Polyneuropathy is a multiple lesion of the peripheral nerves, which is accompanied by such serious symptoms as flaccid paralysis, impaired sensitivity, disorders of the vegetative-vascular nature, etc. Unfortunately, pathology is quite common.
What does the clinical picture look like? What triggers the disease? What types of it exist? How is the diagnosis carried out? What is needed for treatment? This topic raises many questions, and everything is worth giving answers now.
Medical classification
First of all, it should be noted that the disease in question has a very detailed classification. There are various types of polyneuropathy, they differ in etiology, pathomorphology of damage and the nature of the course. Even the international classification of diseases does not indicate the entire list.
In the international classifier ICD-10, polyneuropathy is on a par with lesions of the nervous system. According to the classification, this group includes blocks G00-G99, G60-G64 and G62. In the ICD-10 polyneuropathy, the following items are reserved:
- Medicinal - G62.0.
- Alcohol - G62.1.
- Toxic - G62.2.
- Radiation - G62.8.
- Without further clarification (BDU) - G62.9.
Naturally, the real list is much longer. But the classification says that if accurate identification of the cause is necessary, specialists use additional codes of external causes of class XX.
Axonal polyneuropathy
Its causes, as a rule, are serious metabolic disorders. There is also a certain classification. There are three types:
- Acute axonopathy. Usually associated with criminal or suicidal poisoning. The disease proceeds against the background of a pattern of severe intoxication with carbon monoxide, organophosphorus compounds, arsenic and methyl alcohol. It lasts 2-4 days, then within a few weeks there comes a cure.
- Subacute axonopathy. The development of this disease takes several weeks or even months. The subacute form is characteristic of many neuropathies of a metabolic and toxic nature.
- Chronic axonopathy Its development takes six months or more. The most common case is alcoholic polyneuropathy. The main reason, of course, is chronic alcohol intoxication. It also occurs in diabetes mellitus, lymphoma, cancer, cirrhosis, amyloidosis and some other diseases.
And before you talk about the treatment of polyneuropathy of this type, it is worth considering its manifestations. The following is usually observed:
- Sensation of numbness in the distal parts of the lower extremities (feet and slightly above them).
- Pain in the calf muscles.
- Limb dysfunction, developing over time, usually lower. It is expressed by weakness and paralysis.
- Damage to the nerves responsible for flexion and extension of the foot.
- Violation of the sensitivity of the skin in the "gloves" and "socks."
- Mental disorders.
- Changing the color of the limbs to painful.
- Increased sweating.
- Edema of the distal extremities, a change in their temperature.
- Damage to the oculomotor and optic nerve.
If the body continues to have toxic effects, then the symptoms continue to grow. If it is not stopped, then the state of health will significantly deteriorate.
Axonopathy Treatment
First, the therapist examines and interviews the patient. Then he is referred to a neurologist who checks periosteal and tendon reflexes, as well as their symmetry. Then a person will have to submit his biomaterial for analysis - this is necessary to study the level of uric acid, urea and creatinine. In diabetes, they also donate blood from a vein and finger.
If the diagnosis of axonopathy is confirmed, the doctor prescribes a comprehensive treatment that affects the symptoms and cause. Here is an approximate treatment regimen:
- With dystrophy and alcoholic polyneuropathy, B vitamins are prescribed either as part of drugs or in ampoules.
- With flaccid paralysis, the use of cholinesterase inhibitors is indicated . These include Neuromidin, Kalimin, and Neostigmine.
- To eliminate spastic paralysis, muscle relaxants and anticonvulsants are prescribed - Midokalm, Baclofen, Sirdalud, Tizanidine.
- For polyneuropathy caused by intoxication, specific antidotes, forced diuresis, peritoneal dialysis and gastric lavage are prescribed.
- In case of heavy metal poisoning, sodium thiosulfate, calcium tetracycline and D-penicillamine are shown to a person.
- Glucocorticoid hormones help cope with autoimmune neuropathies.
- Atropine-like agents help in the treatment of intoxication with organophosphorus substances.
- Diabetic polyneuropathy is eliminated by hypoglycemic drugs. These include Glibenclamide and Metformin. Antihypoxants also help to utilize the oxygen circulating in the body. In diabetic polyneuropathy, Actovegin, Mexidol and Emoxipin help.
In general, if you feel a burning sensation of the skin, numbness, movement disorders and loss of sensation, you should consult a doctor. Only he can prescribe adequate treatment.
Diabetic polyneuropathy
It is necessary to tell about it separately. Because this pathology in diabetes is not a consequence or a separate disease, but a complication. The cause of the occurrence is damage to the nervous system. The disease forms in people 15-20 years after diabetes has manifested itself. According to statistics, the frequency of progression to a complicated stage is 40-60%.
