMG)
- Electrical test of nerve conduction
- X-rays or other imaging tests
Goals of treatment include:
- Finding the cause
- Controlling the symptoms
- Promoting a patient's self-care and independence
Depending on the cause, treatment may include:
- Changing medicines, if they are causing the problem
- Controlling blood sugar level
- Not drinking alcohol
- Taking daily nutritional supplements
PROMOTING SELF-CARE AND INDEPENDENCE
- Exercises and retraining to maximize function of the damaged nerves
- Job (vocational) therapy
- Occupational therapy
- Orthopedic treatments
- Physical therapy
- Wheelchairs, braces, or splints
CONTROL OF SYMPTOMS
Safety is important for people with neuropathy. Lack of muscle control and decreased sensation can increase the risk of falls or other injuries.
If you have movement difficulties, these measures can help keep you safe:
- Leave lights on.
- Remove obstacles (such as loose rugs that may slip on the floor).
- Test water temperature before bathing.
- Use railings.
- Wear protective shoes (such as those with closed toes and low heels).
- Wear shoes that have non-slippery soles.
Other tips include:
- Check your feet (or other affected area) daily for bruises, open skin areas, or other injuries, which you may not notice and can become infected.
- Check the inside of shoes often for grit or rough spots that may injure your feet.
- Visit a foot doctor (podiatrist) to assess and reduce the risk of injury to your feet.
- Avoid leaning on your elbows, crossing your knees, or being in other positions that put prolonged pressure on certain body areas.
Medicines used to treat this condition:
- Over-the-counter and prescription pain relievers to reduce stabbing pain (neuralgia)
- Anticonvulsants or antidepressant
- Lotions, creams, or medicated patches
Avoid pain medicine whenever possible, or use it only when necessary. Keeping your body in the proper position or keeping bed linens off a tender body part may help control pain.
For additional information and support, see: www.neuropathy.org.
You can fully recover from peripheral neuropathy if your health care provider can find the cause and successfully treat it, and if the damage does not affect the entire nerve cell.
The amount of disability varies. Some people have no disability. Others have partial or complete loss of movement, function, or feeling. Nerve pain may be uncomfortable and may last for a long time.
Occasionally sensorimotor polyneuropathy causes severe, life-threatening symptoms.
- Injury to feet (caused by bad shoes or hot water when stepping into the bathtub)
- Trouble walking
Calling your health care provider
Call your health care provider if you have loss of movement or feeling in a part of your body. Early diagnosis and treatment increase the chance of controlling the symptoms.
Katitji B, Koontz D. Disorders of the peripheral nerves. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC. Bradley’s Neurology in Clinical Practice. 6th ed. Philadelphia, PA:Elsevier Saunders; 2012:chap 76.
Shy ME. Peripheral neuropathies. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 428.
Last reviewed 2/27/2013 by Luc Jasmin, MD, PhD, Department of Neurosurgery, Cedars Sinai Medical Center, Los Angeles and Department of Anatomy, University of California, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.
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