[Polyneuropathies--symptoms, causes and diagnostic procedure].

The diagnosis of a polyneuropathy (PNP) is particularly a clinically based diagnosis. The polyneuropathic syndrome consists of typical symptoms like paraesthesias, pain, cramps and fasciculations as well as characteristic signs like loss of tendon reflexes, weakness and wasting of muscles, sensory loss, cranial nerve palsy and alterations of the autonomic nervous system. The analysis of manifestation-types is very important for the differential diagnosis. The symmetrical sensory type of manifestation can be found in the beginning of almost all toxic neuropathies as well as in uremic and diabetic neuropathy. The symmetrical-motor type of manifestation can be a further development of the symmetrical sensory type of manifestation or exists from the beginning in the case for example of Guillain-Barré-Syndrome. The asymmetric type of manifestation can be observed in the vascular neuropathies and in some types of inflammatory neuropathies like the neuroborrelioses or the neuralgic amyotrophy. The investigation of the CSF, electromyography and electroneurography as well as a great number of chemical lab tests are important for the etiological classification. According to the etiology, the polyneuropathies can be subdivided into four groups such as inflammatory, vascular, exotoxic and endotoxic-metabolic-hereditary diseases. The most frequent etiologies are diabetes mellitus and chronic alcoholism.