Polyneuropathy of the lower and upper extremities: symptoms, treatment, drugs

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  • 1Polyneuropathy of upper and lower extremities: causes, symptoms and treatment of pathology
    • 1.1Polineuropathy of extremities of various species. Classification of the disease
    • 1.2The causes of polyneuropathy of the extremities
    • 1.3Symptoms and manifestations of the disease
    • 1.4Diagnosis of the disease
    • 1.5Treatment of polyneuropathy of the upper and lower extremities
    • 1.6Complication after polyneuropathy and prognosis for cure
    • 1.7Prevention of disease
    • 1.8Folk methods of prevention and treatment of polyneuropathy
  • 2Polyneuropathy of the lower extremities: symptoms, treatment with drugs
    • 2.1Polineuropathy of the lower extremities - why does it arise?
    • 2.2Clinical picture
    • 2.3Classification
    • 2.4Diagnosis of pathology
    • 2.5Treatment - prevention of progression of pathology
    • 2.6The main groups of drugs for the treatment of polyneuropathy
    • 2.7Metabolic means
    • 2.8Vitamin Complexes
    • 2.9Painkillers
    • 2.10Medications that improve nerve conduction
    • 2.11Methods of physiotherapy
  • 3What is the polyneuropathy of the lower extremities?
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  • 4Polyneuropathy of the upper and lower extremities, symptoms and treatment, drugs
    • 4.1Features of pathology
    • 4.2Forms of ailment
    • 4.3Symptoms
    • 4.4Diagnostics
    • 4.5Medication
    • 4.6Forecast

Polyneuropathy of upper and lower extremities: causes, symptoms and treatment of pathology

Polyneuropathy of the upper and lower extremitiesIs a pathology in the work of peripheral nerve endings.

Basically, the ailment affects the nervous system of the upper and lower extremities.

There is a disease in the loss of sensitivity, dysfunction of BCC, a decrease in the performance of muscles.

In general, pathologies are atrophic and bring a lot of suffering. More often the foci of the disease spread precisely in the lower extremities. As a rule, the disease spreads from below upwards. This is due to the fact that the first disease affects the long nerve fibers.

Polineuropathy of extremities of various species. Classification of the disease

Polyneuropathy is divided into the main 4 types of lesion localization and the effects on certain fibers and their structures.

Polyneuropathy by type of affected fibers. In the human body, the fibers are divided among themselves in their functionality. The disease that affects each group has its symptoms and signs. Thus, for their defeat, the disease can be divided into:

  • type of disease affecting the motor nerve fibers. This species distinguishes itself by such characteristic signs as a decrease in the working capacity of muscles, frequent convulsions, failure of the sensitivity of muscle fibers, to complete atrophy;
  • type of disease affecting sensory fibers. Nerve fibers responsible for sensitivity and sensory perception;
  • type of disease affecting vegetative fibers. For this species is characterized by a violation of the blood flow system, abundant sweating, impotence and diseases of the genitourinary system;
  • mixed type, is caused by the defeat of all types of nerve fibers;

The structure of nerve fibers consists of axons and myelin sheaths. Polineuropathy can affect only a certain layer in the structure of the nerve fiber. Thus, the nature of the lesion of the disease can be divided into:

  1. The disease affecting the layer of axons in the nerve fibers takes a long time and manifests itself in the atrophy of the limbs. As it affects to a greater degree the autonomic functions of the limbs;
  2. The disease that destroys the myelin sheath develops much faster. There is a pathology in violation of sensory and motor functions;

By localization of lesions it is possible to define such species as distal (foci are located in the lower parts) and proximal (foci are located in the upper regions).

It is possible to assess the type of polyneuropathy due to various causes of the disease:

  • toxic polyneuropathy. The onset of the disease is provoked by poisoning with antibiotics or other toxic substances (salts, heavy metals, arsenic);
  • Dismetabolic polyneuropathy. The nature of the onset comes from functional disorders in nerve fibers. Which occur against the background of penetration into the blood of the decay products of certain drugs. As a consequence, there is a violation of metabolic processes that lead to the disease;
  • alcoholic polyneuropathy. The disease is triggered by the abuse of alcohol and its breakdown products;
  • diabetic polyneuropathy. The disease occurs against the background of diabetes mellitus;

The causes of polyneuropathy of the extremities

Despite the fact that different types of polyneuropathy are caused by various causes of the onset, the main reasons for the development of pathology include:

  1. Violation of the immune system. There is a special pathology of immunity, in which immune cells devour each other, affecting the immune nerve fibers;
  2. genetic abnormalities and other congenital factors, including hereditary;
  3. metabolic disease. For example, a violation of the exchange of blood sugar in diabetes mellitus, or a violation of the exchange of protein products in the blood with uremia;
  4. poisoning with chemicals and products of their decay;
  5. bacterial and viral infections, concomitant damage to the immune and nervous system in the body;
  6. various tumors;
  7. systemic diseases, manifested by disorders in connective tissues and vessels;
  8. avitaminosis;
  9. hormonal disorders in the glands;
  10. diseases of the genitourinary system;
  11. disease of the liver and gallbladder;

Symptoms and manifestations of the disease

Polyneuropathy of the upper and lower extremitiesfor symptomatology and manifestation can be divided into primary, when symptoms and lesions are sensitive character and a more severe secondary, which is due to disorders of the functioning of the nervous system extremities. Symptoms and signs expressing the disease:

  • tremor of extremities. May be permanent, periodic and manifest in certain circumstances;
  • cramps and spasms with painful sensations in the muscles of the upper and lower extremities;
  • twitching. Which are due to involuntary muscle contraction (fasciculation);
  • creeps and a feeling of trembling on the skin;
  • sharp jumps in blood pressure in the arteries. Such symptoms occur when the nerve fibers are responsible for the operation of blood vessels and cardiac functions;
  • a sharp increase in heart rate;
  • lowering the efficiency of muscle fibers. As a rule, weakness develops initially in the farthest muscles of the limbs, fingers and heels;
  • decreased muscle tone;
  • complete muscular atrophy;
  • atrophy of the sensitivity of the skin;
  • loss of orientation in space with sharp bends, ascents, walking with blindfolds and failures in a sense of balance;
  • oxygen starvation of the brain. As a consequence, dark circles and flies in front of the eyes, dizziness, darkening in the eyes. Especially often, these signs manifest themselves with a sharp rise from the prone position;
  • constant value of heart rate, pulse;
  • dry skin;
  • violation of the gastrointestinal tract, in the form of constipation;
  • swelling of the legs;
  • sensation of stitching pain;

Diagnosis of the disease

At the first signs of the disease you need to immediately go to the doctor. Your attending physician will assess your general condition and, if necessary, prescribe a diagnosis for the determination of polyneuropathy of the upper and lower extremities. Diagnosis of the definition of the disease is:

  1. the study of complaints of the patient and his already existing diseases in the anamnesis;
  2. consideration of the fact of taking alcohol in exorbitant quantities. Abuse of alcoholic beverages;
  3. questioning the patient, identifying his place of work and excluding contact with chemicals;
  4. The presence of diseases in the patient, manifested in changes in the metabolism of sugar and protein products in the blood;
  5. hereditary factor. Does the patient have relatives with such a disease?
  6. general blood analysis;
  7. a blood glucose test and protein products;
  8. a blood test for toxic substances;
  9. biopsy of nerve fibers;
  10. electroneuromyography. Diagnosis of the depth of nerve fiber damage;
  11. consultation of narrow specialists in the direction of endocrinology and therapy;
  12. ultrasound diagnosis of internal organs;
  13. X-ray examination;
  14. analysis of cerebrospinal material;
  15. research of reflexes;
  16. checking the speed of nervous reactions;
  17. identification of concomitant somatic symptoms;
  18. palpation of nerve trunks;
  19. additional methods at the discretion of the doctor;

Having carried out full diagnostics, the doctor determines the degree and nature of polyneuropathy. Based on these data, adequate treatment is prescribed.

Treatment of polyneuropathy of the upper and lower extremities

Treatment of a disease affecting the nervous system of fibers is a complex process. Includes several types of treatment and procedures.

The first stage on the way to recovery is the determination of the primary primary diseases, the consequence of which was polyneuropathy.

The whole complex of primary procedures and courses should be aimed at eliminating the primary causes of the disease. In order to exclude its further repetition.

Drug therapy is prescribed taking into account the course of the disease and consists of taking the following drugs:

  • methylprednisolone. Glucocorticoid drug;
  • analgin and tramadol, for the removal of severe pain;
  • preparations suppressing immune processes;
  • potassium salts, vitamin B, vitamin C;
  • protein diet;
  • antihistamines (tavegil, suprastin, zodak);
  • drugs that improve blood circulation;
  • drugs that improve muscular-nerve patency (proserin);
  • Mildronate and Pyracetam. To improve nutrition of nerve fibers;
  • use of drugs that purify the blood for alcohol and toxic polyneuropathy;
  • antidepressants in the treatment of pain syndrome;
  • blockers of fast sodium channels for analgesic effect;
  • anesthesia with gabapentin courses;
  • anticonvulsants;

In addition to drug therapy, physiotherapy procedures are widely used in courses aimed at treating polyneuropathy. Fizprotsedury usually used to consolidate the results of treatment or in its residual stages. Physiotherapeutic methods used in the courses:

  1. massotherapy;
  2. magnetic influence on the periphery of nerve fibers;
  3. use of electrical appliances, for direct stimulation of nerve fibers;
  4. Indirect massage of internal organs;

To maintain the tone of the muscle fibers and to support their performance, the patient is assigned a permanent therapeutic gymnastics. with a special course of procedures. The doctor calculates the necessary physical activity and the necessary set of exercises.

Complication after polyneuropathy and prognosis for cure

Polineuropathy, like all diseases of the nervous system, entails consequences. The most common is the total loss of the ability to move independently.

This outcome is due to the neglect of various forms of the disease, which led to a complete atrophy of the muscle fibers in the limbs. And full of their impotence.

Polineuropathy should in no case be left without attention and delay the beginning of the treatment course.

Complete recovery from the disease is possible only at the beginning of the treatment process in the initial stage of the disease. After the disease develops into a chronic form, the cure ceases to be real.

However, with proper observance of the doctor's recommendations, you can virtually get rid of the manifestation of polyneuropathy.

With proper treatment, a complete slowdown in the distribution of lesions of nerve fibers in the limbs is possible.

Prevention of disease

The disease polyneuropathy is quite a serious disease, which everyone would like to avoid whenever possible. In order that you do not touch a neurological illness, you must observe and adhere to a number of simple rules:

  • to exclude the use of alcoholic and low alcoholic beverages;
  • when interacting and contacting with chemicals, use protective devices and take cleansing preparations;
  • eating natural products. Avoid eating foods with a high risk of chemical poisoning;
  • Do not take self-prescribed antibiotics and other medications. Take medicine only for strict doctor's prescriptions;
  • timely start treatment of viral and bacterial infections. Prevent neglected diseases and consequences;
  • take seasonal vitamin courses that strengthen the immune system;

At the first, even a few, signs of polyneuropathy immediately consult a doctor for diagnosis and adequate treatment. By timely treatment, you shorten the rehabilitation period and have all chances to stop the disease.

