Editing Peripheral neuropathy (section)

===Polyneuropathy===
{{Main|Polyneuropathy}}
"''Polyneuropathy''" is a pattern of nerve damage that is quite different from mononeuropathy, often more serious and affecting more areas of the body. The term "peripheral neuropathy" sometimes is used loosely to refer to polyneuropathy. In cases of polyneuropathy, many nerve cells in various parts of the body are affected, without regard to the [[nerve]] through which they pass; not all nerve cells are affected in any particular case. In [[Polyneuropathy|distal axonopathy]], one common pattern is that the cell bodies of neurons remain intact, but the [[axon]]s are affected in proportion to their length; the longest axons are the most affected. [[Diabetic neuropathy]] is the most common cause of this pattern. In demyelinating polyneuropathies, the [[myelin]] sheath around axons is damaged, which affects axons' ability to conduct electrical impulses. The third and least common pattern directly affects the [[cell bodies]] of neurons. This affects the [[sensory neuron]]s (known as ''[[sensory neuronopathy]]'' or ''dorsal root ganglionopathy'').<ref name="Amato 2020">{{cite journal |last1=Amato |first1=Anthony A. |last2=Ropper |first2=Allan H. |title=Sensory Ganglionopathy |journal=New England Journal of Medicine |date=22 October 2020 |volume=383 |issue=17 |pages=1657–1662 |doi=10.1056/NEJMra2023935|pmid=33085862 }}</ref><ref name="Gwathmey 2016">{{cite journal |last1=Gwathmey |first1=Kelly Graham |title=Sensory neuronopathies |journal=Muscle & Nerve |date=January 2016 |volume=53 |issue=1 |pages=8–19 |doi=10.1002/mus.24943|pmid=26467754 }}</ref>

The effect of this is to cause symptoms in more than one part of the body, often symmetrically on the left and right sides. As for any neuropathy, the chief symptoms include motor symptoms such as weakness or clumsiness of movement; and sensory symptoms such as unusual or unpleasant sensations such as [[Paresthesia|tingling or burning]]; [[Hypoesthesia|reduced ability to feel sensations]] such as texture or temperature, and impaired balance when standing or walking. In many polyneuropathies, these symptoms occur first and most severely in the feet. Autonomic symptoms also may occur, such as dizziness on standing up, [[erectile dysfunction]], and difficulty controlling urination.{{citation needed|date=June 2022}}

Polyneuropathies usually are caused by processes that affect the body as a whole. [[Diabetes]] and [[impaired glucose tolerance]] are the most common causes. Hyperglycemia-induced formation of advanced [[glycation]] end products (AGEs) is related to diabetic neuropathy.<ref name="ReferenceA">{{cite journal | vauthors = Sugimoto K, Yasujima M, Yagihashi S | title = Role of advanced glycation end products in diabetic neuropathy | journal = Current Pharmaceutical Design | volume = 14 | issue = 10 | pages = 953–61 | year = 2008 | pmid = 18473845 | doi = 10.2174/138161208784139774 }}</ref> Other causes relate to the particular type of polyneuropathy, and there are many different causes of each type, including inflammatory diseases such as [[Lyme disease]], vitamin deficiencies, blood disorders, and toxins (including alcohol and certain prescribed drugs).

Most types of polyneuropathy progress fairly slowly, over months or years, but rapidly progressive polyneuropathy also occurs. It is important to recognize that at one time it was thought that many of the cases of [[small fiber peripheral neuropathy]] with typical symptoms of tingling, pain, and loss of sensation in the feet and hands were due to [[glucose intolerance]] before a diagnosis of diabetes or pre-diabetes. However, in August 2015, the Mayo Clinic published a scientific study in the Journal of the Neurological Sciences showing "no significant increase in...symptoms...in the prediabetes group", and stated that "A search for alternate neuropathy causes is needed in patients with prediabetes."<ref name="pmid26049659">{{cite journal | vauthors = Kassardjian CD, Dyck PJ, Davies JL, Carter RE, Dyck PJ | title = Does prediabetes cause small fiber sensory polyneuropathy? Does it matter? | journal = Journal of the Neurological Sciences | volume = 355 | issue = 1–2 | pages = 196–8 | date = August 2015 | pmid = 26049659 | pmc = 4621009 | doi = 10.1016/j.jns.2015.05.026 }}</ref>

The treatment of polyneuropathies is aimed firstly at eliminating or controlling the cause, secondly at maintaining muscle strength and physical function, and thirdly at controlling symptoms such as [[neuropathic pain]].{{citation needed|date=June 2022}}