Polyneuropathien im Alter

Polyneuropathien (PNP) zählen zu den häufigsten neurologischen Erkrankungen des höheren Lebensalters. Durch Beeinträchtigung der Mobilität, Erhöhung des Sturzrisikos und neuropathische Schmerzen können sie die Lebensqualität der Patienten deutlich einschränken. Aufgrund der Vielzahl an möglichen Ursachen und weil häufig mehrere potenzielle Auslöser vorliegen, ist die Diagnostik gerade in höherem Lebensalter schwierig und erfordert ein systematisches Vorgehen.

Abstract

Polyneuropathies are among the most common neurological diseases in elderly individuals. They can negatively impact patients’ health-related quality of life via impaired mobility, increased risk of falling, and neuropathic pain. Diagnosis of polyneuropathies in elderly individuals is especially challenging due to their multimodal etiology and requires a systematic approach.

Schlüsselwörter

Neuropathie - Altern - neurologische Erkrankung - kognitive Funktion

Key word

Neuropathy - aging - neurological disease - cognitive function

Publication History

Article published online:
04 April 2024

• Literatur

• 1 Lauria G, Merkies IS, Faber CG. Small fibre neuropathy. Curr Opin Neurol 2012; 25: 542-549 DOI: 10.1097/WCO.0-b013e32835804c5.
• 2 Hanewinckel R, van Oijen M, Ikram MA. et al. The epidemiology and risk factors of chronic polyneuropathy. Eur J Epidemiol 2016; 31: 5-20 DOI: 10.1007/s10654-015-0094-6.
• 3 Visser NA, Notermans NC, Linssen RS. et al. Incidence of polyneuropathy in Utrecht, the Netherlands. Neurology 2015; 84: 259-264 DOI: 10.1212/WNL.0000000000001160.
• 4 England JD, Asbury AK. Peripheral neuropathy. Lancet 2004; 363: 2151-2161 DOI: 10.1016/S0140-6736(04)16508-2.
• 5 Sommer C, Richter H, Rogausch JP. et al. A modified score to identify and discriminate neuropathic pain: a study on the German version of the Neuropathic Pain Symptom Inventory (NPSI). BMC Neurol 2011; 11: 104 DOI: 10.1186/1471-2377-11-104.
• 6 Treede RD, Jensen TS, Campbell JN. et al. Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology 2008; 70: 1630-1635 DOI: 10.1212/01.wnl.0000282763.29778.59.
• 7 Heuss D, Hund E, Klehmet J et al. Diagnostik bei Polyneuropathien, S1-Leitlinie 2019. In: Deutsche Gesellschaft für Neurologie, Hrsg. Leitlinien für Diagnostik und Therapie in der Neurologie 2019. AWMF-Registernummer 030/067. Im Internet: https://www.awmf.org/leitlinien/detail/ll/030-067.html Stand: 02.10.2019
• 8 Bril V, Perkins BA. Validation of the Toronto Clinical Scoring System for diabetic polyneuropathy. Diabetes Care 2002; 25: 2048-2052
• 9 Merkies IS, Schmitz PI, van der Meche FG. et al. Clinimetric evaluation of a new overall disability scale in immune mediated polyneuropathies. J Neurol Neurosurg Psychiat 2002; 72: 596-601
• 10 Taylor PK. Non-linear effects of age on nerve conduction in adults. J Neurol Sci 1984; 66: 223-234
• 11 Rolke R, Magerl W, Campbell KA. et al. Quantitative sensory testing: a comprehensive protocol for clinical trials. Eur J Pain 2006; 10: 77-88 DOI: 10.1016/j.ejpain.2005.02.003.
• 12 Dräger B, Young P. [Pragmatic Diagnosis of Hereditary Neuropathies]. Akt Neurol 2016; 43: 256-266 DOI: 10.1055/s-0042-105430.
• 13 Goedee HS, van der Pol WL, van Asseldonk JH. et al. Diagnostic value of sonography in treatment-naive chronic inflammatory neuropathies. Neurology 2017; 88: 143-151 DOI: 10.1212/WNL.0000000000003483.
• 14 Lichtenstein T, Sprenger A, Weiss K. et al. MRI biomarkers of proximal nerve injury in CIDP. Ann Clin Transl Neurol 2018; 5: 19-28 DOI: 10.1002/acn3.502.
• 15 Kronlage M, Pitarokoili K, Schwarz D. et al. Diffusion tensor imaging in chronic inflammatory demyelinating polyneuropathy: diagnostic accuracy and correlation with electrophysiology. Invest Radiol 2017; 52: 701-707 DOI: 10.1097/RLI.0000000000000394.
• 16 Mellgren SI, Lindal S. Nerve biopsy – some comments on procedures and indications. Acta Neurol Scand 2011; 124: 64-70 DOI: 10.1111/j.1600-0404.2011.01546.x.
• 17 Vrancken AF, Gathier CS, Cats EA. et al. The additional yield of combined nerve/muscle biopsy in vasculitic neuropathy. Eur J Neurol 2011; 18: 49-58 DOI: 10.1111/j.1468-1331.2010.03041.x.