Folk methods of prevention and treatment of polyneuropathy

Treatment with infusion: crushed flowers of red clover (pre-dried), garlic powder, sweetener, dry clopogon chop, sage, yellow-root and cassia bark. Tablespoons of the crushed mixture pour 600 ml of boiling water and insist in a thermos for about 4 hours or more. Take 100ml 3 times a day.

Dry leaves of ginkgo biloba 4 liters pour 1 liter of boiling water. Insist 4 days. Take instead of tea.

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Treatment with oil: fill the jar, l chopped St. John's wort. Fill with warm vegetable oil. we insist the mixture for 20 days in a dark warm place. On preparation, strain and add grated ginger about 1 tbsp. Oil is used for massages and wraps.

Seeds of milk thistle 4 tbsp grinded in a mortar and add 150g of olive oil about 600C. Add 2 tbsp of dry mint. Take 2 tablespoons for half an hour before meals three times a day. The course of treatment is 20 days.

It should be remembered that all folk methods are effective only in conjunction with adequate therapy attributed to your doctor. Before beginning any course, you should discuss this method of treatment with your doctor. Self-treatment is dangerous!

A source: http://tvojajbolit.ru/nevrologiya/polineyropatiya-verhnih-i-nizhnih-konechnostey-prichinyi-simptomyi-i-lechenie-patologii/

Polyneuropathy of the lower extremities: symptoms, treatment with drugs

Polyneuropathy of the lower limbs is a common pathology associated with the defeat of peripheral nerves. The disease is characterized by trophic and vegetative-vascular disorders affecting the lower extremities, manifested by a sensitivity disorder and flaccid paralysis.

The danger of pathology is that over time, its manifestations are aggravated, there are problems with movement, which affects the ability to work and prevents a full life. Today, let's talk about the symptoms and treatment of polyneuropathy of the lower extremities, and also consider methods aimed at preventing further progression of pathology.

Polineuropathy of the lower extremities - why does it arise?

Polyneuropathy of the lower extremities is not an independent disease. According to the ICD 10, this condition is considered a neurological syndrome, which accompanies a variety of diseases:

  1. diabetes mellitus (diabetic polyneuropathy of the lower extremities);
  2. chronic alcohol intoxication (alcoholic polyneuropathy of the lower extremities);
  3. beriberi (especially with a lack of vitamin B);
  4. severe poisoning with drugs, arsenic, lead carbon monoxide, methyl alcohol (acute axonal polyneuropathies);
  5. Systemic diseases - biliary cirrhosis, malignant tumors, lymphoma, diseases of the blood, kidneys (chronic axonal polyneuropathies);
  6. infectious diseases (diphtheria polyneuropathy);
  7. hereditary and autoimmune pathologies (demyelinating polyneuropathies).

The cause of the disease can be a variety of health disorders and chronic diseases. Disrupt the work of the peripheral nervous system can cancerous tumors. In addition, signs of polyneuropathy may appear after a course of chemotherapy.

To cause problems with impaired sensation and damage to nerve fibers infectious and inflammatory processes in the joints, any kind of intoxication of the body (drugs, alcohol, chemical substances). In children, this ailment is most often hereditary, for example, the symptoms of porphyria polyneuropathy manifest in the child immediately after birth.

Thus, all the factors that provoke the development of the pathological state of the physician are divided into several groups:

  • metabolic (associated with the violation of metabolic processes);
  • hereditary;
  • autoimmune;
  • infectious-toxic;
  • toxic;
  • alimentary (caused by errors in nutrition).

Polyneuropathy never appears as an independent ailment, the defeat of nerve fibers is always associated with an etiological factor that negatively affects the state of the peripheral nervous system.

Clinical picture

Polyneuropathy of the upper and lower extremities begins with increasing muscle weakness, which is associated with the developing lesion of nerve fibers.

First of all, the distal parts of the limbs are damaged.

Thus the sensation of a numbness arises in the field of feet and gradually extends on all leg.

Patients with polyneuropathy complain of burning sensations, crawling, tingling, numbness of the limbs. Various kinds of paresthesia are complicated by muscle pains.

As the symptoms increase, patients experience severe discomfort even if they accidentally touch the problem area.

In the later stages of the disease, the gait is unstable, the coordination of movements is impaired, and there is a complete lack of sensitivity in the area of ​​nerve fibers.

Muscular atrophy is expressed in the weakness of the arms and legs and in severe cases can result in paresis or paralysis. Sometimes unpleasant sensations in the extremities arise in a state of rest, forcing to perform reflex movements. Such manifestations of physicians are described as "restless legs syndrome".

Pathology is accompanied by vegetative disorders, which are manifested by vascular disorders (sensation of cold in the affected limbs, marble pallor of the skin) or trophic lesions (ulcers and cracks, peeling and dry skin, the appearance of pigmentation).

Manifestations of polyneuropathy are difficult not to notice, as the pathology progresses, they become evident not only for the patient, but also for the surrounding people.

The gait changes and becomes heavier, as the legs become "cotton difficulties arise with movement, a person with difficulty overcomes even the small distances that previously passed for A couple of minutes.

As the pathology progresses, the sensation of numbness in the limbs increases.

There is a pain syndrome, which manifests itself in different ways, one part of the patients feels only minor discomfort, while the other - complains of aching or sharp, burning pain.

Patients have swelling of the extremities, violation of knee reflexes, lack of response to the stimulus. In this case, only one or several characteristic symptoms may appear, all depending on the severity of the lesion of a particular nerve trunk.