It is important to note that in the case of this pathology there is a classification. It presents three types of disease, indicating a damaged segment in the nervous system:
- Motor - manifested in the violation of movements.
- Sensory - it is diagnosed if a person worsens susceptibility to external stimuli.
- Sensomotor - manifestations of both types of ailments are combined.
It is also worth recalling that, regardless of the causes of polyneuropathy, it can be amyotrophic, painless, chronic and acute. This is a classification by intensity. In the case of a disease of a diabetic type, it is also relevant.
Symptoms can be identified in the following list:
- Pain of a dagger, piercing character.
- Enhanced sensitivity.
- Burning.
- Tingling.
- Sensation of pain even with a light touch.
- Instability when walking.
- Tingling in the extremities, followed by a feeling of necrosis.
- Numbness and numbness.
Often, headaches, cramps, dizziness, urinary incontinence, diarrhea, impaired vision and speech, and anorgasmia in women are added to the symptoms of polyneuropathy of the upper extremities of a diabetic type.
Therapy of a disease of a diabetic type
Most often, with the onset and development of this disease, the doctor prescribes the following drugs:
- Metabolic agents. B1 positively affects the synthesis of acetylcholine, which also contributes to the transfer of momentum from one fiber to another. B6 does not allow free radicals to accumulate. B12 improves the nutrition of nerve tissue and the restoration of the sheath of peripheral nerves.
- Complex medicines. The most effective are Vitagamma, Milgamma, Combilipen, Compligam B and Neurobion. As a rule, injections are prescribed first. Then, as the condition improves, pills are prescribed. In general, the reception lasts 3-5 weeks.
- "Actovegin." This drug deserves special attention. It is made from calf blood. Helps to improve tissue nutrition, restore sensitivity, eliminate pain, stimulate regeneration processes.
- Vascular preparations. The best are Wazonite, Pentoxifylline and Trental. These drugs normalize blood flow and dilate blood vessels, thereby affecting the nutrition of peripheral nerves.
It is also important to take painkillers. Unpleasant sensations experienced by a person with a disease of a diabetic type are neuropathic in nature. Therefore, anti-inflammatory and simple painkillers will not help. Effective drugs include anticonvulsants (Finlepsin), antidepressants (Amitriptyline), opioids (Oxycodone), anesthetics (Capsicam), and analgesics (Catadolone).
Demyelinating polyneuropathy
This is an extremely rare inflammatory disease characterized by damage to the peripheral nerves. In terms of symptoms, it is similar to Guillain-Barré syndrome. As a rule, with this form of polyneuropathy, the legs suffer most often. It is in the lower extremities that gradually increasing weakness is observed, which is the main symptom of the disease. The following manifestations also make themselves known:
- Symmetric muscle weakness in the distal and proximal parts, lasting more than two months.
- The disappearance or weakening of tendon reflexes.
- Sensory deficiency.
- Gait instability.
- Partial blockade of motor activity.
It should be noted that there are many forms of polyneuropathy demyelinating type. Among them, motor-sensory acquired, multifocal motor, distal symmetric, isolated sensory, etc. are distinguished.
An accurate diagnosis of polyneuropathy is made after many studies. The doctor studies the nerve conduction of the patient, reveals an increase in protein content, the presence of histological signs of remyelination and demyelination. Electrophysiological and laboratory diagnostic methods, tomography, as well as nerve biopsy are used.
Treatment of a demyelinating type of disease
Therapy, which the doctor will prescribe after the diagnosis of polyneuropathy, will be aimed at blocking the pathoimmune processes. Also, the goal of treatment is to suppress inflammation and prevent further axon degeneration.
After the results appear, the implementation of maintenance therapy is mandatory. This is necessary to reduce the frequency of exacerbations and prevent the possible progression of the disease. The result of treatment can be seen in improving the sensitivity and motor skills of the patient. It is believed that remission has come if a person can once again carry out daily activity.
As a rule, the treatment of polyneuropathy of this type includes:
- Reception of corticosteroids. The most effective are Prednisone, Nycomed, Medopred, and Prednisone Gemsuccinate.
- The course of the drug "Gamuneks-S". It has a positive effect on immunity. The drug does not contain preservatives - it is a natural immunoglobulin made from a pool of blood plasma from healthy donors.
- Plasmapheresis This procedure involves the collection of blood, its further purification and then returning back to the bloodstream.
- Intravenous administration of immunoglobulins.
Such therapy helps prevent secondary destruction of axons and prevent the progression of the disease. According to statistics, in 60-80% of people, their condition improves even when using one of the listed methods.
