Polyneuropathy of the upper extremities is a pathology of the peripheral nervous system, in which peripheral nerves can be affected. Next, let's talk about the symptoms, treatment methods and diagnosis of this disease.
About the disease
From Greek, this disease can be translated as "a disease of many nerves." This translation accurately conveys the essence of pathology. With the development of polyneuropathy in a person, almost all peripheral small nerves can be affected. The causes of this disease are different, but the symptoms of polyneuropathy of the upper extremities are always very similar, regardless of what exactly caused the disease.
Reasons for the development of pathology
The most common causes of limb polyneuropathy are the following factors:
- The presence of infection in humans.
- The emergence of external and internal intoxication.
- The appearance of metabolic disorders.
- Development of vitamin deficiency in a patient.
The spectrum of somatic pathologies that cause polyneuropathy of the upper and lower extremities is very diverse. Causes of peripheral nerve damage can be diabetic, hyperthyroid and hypothyroid endocrinopathies. Pathological processes develop with various systemic diseases, for example, against the background of periarteritis nodosa, lupus erythematosus, scleroderma, and so on. The disease occurs in people with uremic, hepatic, amyloid, or metabolic disorders. Polyneuropathy of the upper extremities is sometimes a manifestation of blood pathologies, alcohol and drug intoxication, as well as paraproteinemia.
Types of pathology
The subacute type of polyneuropathy progresses within eight weeks. Chronic damage to the peripheral nerves includes inflammatory, metabolic and toxic. With these pathologies, clinical symptoms develop within a few months or even years. The chronic form of polyneuropathy of the upper extremities includes:
- Chronic inflammatory demyelinating polyneuropathy.
- Hereditary, diabetic, dysproteinemic and hepatic.
- Polyneuropathy due to the development of systemic amyloidosis, hypothyroidism, vitamin deficiency, systemic connective tissue disease and chronic respiratory disease.
- Paraneoplastic polyneuropathy of the upper and lower extremities in patients with lymphoma, multiple myeloma and cancer.
With polyneuropathy of the limbs, myelin sheaths or axial cylinders are mainly affected. In the case of infectious polyneuropathies, the reactions of the membranes and blood vessels that feed the nerves predominate in patients. If a person has acute infectious sensory polyneuropathy of the upper extremities from polyblasts and lymphocytes, infiltrates appear.
Next, we will talk about the symptoms of the pathology under consideration.
Symptoms of polyneuropathy of the upper limbs
The clinical manifestations of polyneuropathies are based on sensory, motor and autonomic symptoms. Depending on the causes of the disease, individual signs or their general combination may prevail. Sensitive symptoms are characteristic of metabolic and toxic polyneuropathy. Negative manifestations occur in the presence of chronic inflammatory demyelinating polyneuropathy. Also, symptoms can be observed in case of deficiency of vitamins E and B 12 , and, in addition, against the background of intoxication and paraneoplastic polyneuropathy. The manifestation of the disease is characterized by a decrease in the sensitivity of the limbs in the form of “socks” and “gloves”, as well as in the lower abdomen.
Sensory symptoms
Sensory symptoms include:
- The occurrence of pain.
- Presence of crawling or numbness without causing irritation.
- A burning sensation.
- Sensitivity increase.
- The development of hyperalgesia, which is an abnormally high sensitivity of the body to various pain stimuli.
- The occurrence of dysesthesia, that is, a perversion of sensitivity, against which the cold is perceived as if it was warm.
- The development of hyperpathy, that is, a perversion of sensitivity, manifested by an increase in the threshold of perception with irritation. In this case, the exact localization of sensations is absent.
- The development of allodynia, that is, pain in the case of exposure to irritants, which usually do not cause it.
Doctors associate the appearance of sensitive symptoms with the restoration of nerve cell processes. Against the background of damage to fibers that conduct strong sensitivity, sensory ataxia occurs. With this disease, patients often experience shakiness when walking, intensifying in the dark and with eyes closed.
What other symptoms of polyneuropathy of the upper and lower extremities are?
Positive motor symptoms
Positive motor symptoms include:
- Neuromyotonia, which is a pathological condition in which constant tension, cramping, or delayed relaxation of muscle fiber occurs immediately after contraction.
- The development of fasciculation. In this case, we are talking about reducing one or several fibers at once.
- The appearance of myokimia, that is, a fragmented contraction of individual muscles.
- The occurrence of periodic convulsions in the calf muscles.
- The development of restless legs syndrome.