Classification

By the nature of the flow polyneuropathy of the lower extremities can be:

  1. Sharp. It develops for 2-3 days most often against the background of severe poisoning with medicines, methyl alcohol, mercury salts, lead. Treatment takes an average of 10 days.
  2. Subacute. Symptoms of lesions increase gradually over a couple of weeks. Pathology usually occurs against a background of toxicosis or metabolic disorders and requires long-term treatment.
  3. Chronic. This form of the disease progresses against the background of diabetes mellitus, alcoholism, hypovitaminosis, blood diseases or oncology. Develops gradually, for a long time (from six months and longer).

Given the lesion of nerve fibers, polyneuropathy is divided into several types:

  • Motor (motor). The neurons responsible for movement are affected, resulting in impaired or completely lost motor functions.
  • Sensory polyneuropathy of the lower extremities. Nerve fibers that are directly related to sensitivity are damaged. As a result, painful, thrusting sensations arise even with a slight touch to the problem area.
  • Vegetative. There is a violation of regulatory functions, which is accompanied by such manifestations as hypothermia, severe weakness, abundant separation of sweat.
  • Mixed neuropathy of the lower extremities. This form includes a variety of symptoms from all of the above conditions.

Depending on the lesion of cellular neural structures, polyneuropathy can be:

  1. Axonal. Affects the axial cylinder of nerve fibers, which leads to a decrease in sensitivity and impairment of motor functions.
  2. Demyelinating. Myelin breaks down, which forms a shell of nerves, as a result of pain pain, accompanied by inflammation of the nerve roots and weakness of the musculature of the proximal and distal segments extremities.

The demyelinating form of polyneuropathy is the most serious form of the disease, the development mechanism of which has not been fully studied so far. However, as a result of a number of studies, scientists advanced a theory about the autoimmune nature of pathology.

At the same time, the human immune system perceives its cells as foreign cells and produces specific antibodies that attack the roots of nerve cells, destroying their myelin sheaths.

As a result, nerve fibers lose their functions and provoke innervation and muscle weakness.

Good to know

Since almost all autoimmune pathologies are associated with heredity, it is assumed that the genetic factor may be the cause of the development of this form of pathology.

Diagnosis of pathology

Ultrasound

If there is a suspicion of polyneuropathy, the patient will have to undergo a number of diagnostic procedures, including laboratory and instrumental studies.

After the history is collected, the doctor will conduct an external examination, examine the reflexes, and then send the patient to the laboratory for blood donation for general and biochemical analysis.

In addition, the patient will be given an ultrasound scan of internal organs, a radiography of the affected areas, and a cerebrospinal fluid intake.

If necessary, take a biopsy of nerve fibers for the study.

The selection of the treatment regimen starts only after a full examination and diagnosis.

Treatment - prevention of progression of pathology

The basis of therapeutic measures for polyneuropathy is the combination of medical and physiotherapeutic methods aimed at preventing the progression of pathology and the restoration of impaired innervation of the nervous fibers. The methods of therapy in many will depend on the cause that contributes to the development of pathology.

If the blame for all severe chronic diseases, primarily involved in the treatment of the underlying disease. So, with diabetic polyneuropathy, drugs are selected that will not affect the level of the glycemic index, and the therapy itself is carried out in stages.

First correct the diet, normalize the body weight, develop for the patient a complex of therapeutic gymnastics.

In the future, the treatment scheme includes neurotropic vitamins and injections of alpha-lipoic acid, prescribe immunosuppressive agents and glucocorticoids.

In the toxic nature of the disease, first of all, detoxification activities are carried out, after which the necessary medications are prescribed.

If the pathology develops against the background of thyroid dysfunction, during the treatment hormonal preparations are used.

Malignant neoplasms are treated operatively by removing the tumor, which compresses the nerve roots.

For the development of limbs and elimination of motor disorders, methods of therapeutic physical training (LFK) are used. To restore sensitivity, vitamins of group B help, pain relief is prescribed for analgesics in the form of ointments, tablets or injections.

The main groups of drugs for the treatment of polyneuropathy

Metabolic means

These drugs are the first choice in the treatment of polyneuropathy, their therapeutic effect is directed to Improve blood circulation in the area of ​​damage, improve tissue trophism and regenerate the nervous fibers. Most often in the treatment plan include medicines from this list:

  • Actovegin;
  • Cerebrolysin;
  • Mexidol;
  • Alpha-lipoic acid;
  • Instenon;
  • Cytochrome C;
  • Trental.

The drugs are aimed at improving neuromuscular conduction, accelerating metabolism, improving the supply of tissues with blood and oxygen.

Metabolic agents are able to have an antioxidant effect, to fight against free radicals, stop the processes of destruction of nervous tissue and help restore disturbed functions.

Vitamin Complexes

In the process of treatment an important role is assigned to vitamins of group B (B1, B12, B6). Preference is given to combination preparations that are released in tablet form or in the form of injections. Among the injection forms most often prescribed:

  1. Kombilipen;
  2. Vitagamma;
  3. Milgamma;
  4. Vitaxon.

In addition to the optimal set of vitamins, these medicines contain lidocaine, which additionally provides an analgesic effect. After the course of injections, prescribe vitamin preparations in tableted form - Neuromultivit, Neurobionum, Keltikan.

Painkillers

With polyneuropathy, the use of conventional analgesics (Analgin, Pentalgin, Sedalgin) does not give the desired effect. Earlier, for the management of the pain syndrome, injections of lidocaine were prescribed. But its use provoked jumps in blood pressure and a disturbance of the heart rhythm.