Inflammatory polyneuropathy
By this name, it is customary to understand multiple lesions of the nerve trunks provoked by an inflammatory reaction that has an autoimmune genesis. This disease is dangerous in that it affects not one, but several peripheral trunks. In addition, damage usually destroys their myelin sheath.
It is not completely clear for what reasons a disease of this type occurs. Many believe that it is formed due to an autoimmune process. In the diagnosis, it is possible to detect clusters of mononuclear cells, to identify the activation of macrophages and the presence of perivascular processes. The disease is fraught not only with sensory and motor disorders, but also with the expansion of the subshell space of nerves.
Separate attention should be noted serum neuropathy. It usually develops after a person is given an injection against tetanus. After 7-10 days after the injection, the ailment begins to manifest itself. Symptoms can not be confused with anything: fever, pain in the shoulder girdle, itchy rashes. These manifestations are accompanied by numbness of the hands and weakness of the upper limbs. Many patients experience atrophy of the muscles of the shoulder girdle and proximal arm muscles. Arthralgia (joint pain of a volatile nature), loss of sensitivity in the axillary nerve are often diagnosed. Purulent inflammation of the lymph nodes may also develop.
As part of the diagnosis, a general blood test, serum protein electrophoresis , electroneuromyography, as well as laboratory studies of the composition of blood serum are carried out. It is mainly eliminated by drugs such as Diphenhydramine and Prednisolone. It is not forbidden to conduct alternative treatment with serum polyneuropathy. Also, the doctor may prescribe antihistamines and corticosteroids and plasmapheresis.
Peripheral Polyneuropathy
This disease must also be described separately. The person who has been exposed to it suffers from damage to the distal parts of both the upper and lower extremities.
In addition to the symptoms listed above, the following symptoms are noted:
- Night cramps.
- Muscle weakness that flows into atrophy.
- Thinning of the skin.
- Fragility and fragility of the nail plates.
- Violation of sensitivity in the oral area.
- Tremor of hands.
The development of this disease contributes to the use of reverse transcriptase inhibitors. The most famous representatives of this group of drugs are Zalcitabine, Stavudin and Didanosine. All of these drugs are active against HIV. It is very important that the specialist timely determines the presence of this type of polyneuropathy in the patient and cancels the drug, which provoked the development of this disease.
Treatment of peripheral disease
Your doctor may prescribe any of the previously listed medications. But in this case, in addition to standard settings, it is necessary to comply with specific recommendations. In particular, taking alpha lipoic acid. It is an endogenous antioxidant whose action is aimed at binding free radicals. Acid takes part in metabolic processes, and also acts as coenzyme Q, which helps to assimilate substances with a pronounced antitoxic effect.
In essence, alpha lipoic acid prevents the destruction of nerve cells. Namely, this process most often leads to disorders. In addition to acid, the doctor may prescribe medications that improve tissue nutrition, glucose utilization, and also have a venotonic, vasodilating and diuretic effect. It should be noted that all of these properties combines a drug called "Instenon".
Folk remedies
The most effective treatment for polyneuropathy with medication. But folk remedies can also be beneficial. They can be used as adjuvant therapy. Here are some popular recipes:
- Cocktail to eliminate alcoholic polyneuropathy. To prepare it, beat the olive oil (2 tbsp.) With chicken yolk. Then add freshly squeezed carrot juice (100 ml) and honey (2 tsp). Drink two hours before meals. A day should be consumed twice.
- Means against diabetic polyneuropathy. Pour crushed bay leaves (1 tbsp. L.) And fenugreek seeds (3 tbsp. L.) Into a thermos. Pour boiling water over a liter. Give 2 hours to insist, strain. Drink during the day when thirst occurs.
- A medicine for the treatment of polyneuropathy of the lower extremities. Pour half a glass of chopped rosemary in 9% vinegar (0.5 L), close, shake and let it brew for 10 days. Shake occasionally. After the time you can use: 1 tbsp. l breed the resulting infusion in 1 tbsp. l water and rub the resulting mixture of feet three times a day.
- Universal remedy with ginger and hypericum. In a 0.5-liter jar, crushed St. John's wort loosened up. Pour vegetable oil warmed up to 60 ° . For 20 days, insist in a dark place. Strain, add dry ginger root (1 tbsp.), Mix. Use oil to massage and wrap limbs twice a day.
- A medicine for eliminating sensory polyneuropathy. Ground the leaves of ginkgo biloba (4 tbsp.). Pour into a thermos and pour a liter of boiling water. Give 3 hours to brew. Then strain and drink during the day.
Also, with polyneuropathy of the extremities, various infusions can be taken to remove toxic substances from the body and cleanse the liver. There are many recipes, but before you start taking your favorite remedy, you need to consult your neurologist.