Autonomic symptoms
The manifestation of positive motor symptoms is associated with spontaneous displaced generations of nerve impulses during regeneration. Such symptoms appear as a result of damage to the autonomic nerve fiber, it is divided into visceral, vasomotor and trophic manifestations. Visceral symptoms are a manifestation of diabetic, amyloid, porphyria, alcoholic and toxic polyneuropathies. Among visceral symptoms, there are:
- Cardiac manifestation in the form of a decrease in pressure against a background of a change in body position.
- Urogenital manifestation, when there is a violation of the functions of the sphincters and erectile dysfunction.
- Disturbance of the digestive system.
- The appearance of respiratory distress.
- Violation of sweating, failure of thermoregulation and pupillary reaction.
Vegetative trophic symptoms
Vegetative trophic symptoms of the disease include deformation of the nails along with the formation of ulcers on the limbs, thinning of the skin and the development of neuroarthropathy. Autonomic vasomotor symptoms are characterized, as a rule, by a change in the temperature of the skin surface of the hands and feet, and, in addition, by their marble color and swelling.
Diagnosis of polyneuropathy
The diagnosis of polyneuropathy is considered primarily syndromic. His doctors determine the prevalence of clinical symptoms. At the same time, attention is given to sensory, motor and autonomic manifestations. The nature of the disease is no less important, that is, the attention of specialists is drawn to whether it is acute, subacute or chronic. All these nuances are essential for suggesting the causes of pathology and prescribing adequate treatment. Neurologists differentiate axonal and demyelinating polyneuropathy. This plays an important role for adequate therapy and prognosis of the disease.
To establish the causes of the disease, along with the localization of pathological processes and the degree of nerve damage by doctors, the following methods of instrumental and laboratory diagnosis are used:
- Conducting electroneuromyography.
- Performing a clinical blood test.
- Taking liver samples from a patient.
- Estimation of the level of urea, glycated hemoglobin and creatinine.
After obtaining the result of the examination, a diagnosis of limb polyneuropathy is established, and at the same time, specialists take into account the symptoms of the disease and prescribe adequate therapy.
Treatment principles
In the treatment of polyneuropathies of the upper extremities, which are caused by somatic pathologies, neurologists prescribe etiological therapy aimed at treating a underlying disease that caused damage to the peripheral nerves. In addition, pathogenetic treatment is additionally carried out, whose goal is the correction of the main mechanism leading to the development of polyneuropathy of the limbs. Used by doctors and medicines that are antioxidants. For these purposes, patients are prescribed lipoic acid preparations. In addition to the antioxidant effect, they also have an insulin-like effect. Lipoic acid favors the restoration of the sheath of nerve fibers in myelinopathy. Thanks to this acid, the conduction of impulses along the nerve fiber is restored.
What else involves the treatment of polyneuropathy of the lower and upper extremities? In order to improve microcirculation and blood supply in the structure of the nervous system, a drug called Actovegin is used. It is used for diabetic polyneuropathy. The mechanism of action of Actovegin consists in optimizing the process of energy metabolism, improving microcirculation and lowering glucose levels.
Pain correction
The basis of symptomatic treatment is the correction of pain. Treatment of a neuropathic disease is a very difficult task. To relieve pain, local anesthetics are used along with opioid analgesics and anticonvulsants. In the carbamazepine group, Gabapentin is considered the most promising. In the treatment of pain, tricyclic antidepressants are used. But they are not prescribed for autonomic or visceral polyneuropathy in the case of the following manifestations:
- Against the background of insufficiency of the heart and blood vessels.
- In the presence of intracardiac conduction disturbances.
- Against the background of obstructive urogenital tract disease.
- If the patient has glaucoma.
- Against the background of orthostatic hypotension
The combination of antidepressants with the drug "Gabapentin" enhances the effect of drug treatment. For the purpose of rehabilitation therapy, drugs are used that contribute to the recovery of myelin (we are talking about B vitamins and lipoic acid preparations). Such drugs significantly improve the conduct of nerve impulses.
Symptoms and treatment of polyneuropathy of the upper and lower extremities are interrelated.
Patient Reviews
According to patients, in the treatment of limb polyneuropathy due to somatic ailments, neurologists often prescribe etiological therapy to patients, which is aimed at eliminating the underlying pathology that caused damage to the peripheral nerves.
Also in the comments, people write that in the process of treatment, they undergo additional pathogenetic treatment, the purpose of which is primarily to correct the main mechanism that leads a person to the development of an ailment.
We examined the symptoms of treatment for polyneuropathy of the upper extremities.