Today, a safer variant is developed, which allows applying an anesthetic locally. For relief of pain recommend to use a patch Versasitis, which is based on lidocaine.

It is simply fixed on the problem area, which makes it possible to achieve anesthesia without irritation and side reactions.

If the pain syndrome has a clear place of localization, you can use local remedies - ointments and gels with analgesic effect (eg, Capsicum).

Well cope with the manifestations of pain syndrome anticonvulsant drugs - Gabapentin, Neurontin, Lyrics, which are released in the form of capsules or tablets.

Reception of such funds begins with minimal doses, gradually increasing the amount of the medicine. The therapeutic effect is not instantaneous, it accumulates gradually.

The effectiveness of the drug can be judged not earlier than in 1-2 weeks from the beginning of admission.

In severe cases, when pain can not be removed by the above mentioned means, prescribe opioid analgesics (Tramadol) in combination with Zaldiar preparation. If necessary, the doctor may prescribe the use of antidepressants. Most often appoint Amitriptyline, with poor tolerance - Ludomil or Venlaksor.

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Medications that improve nerve conduction

In the treatment of polyneuropathy necessarily involve drugs that improve the conductivity of the nerve impulse to the hands and feet.

Restore the sensitivity of the pill or injection of Axamon, Amiridin or Neuromidine.

The course of therapy with these drugs is quite long - at least a month.

During the treatment the doctor can combine different groups of drugs to achieve the most pronounced therapeutic effect.

Methods of physiotherapy

Along with the methods of therapeutic physical education, the complex treatment of polyneuropathy necessarily includes physiotherapeutic procedures. The doctor can recommend the following methods:

  • darsonvalization;
  • ultratonotherapy;
  • reception of galvanic baths;
  • paraffin or ozocerite applications;
  • electrophoresis medicinal;
  • massotherapy;
  • underwater shower massage.

The patient is necessarily expected to practice therapeutic gymnastics under the guidance of an experienced instructor, who individually selects a rehabilitation program and will conduct health classes.

Regular courses of physiotherapy will help restore muscle tone, restore lost sensitivity, improve supply tissues with oxygen, nutrients, activate nerve conduction and literally put the patient on legs.

A source: https://glavvrach.com/polineyropatiya/

What is the polyneuropathy of the lower extremities?

Polyneuropathy of the lower limbs is a structural lesion of nerve fibers. This can be a very slow process or, conversely, a rapidly developing pathology.

The faster a person turns for help, the less damage the fibers of the peripheral nervous system will undergo.

If the patient addresses too late, some functions can not be returned.

Separate several types of disease:

  1. 1. Peripheral neuropathy is the most common subspecies. It is a defeat of the structure of the fine nerve fibers, of which peripheral nerves are composed. When the damage affects the nerve of the motor system, the process of muscle contraction is disrupted. Initial symptoms: decreased reflexes of the legs, muscle weakness and spasms, convulsions. Later, without medical assistance, they are replaced by muscle atrophy. Degradation of sensitive nerve fibers leads to acute pain, numbness, tingling, a feeling of "crawling crawling" or a foreign body under the skin. If the nerves of the vegetative system are involved in the process, dryness and thinning of the skin are observed, a violation sweating, hair loss, the appearance of pigmentation spots, poor healing and suppuration of any wounds. In the advanced stage, trophic ulcers are possible leading to gangrene.
  2. 2. Post-traumatic neuropathy develops after compression and trauma of nerve fibers with ligaments, post-operative scars or muscles.
  3. 3. Diabetic neuropathy is a complication in patients with diabetes mellitus. It is easy to detect it, but it is difficult to cure.
  4. 4. Alcoholic neuropathy is common in people who abuse alcohol for a long time. Alcohol in itself destroys the central and peripheral nervous system. In addition, alcohol lovers often have an avitaminosis, which also has a bad effect on the state of nerve fibers.
  5. 5. Ischemic neuropathy happens in people with malnutrition, and this leads to thinning of the nerve fibers. This form is accompanied by a thrombosis. In combination with hypertension, dizziness and vasospasm can occur.

Causes of polyneuropathy can lie in the following:

  • 1. Intoxication, that is, a systematic effect on the body of toxic agents: lead, mercury, cadmium, lithium, Arsenic, Acetone, carbon monoxide or some medicines containing bismuth salts, some antibiotics. Toxic polyneuropathy happens with alcoholism and drug addiction.
  • 2. Diabetes mellitus and endocrine system diseases. In patients with diabetes, a complication often occurs, known as diabetic foot. The lower part of the legs loses sensitivity, the wounds do not heal, the skin dries and cracks, the pathology affects the bones and soft tissues. As a result, gangrene begins, and the leg can be amputated to the knee or higher.
  • 3. Injuries. Nerve fibers innervating the lower limbs can be affected during an accident, car accident or sports activities. Irradiation and hypothermia can also have a destructive effect on the peripheral nervous system.
  • 4. Deficiency of vitamins. The constant shortage of vitamins and minerals leads to dystrophic phenomena in the nerves and tissues. Neuropathy develops precisely against the background of metabolic and vitamin B deficiency disorders.
  • 5. Infectious diseases. Complications after viral and bacterial diseases can adversely affect the state of nerve fibers. Such pathologies include influenza, diphtheria, chickenpox, mumps, HIV, and others.
  • 6. Multiple sclerosis and other diseases that cause the destruction of the nerves can be accompanied by polyneuropathy of the lower and upper extremities.
  • 7. Oncological diseases.
  • 8. Genetic diseases that provoke polyneuropathy. For example, amyotrophy of Charcot-Marie-Toot, at which selective demyelination occurs in the nerves, muscle tissues, there is a denervation with a partial atrophy of the fibers.
  • 9. Autoimmune diseases, in which peripheral nerve cells are mistaken for the immune system as foreign agents, and are destroyed.

