Not infrequently, in the course of a polyneuropathy, which can lead to sensory disturbances and numbness, and the temperature perception of feet and hands may be changed. For example, toes or fingers may feel particularly cold with warm ambient temperature and also warm skin temperature. In everyday life, for example, it may be difficult due to the polyneuropathy, the water temperature when showering or bathing properly assess. In cold weather, the reverse effect can be observed, so that a feeling of heat or painful burning is perceived.
These paradoxical, false impressions or discomfort arise from disease of a particular group of nerve fibers, the "small fibers", i. small-caliber markers and unmarked nerve fibers. These fibers not only convey sensory impressions but also regulate skin circulation, skin moisture and metabolic processes. Not infrequently it comes in the context of a small fiber polyneuropathy to a strong dry skin and even redness of the skin on lower legs, feet and hands comparable to a sunburn or skin irritation.
Disorders and signs of polyneuropathy
Not infrequently, the pain and discomfort of the small fiber neuropathy but also the accompanying symptoms such as indigestion, sleep disorders and feelings of exhaustion are similar to the description of a fibromyalgia. The ANS Clinic is looking for a small fiber neuropathy using specialized examination methods. Should interdisciplinary diagnostics be necessary, this will be coordinated by us. The aim of the diagnosis is above all to find a treatable cause.
A polyneuropathy can affect all nerves of the body in principle. Discomfort, pain and numbness indicate a disease of the sensitive skin-supplying nerves. As part of the investigations is also paid attention to whether more shares of the nervous system are affected. Therefore, attention is paid to possible muscle weakness, disorders of balance and coordination, circulatory weakness and bladder or indigestion.
Therefore, in addition to studies of muscle strength is relevant, whether it comes to gait disorders, tripping and falling. Important observations in this context may be, for example, the sticking of the tiptoe to door sills or a non-rolling of the feet while walking. If primarily hip and thigh muscles are affected, standing up from the squat or climbing stairs becomes difficult. If the Schultergürtel-, the arm or hand muscles are affected, the carrying of bags but also the opening of bottles or glasses can be difficult.
Polyneuropathy - causes span a wide range
Discomfort and pain caused by diseases of the sensitive nerve fibers typically interfere when you want to relax, in the evening or when sitting still. Occasionally, a urge to move the legs may arise, which makes it impossible to sit still. Even the night's sleep can be disturbed by a urge to move the legs very much. In the search for alleviation of discomfort, many sufferers find that foot baths, massages, transcutaneous electrical nerve stimulation (TENS) or even acupuncture provide only temporary relief.
For the diagnosis of a polyneuropathy of the so-called small fibers, that is, a disease of the slow-conducting, myelin-poor nerve fibers, suitable investigation methods are now available. We use these examinations in the ANS Clinic at the Düsseldorf specialist center for the diagnosis.
Through careful consideration in the context of polyneuropathy, the functions of the vegetative (internal) organs are also recorded. Therefore, it is not unlikely that a treatable cause will be found. Occasionally, tingling or ants running on feet and hands may be associated with medication or lack of specific vitamins. The mentioned maladies may also indicate diseases in the field of rheumatology, gastroenterology or cardiology. Malaise and pain can occur early in the course of a chronic illness such as diabetes mellitus or also a liver or kidney weakness.
Aware of the rare
Other possible causes of nerve diseases, which are accompanied by abnormal sensations, include chronic inflammatory changes, for example in the context of infections or autoimmune diseases, toxic nerve damage, thyroid disorders but also the lack of specific vitamins or trace elements. Also included in the search for causes are precautionary examinations and in some cases the imaging examination of the chest and abdomen.
Many causes can be treated well. Through many years of experience in the field of polyneuropathy, especially with the involvement of the autonomic (autonomic) nervous system, we include a wide range of causes in diagnostics. In addition, we work closely with colleagues in other medical specialties. In the clarification and treatment of rare diseases, the meanwhile wide network of our cooperation with specialized medical specialists helps us.
The spectrum of drug treatment options is wide. It can be achieved pain relief, sleep improvement and also an improvement in mood. Not always, however, medications are needed for treatment. Just as diverse are therefore the non-drug treatment methods, which we resort to in the treatment. In the treatment of polyneuropathy with the involvement of the Small Fibers, in our experience, the combination of medical and non-medical treatment methods has proven to be successful.
Patients recalled the follwing experiences:
Like small insects crawling on my skin. That's how my feet felt when I came to rest. This bothered me in the evening especially when falling asleep. I did not expect that solving my problem is easy.
Patients recalled the follwing experiences:
"From the outside, it can not be determined, the skin is warm and rosy. Nevertheless, I always have the feeling that my feet are cold. I did not think that there was any connection with my rheumatism. I am glad that my treatment was coordinated together with my rheumatologist . "
„You have questions about ANS Clinic or would like to make an appointment? I'm happy to help.“
Prof. Dr. Med. Christina Haubrich