• 18 Üçeyler N, Devigili G, Toyka KV. et al. Skin biopsy as an additional diagnostic tool in non-systemic vasculitic neuropathy. Acta Neuropathol 2010; 120: 109-116 DOI: 10.1007/s00401-010-0662-5.
• 19 Pop-Busui R, Boulton AJ, Feldman EL. et al. Diabetic neuropathy: a position statement by the American Diabetes Association. Diabetes Care 2017; 40: 136-154 DOI: 10.2337/dc16-2042.
• 20 Serhiyenko VA, Serhiyenko AA. Cardiac autonomic neuropathy: Risk factors, diagnosis and treatment. World J Diabetes 2018; 9: 1-24 DOI: 10.4239/wjd.v9.i1.1.
• 21 Gibbons CH, Freeman R. Treatment-induced diabetic neuropathy: a reversible painful autonomic neuropathy. Ann Neurol 2010; 67: 534-541 DOI: 10.1002/ana.21952.
• 22 Chevret S, Hughes RA, Annane D. Plasma exchange for Guillain-Barre syndrome. Cochrane Database Syst Rev 2017; 2: CD001798 DOI: 10.1002/14651858.CD001798.pub3.
• 23 Hattori N, Misu K, Koike H. et al. Age of onset influences clinical features of chronic inflammatory demyelinating polyneuropathy. J Neurol Sci 2001; 184: 57-63
• 24 Joint Task Force of the EFNS and the PNS. European Federation of Neurological Societies/Peripheral Nerve Society Guideline on management of chronic inflammatory demyelinating polyradiculoneuropathy: report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society-First revision. J Peripher Nerv Syst 2010; 15: 1-9 DOI: 10.1111/j.1529-8027.2010.00245.x.
• 25 Sommer C, Gold R, Heuss D et al. Therapie akuter und chronischer immunvermittelter Neuropathien und Neuritiden, S2e-Leitlinie, 2018. In: Deutsche Gesellschaft für Neurologie, Hrsg. Leitlinien für Diagnostik und Therapie in der Neurologie 2018. AWMF-Registernummer 030-130. Im Internet: https://www.awmf.org/leitlinien/detail/ll/030-130.html Stand: 02.10.2019
• 26 Collins MP, Dyck PJ, Gronseth GS. et al. Peripheral Nerve Society Guideline on the classification, diagnosis, investigation, and immunosuppressive therapy of non-systemic vasculitic neuropathy: executive summary. J Peripher Nerv Syst 2010; 15: 176-184 DOI: 10.1111/j.1529-8027.2010.00281.x.
• 27 Rison RA, Beydoun SR. Paraproteinemic neuropathy: a practical review. BMC Neurol 2016; 16: 13 DOI: 10.1186/s12883-016-0532-4.
• 28 Voltz R. Paraneoplastic neurological syndromes: an update on diagnosis, pathogenesis, and therapy. Lancet Neurol 2002; 1: 294-305
• 29 Zajaczkowska R, Kocot-Kepska M, Leppert W. et al. Mechanisms of Chemotherapy-Induced Peripheral Neuropathy. Int J Mol Sci 2019; DOI: 10.3390/ijms20061451.
• 30 Gu Y, Menzies AM, Long GV. et al. Immune mediated neuropathy following checkpoint immunotherapy. J Clin Neurosci 2017; 45: 14-17 DOI: 10.1016/j.jocn.2017.07.014.
• 31 Romagnolo A, Merola A, Artusi CA. et al. Levodopa-induced neuropathy: a systematic review. Mov Disord Clin Pract 2019; 6: 96-103 DOI: 10.1002/mdc3.12688.
• 32 Triantafyllou NI, Nikolaou C, Boufidou F. et al. Folate and vitamin B12 levels in levodopa-treated Parkinsonʼs disease patients: their relationship to clinical manifestations, mood and cognition. Parkinsonism Relat Disord 2008; 14: 321-325 DOI: 10.1016/j.parkreldis.2007.10.002.
• 33 Finsterer J, Iglseder S, Wanschitz J. et al. Hereditary transthyretin-related amyloidosis. Acta Neurol Scand 2019; 139: 92-105 DOI: 10.1111/ane.13035.
• 34 Zis P, Sarrigiannis PG, Rao DG. et al. Chronic idiopathic axonal polyneuropathy: a systematic review. J Neurol 2016; 263: 1903-1910 DOI: 10.1007/s00415-016-8082-7.
• 35 Finnerup NB, Attal N. Pharmacotherapy of neuropathic pain: time to rewrite the rulebook?. Pain Manag 2016; 6: 1-3 DOI: 10.2217/pmt.15.53.
• 36 Finnerup NB, Attal N, Haroutounian S. et al. Pharmacotherapy for neuropathic pain in adults: a systematic review and metaanalysis. Lancet Neurol 2015; 14: 162-173 DOI: 10.1016/S1474-4422(14)70251-0.
• 37 Holt S, Schmiedl S, Thurmann PA. Potentially inappropriate medications in the elderly: the PRISCUS list. Dtsch Arztebl Int 2010; 107: 543-551 DOI: 10.3238/arztebl.2010.0543.
• 38 Haanpaa M, Cruccu G, Nurmikko TJ. et al. Capsaicin 8% patch versus oral pregabalin in patients with peripheral neuropathic pain. Eur J Pain 2016; 20: 316-328 10.1002/ejp.731