The disease often combines damage to sensory and motor fibers, so the main signs of polyneuropathy include:

  1. 1. Muscle weakness and partial paralysis of the legs.
  2. 2. Decrease, subsequently the absence of tendon reflexes.
  3. 3. Pain along the peripheral nerves. A person complains of pain (sometimes very strong), it can be a feeling of squeezing the legs with belts, buzzing or bursting.
  4. 4. Swelling of the feet.
  5. 5. Feeling of burning, tingling, "creepy."
  6. 6. Hyperesthesia is a hypersensitivity to irritants, that is, even a slight touch to the leg can cause painful sensations.
  7. 7. Hypesesia is a dullness of sensations, a decrease in sensitivity. The patient says that his legs are numb. Touching them is almost not felt, a person can not understand, in hot or cold water he puts a foot.
  8. 8. The skin in some parts of the foot is discolored or pigmented. The doctor may notice a lack of hair, excessive dryness, irritation, purulent wounds and traces of poorly healing abrasions.
  9. 9. The patient can not walk on socks, bend his toes and turn the foot towards the sole. In addition, he is not able to stand and walk normally on his heels. When walking a person with polyneuropathy unfolds a foot inside and strangely bends his legs - there is a so-called gait of a cock (steppe).
  10. 10. In the late stages of the disease leads to complete muscle atrophy, the emergence of non-healing trophic ulcers, the development of the Guillain-Barre syndrome. It is characterized by the appearance of paralysis of the lower and upper extremities, and then of the respiratory muscles.

Polyneuropathy can have a chronic form and run very slowly. However, there are cases when the disease develops rapidly, rising from the peripheral nerve fibers to the central parts of the nervous system.

Very rare manifestation of the disease is contracture of the muscles of the lower extremities. As a result, the joint can not fully bend or straighten out due to muscle weakness or atrophy.

Polyneuropathy has characteristic features that a physician can detect by external examination, probing and checking reflexes. Further, he will find out what exactly is bothering the patient, whether any of his relatives suffered from similar diseases.

If neuropathy develops very rapidly, the doctor will ask the patient's place of work, medicines, which he took for the last two days and food products that could cause poisoning.

As an instrumental diagnostic method, electroneuromyography is performed, with the help of which damage is established in various parts of the nervous system, whether peripheral or central. This procedure determines what is damaged - muscles, nerve fibers or bodies of neurons.

Next, the doctor must find the root cause of the pathology, which provoked neuropathy.

Only by eliminating the source of the defeat of nerves, you can succeed in treatment.

In this case, additional tests can be prescribed: blood tests, urine tests, cerebrospinal fluid, radiographs of the legs, ultrasound of internal organs, etc.

In order to remove the symptoms of neuropathy, therapy is aimed at restoring normal conduction and integrity of nerve fibers, as well as correction of blood supply in the affected areas. However, it is very important to consider which disease triggered the neuropathy itself.

In this regard, in parallel, they are also fighting with it. For autoimmune diseases, cytological and hormonal treatment is necessary. At an intoxication caused by a renal insufficiency, hemodialysis is carried out, and at toxic poisoning - plasma plasmapheresis of a blood, etc.

Possible doctor appointments:

  • 1. To improve nerve fiber nutrition prescribe vasoactive drugs (Trental, Pentoxifylline, Vazonite, Instenon, Emoxipin, Nicotinic acid, etc.). In addition, antioxidants are recommended (Mexidol, vitamin E, Oktolipen, Berlition, Tsitochrom C and Actovegin).
  • 2. Successfully treating the conductivity of nerve fibers is helped by drugs containing a complex of B vitamins (Ziefort and others).
  • 3. Anticholinesterase agents accelerate the rate of transmission of the nerve impulse. Recently, the popularity is gaining Imidacrine (Amiridin, Neuromidine), the drugs are well compatible with the B vitamins, antioxidants and vasoactive drugs. Complex treatment quickly returns the patient's sensitivity and muscle tone.
  • 4. If the main symptom of neuropathy is pain, non-steroidal anti-inflammatory drugs are prescribed (Xefokam, Ketoprofen, Nimesulide, Meloxicam, etc.) in combination with antidepressants and anticonvulsants medicines. In the series of antidepressants, selective serotonin and norepinephrine reuptake inhibitors (venlafaxine, Dulaxetine, sertraline, etc.) are preferred. Good tolerability among anticonvulsants was demonstrated by Gabapenten (Neurotin) and Pregabalin (Lyrics). If the analgesic effect is insufficient, the Cataladol belonging to the group of selective activators of neuronal potassium channels can recommend. The composition of the Catadalone is flupirtine, which is a non-opioid analgesic of the central action. The medicine is not addictive and addictive.
  • 5. For local anesthesia, ointments and creams are used. It can be a means with non-steroidal anti-inflammatory properties (cream Diclofenac, Ketoprofen gel etc.), local anesthetics (lidocaine) and irritant drugs (Finalgal, Capsicum, Capsaicin). For busy people and those who do not like to spoil clothes, they have come up with medical plasters with anesthetic and NPVS - Versatis and Voltaren plaster. This method reduces the side effects of nonsteroidal anti-inflammatory drugs, lasts for 12 hours.
  • 6. Narcotic drugs with analgesic effect are used in severe cases, for example, with diabetes (Oxycodone, Tramadol).
  • 7. To combat the obvious muscular spasms prescribed muscle relaxants (Midokalm and Baclofen). Patients with muscle weakness should carefully choose the dosage, since the medicine can aggravate the problem.
  • 8. Massage, electrophoresis, magnetotherapy, mud therapy, acupuncture and other physiotherapeutic procedures are also useful in the treatment of polyneuropathy.

