Roth's disease: symptoms and treatment

The disease of the company affects men from 50 years. Most often the cause is the neuropathy of the lateral cutaneous nerve of the thigh with the manifestation of sensitive symptoms that require immediate treatment.

Roth-Bernhardt disease - compression of the lateral cutaneous nerve of the thigh in the area between the anterior superior iliac spine and inguinal ligament with the appearance of sensitive disorders on the skin of the anterior surface of the thigh from the outside in its middle third. It is a frequent form of tunnel syndrome.

As a rule, middle-aged men are ill, but there are also family cases of the disease. In 1895, M. Bernhardt proposed an infectious-toxic theory of nerve damage, and B. TO. Mouth - compression. As a result of the compression of the nerve, the nervous impulse changes and the metabolic processes in the nerve fiber are altered, nerve atrophy, inflammation, pain, and edema occur.

Causes

Roth's disease is the neuropathy of the lateral cutaneous nerve of the thigh (in the figure it is red).

Nerve compression in natural anatomical tunnel channels

There are several such sites with the greatest risk of nerve compression:

1. When the nerve leaves the pelvic cavity under the inguinal ligament, it sharply curves at an angle and passes through the iliac fascia. Here, it is possible to squeeze and rub the nerve fiber with the sharp edge of the fascia of the lower limb in the region of the hip joint when the torso is tilted forward;
2. Most often, the process takes place between the attachment point of the inguinal ligament and the anterior superior iliac spine of the ileal wing. When entering the thigh, the nerve has a poor blood supply - this may be a consequence of ischemia of this area.
3. There are cases when a part of the inguinal ligament splits, thus forming a channel for the passage of the nerve, where it can also be compressed;
4. Neuropathy of the nerve can occur due to its passage close to the uneven bone surface of the edge of the superior ileal bone;
5. Nerve impairment with fibers of the sartorius muscle on the thigh;
6. The lesion can occur in the area of ​​the tunnel formed by the broad fascia of the thigh and when exiting it.

Other causes of Disease Rota

• Wearing a tight belt or squeezing clothes;
• pregnancy, when the lumbar lordosis deepens - a sagging in the lower back, the pelvis then tilts forward and increases the extension of the hip joint, as a result this inguinal ligament stretches and squeezes the nerve, but provided that it passes through the channel formed as a result of the bifurcation of this ligament;
• the accumulation of fat deposits on the abdomen and thighs leads to nerve tension and the appearance of sensitive symptoms;
• a tumor of internal organs of any genesis (inguinal hernia);
• accumulation of ascites in the abdominal cavity;
• retroperitoneal hematoma;
• Inflammatory diseases and operations in the abdominal cavity;
• diabetes, typhoid fever, malaria, shingles, avitaminosis.

Symptoms of defeat

The disease develops gradually, more often on the one hand. In 68% of cases, sensitive disorders (paresthesia) predominate: numbness, tingling or crawling in the nerve zone of the nerve. Less often is the appearance of pruritus and unbearable burning pain like the causalgia. At the final stages of the disease, analgesia may occur (a violation of pain sensitivity) in the zone supplied by this nerve. The appearance of symptoms, in some cases, manifests itself in a standing position, in a forced posture lying on the back with straight legs or with prolonged walking. Painful effect increases with maximum hip lead, decreases with bending.

Treatment

If one of the causes of Roth's disease is overweight, to reduce the tension of the nerve, the patient should lose weight.

1. Conservative (non-surgical) - is aimed at alleviating the symptoms. First of all, they eliminate the cause of nerve compression:

• it is recommended a special diet and exercise physiotherapy exercises in excess weight;
• wear loose clothes, clothes;
• treat ascites with conservative or surgical methods;
• timely detection and surgical treatment of volumetric formations of internal organs.

1. Pathogenetic treatment blocks the cause of the disease.
2. Treatment of pain syndrome can begin with the use of non-steroidal anti-inflammatory drugs (ketorol, diclofenac, meloxicam), in the absence of a positive effect, anticonvulsants means (antiepileptic) - gabapentines (catene) and pregabalin (lyric) - the number one drugs for the treatment of neuropathic pain, they are well tolerated and relieve pain very well, but Pregabalin, referring to the results of clinical studies, have a more pronounced analgesic effect with a lower incidence of adverse events than gabapentins.

In the absence of effect or poor tolerance of these drugs with an average or severe pain syndrome, monotherapy with an opioid analgesic (tramadol), but this is fraught with the appearance of many side effects from the central structures of the nervous system and the development of drug dependence.

• Diuretic therapy for diuretics - lasix, furosemide, diacarb;
• To improve microcirculation, nutrition of the cutaneous lateral nerve of the thigh, vascular drugs are used (nicotinic acid, pentoxifylline, vinpocetine);
• Antioxidant preparations (actovegin, mexidol, espa-lipon) - improve microcirculation of damaged tissues and nerve, increase resistance cells of the body to the effect of damaging environmental factors and oxygen deficiency as a result of nerve ischemia;
• Anticholinesterase drugs - contribute to the restoration of nerve impulse transmission (neuromidine, proserin);
• To improve metabolism (metabolic processes) in the nerve and damaged tissues apply vitamins of group B (kombilipen, milgamma, neuromultivitis);
• Physiotherapy - ultrasound, electrostimulation, electrophoresis with local analgesics, acupuncture, balneotherapy, mud therapy.

If nevertheless painful syndrome was not able to be docked, then injectable hydrocortisone administration may help alleviate the condition or prednisolone with a local anesthetic directly into the tunnel itself or surrounding tissues.

1. To surgical intervention resorted to ineffectiveness of the above therapy and the appearance of gross neurologic symptoms. Operational manipulations are performed in the inguinal ligament and are aimed at relieving the nerve and preventing its further compression.

To select a method of treatment, it is necessary to take into account the individual's somatic characteristics and the cause of neuropathy. In any case, all medical manipulations are appointed by the doctor.

About the illness of Roth-Bernhardt in the program "To live healthy!" With Elena Malysheva:

Roth-Bernhardt Syndrome. Keep freedom of movement

Watch this video on YouTube