The cure for polyneuropathy of the lower limbs is a very difficult task, requiring the combination of medication, physiotherapy and other methods. In this case, an important role is played by an early address to a doctor, a good diagnosis, the desire and desire of the patient himself to get rid of the disease.

A source: http://spina-health.ru/polinejropatiya-nizhnix-konechnostej/

Polyneuropathy of the upper and lower extremities, symptoms and treatment, drugs

Diseases of the nervous system manifest in the form of neurological symptoms.

A person may have contracture (contraction of the joint), trembling of limbs, paresis (weakness) and paralysis of muscle tissue, a decrease or deepening of reflexes, as well as signs of paresthesia.

The last point is the feeling of running goosebumps, numbness and tingling of a certain part of the body.

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Localized symptomatology mainly at the point of innervation of the affected nerve, for example, if the facial branch is damaged, the whole face suffers. Sometimes the cause lurks in the pathological processes that have arisen in the spinal cord and brain.

Separately, it is necessary to distinguish such a disease as polyneuropathy (polyneuropathy). It is a damage to several nerves, mainly external factors.

Other reasons may precede this process, for example, infection or diabetes, which are important to know before proceeding with treatment.

Features of pathology

With multiple nerve injuries, doctors often diagnose polyneuropathy, but that this is very few people know.

Localized lesions mainly in the peripheral part of the central nervous system and preceded by this process are mainly external factors that have long disrupted their work.

Toxic polyneuropathy is the main variety of multiple lesions of nerve fibers.

For her, the previous factor may be diseases, in which substances that are toxic to humans accumulate. Among them, endocrine disruptions can be identified, for example, diabetes mellitus.

This disease is characterized by distal polyneuropathy and it occurs in more than half of the cases.

Such a process appears due to prolonged exposure to high blood sugar levels on the peripheral nerves. In medicine, this type of pathology is called dismetabolic polyneuropathy due to characteristic metabolic disruptions.

For example, the substance may not be inside the body, but constantly enter it from the outside.

Basically, such a toxin is alcohol and this type of disease is called alcoholic polyneuropathy of the lower limbs. As the pathology develops, the patient's hands are gradually affected.

Disease is also part of the group of dysmetabolic failures and covers mainly motor-sensory symptoms.

Oncological diseases of a malignant nature are not uncommon in neuropathy. They poison the entire body and get rid of them is extremely difficult, so the prognosis for recovery is mostly negative. The neoplasms are related to the paraneoplastic type of the disease.

In more rare cases, infection, for example, diphtheria bacillus, causes the development of the disease. Its products of vital activity damage the nerve fibers and gradually begin to malfunction. The disease of this form refers to infectious and toxic at the same time.

The cause polyneuropathy is not always associated with the toxic effects of various substances. The disease sometimes occurs due to immune failures, in which antibodies destroy the myelin sheath of nerve cells.

This type of disease is called demyelinating and refers to a group of autoimmune pathological processes.

Often this type of neuropathy has a genetic developmental factor, and hereditary motor-sensory pathology manifests itself as a lesion of motor muscles.

Forms of ailment

Polyneuropathy of the upper and lower extremities manifests itself as a pronounced neurological symptomatology and the degree of its manifestation depends on the form of the disease and the types of damage.

According to the type of lesion of nerve fibers, the pathology can be of the following types:

  1. Demyelinating polyneuropathy (axonal demyelinating disease). This pathological process is the destruction of the myelin sheath on the processes (axons) coming from neurons;
  2. Axonal polyneuropathy. It arises due to failures in the work of axons;
  3. Neuropathic polyneuropathy. Such a pathology appears due to damage to the body of the neuron (nerve cell).

Pathology can be divided into certain types of effects, namely:

  • Sensory polyneuropathy. Its symptoms include a violation of the sensitivity of nerve endings, for example, a feeling of pain, burning and numbness;
  • Motor polyneuropathy. There is a defeat of the muscles. It occurs in the form of weakness, atrophy, paralysis, etc.;
  • Sensory motor polyneuropathy. In this type of damage, sensory and motor disorders are combined;
  • Vegetative polyneuropathy. Failures in this case arise in the vegetative department of the nervous system, which is responsible for the functioning of internal organs. These nerve fibers are also responsible for other systems that a person can not consciously control, namely heart rhythm, saliva, sweat, etc.;
  • Mixed view. It includes various signs of violation inherent in all groups.

According to the etiologic factor, the ailment is divided into the following groups:

  1. Idiopathic form (polyneuropathy of unknown origin). For such a variety there is no definite reason, but the main version of development is considered immune failures;
  2. Hereditary form. This pathology is transmitted from the parents;
  3. Dismetabolic form. It arises due to disruptions in metabolism;
  4. Toxic form. The development of this variety is due to the influence of toxins on the body;
  5. Postinfectious form. This kind of polyneuropathy appears because of the infections that have affected most body systems, for example, HIV infection or diphtheria;
  6. Paraneoplastic form. It appears against the background of malignant cancer;
  7. Systemic diseases. This type of polyneuropathy is part of another pathological process that has arisen in connective tissue, for example, scleroderma (a failure in collagen production).

Symptoms

Because of polyneuropathy, mainly the legs and arms of a person, more precisely, the feet and hands, suffer.

This is due to the fact that mostly small nerves are damaged, since toxins are most easily destroyed.

Sometimes there is a polyneuric syndrome and it is characterized by the same symptomatology in the upper and lower extremities. Often, damage occurs symmetrically, since toxins are carried by the bloodstream.

With polyneuropathy, the symptoms of nerve damage are as follows:

  • Pain sensations of various manifestations with a burning sensation;
  • Tremor (trembling) in the lower and upper extremities, manifested mainly in the fingers;
  • Uncontrolled fascination, which is a twitching of the muscles;
  • Sensitive failures, which include disturbed perception of temperature, pain, and also feel worse touch (numbness). In diabetics, patients may not even notice the ingress of glass or pebbles into the boot with polyneuropathy of the foot;
  • Paresis (weakness) of the muscles, which makes it harder for a person to walk for long distances and perform daily duties. This symptom is often combined with a low tone of muscle tissue and a decline in strength in the patient, but occurs primarily with polyneuropathy of the lower extremities.

The main danger is the vegetative signs of the disease and among them one can distinguish such symptoms:

  1. Temperature jumps;
  2. Intense work of the sebaceous glands;
  3. Pale skin;
  4. Circulatory abnormalities;
  5. Heart arythmy.

With polyneuropathy of the lower limbs, symptoms are most pronounced most commonly:

  • Decreased sensitivity;
  • Paresis of muscles;
  • Decreased achilles reflexes;
  • Trophic changes.

Polyneuropathy of the upper limbs is actually the same, but the skin color becomes paler and the tremor is much stronger.

However, the disease does not always develop over the years.

In some cases, it manifests itself in 2-3 hours, for example, after irradiation or severe poisoning with toxic substances.

In more rare cases, because of a critical lack of vitamin B12, a sensitive ataxia occurs. For her, damage to the posterior columns of the spinal cord is typical. In them are located the nervous branches responsible for the perception of the joints and muscles.

This pathological process has its own peculiarities, because in ataxia a person can not move in the dark, as he does not understand where his legs and arms are.

However, with good lighting, the problem disappears by itself and the patient does not feel any changes.

In autonomic polyneuropathy, a person can suddenly die from cardiac arrest, which is due to a serious arrhythmia or abnormalities of the ventricles.This form of pathology refers to the cardiac type of polyneuropathy.

Diagnostics

Polyneuropathy of the lower extremities, as well as the upper ones, is determined by the neurologist. The attending physician is guided by the questioning and examination of the patient and mainly the diagnosis is not difficult.

If you still have any questions, then you will have to use the instrumental survey method. In the case of polyneuropathy, diagnosis by ultrasound, as well as computer and magnetic resonance imaging, will not yield results.

Doctors use electroneuromyography to make the correct diagnosis. It serves to detect any slightest disruptions during the passage of a pulse along nerve fibers.

Based on the results of the examination, the neurologist can determine exactly where the disorder originated, namely in the axon, its shell or the body of the neuron.

To make a diagnosis it is sometimes necessary to pass a general blood test, for example, in diabetes, an increased concentration of sugar will be visible in it. In rare cases, doctors take a biopsy of nervous tissue.

Medication

Treatment of polyneuropathy consists in the passage of a long course of therapy.

Its duration usually depends on the degree of damage and their causes, because it is necessary to restore the neural pathways on a new one, and it is extremely difficult to do this.

That is why polyneuropathy refers to organic lesions of the nervous system, and not to functional ones.

First, you need to determine the cause of the disease and eliminate it. To understand how to treat polyneuropathy, you can use the example of diabetics. They should more closely monitor the blood sugar level, so that it always remains normal.

If it concerns alcoholics, then they need to give up alcohol. Otherwise neither the first nor the second group will be helped by the medication.

With oncological diseases before the treatment of pathology, it is necessary to eliminate the neoplasms that have arisen in the body.

With polyneuropathy treatment is carried out with the help of such drugs:

  1. Vitamin complexes, for example, Milgamma;
  2. Antioxidants like Berlition;
  3. Preparations with a metabolic effect to stimulate microcirculation such as Trental;
  4. Anesthetics like the anesthetic ointment Versasitis.

Use ointment and tablets in the treatment of polyneuropathy is recommended in combination with proper nutrition. It is necessary to add more vegetables and fruits to your diet and, if possible, give up fried, smoked and canned food. It is advisable to cook food or cook it for a couple.

Speeding up the healing process can be physiotherapy and most often such procedures are used:

  • Electrophoresis based on dibazol and thiamine;
  • Treatment with foil (wrapping of joints);
  • Therapeutic baths;
  • Acupuncture.

A special benefit is massage with polyneuropathy. Perform it must be an experienced specialist, so as not to aggravate the course of the disease.

Treatment of polyneuropathy of the lower extremities usually consists not only in the use of drugs, but also in gymnastics.

It allows you to maintain muscle tone and improves the general condition of the patient.

Physiotherapy (LFK) should be prescribed depending on the condition of the person, because in most cases physical overload is not recommended.

Forecast

Usually the prognosis for polyneuropathy is not comforting. The disease is difficult to treat and is prone to progress. Over time, a person can become disabled and even die because of disruptions in the work of the heart.

Some types of disease have no treatment at all, for example, caused by autoimmune failures.

If it concerns alcohol poisoning or diabetes, the prognosis is generally positive, but on condition that the patient normalizes the concentration of sugar and refuses alcohol.

Polyneuropathy is a serious damage to the nerve tissue and it must be treated when the first symptoms occur, otherwise the pathology will progress. This development often leads to disability and death.

A source: http://NashiNervy.ru/perifericheskaya-nervnaya-sistema/osobennosti-lecheniya-toksicheskoj-polinejropatii.html