Upper limb polyneuropathy is a pathology of the peripheral nervous system that can affect the peripheral nerves. 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 humans, 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.
Causes for the development of pathology
The most common causes of polyneuropathy of the extremities are the following factors:
- Having an infection in a person.
- The occurrence of external and internal intoxication.
- The appearance of a metabolic disorder.
- Development of beriberi in a patient.
The spectrum of somatic pathologies that cause polyneuropathy of the upper and lower extremities is very diverse. Diabetic, hyperthyroid and hypothyroid endocrinopathies can be the causes of peripheral nerve damage. Pathological processes develop in various systemic diseases, for example, against the background of periarteritis nodosa, lupus erythematosus, scleroderma, and so on. The disease occurs in humans when there is a uremic, hepatic, amyloid, or metabolic disorder. Polyneuropathy of the upper extremities is sometimes a manifestation of blood pathologies, alcohol and drug intoxication, as well as paraproteinemia.
Types of pathology
Subacute type of polyneuropathy progresses within eight weeks. Chronic damage to the peripheral nerves include inflammatory, metabolic and toxic. With these pathologies, clinical symptoms develop over several months or even years. The chronic form of upper limb polyneuropathy 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.
In polyneuropathy of the extremities, the myelin sheaths or axial cylinders are mainly affected. In the case of infectious polyneuropathies in patients, the reactions of the membranes and vessels that feed the nerves predominate. If a person has acute infectious sensory polyneuropathy of the upper extremities, infiltrates appear from polyblasts and lymphocytes.
Next, let's talk about the features of the symptoms of the pathology in question.
Symptoms of upper limb polyneuropathy
The clinical manifestations of polyneuropathies are based on sensory, motor and vegetative 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 B12, 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 symptomatology
To sensory symptoms include:
- The occurrence of pain.
- Presence of a feeling of crawling or numbness without causingirritation.
- Having a burning sensation.
- Increase sensitivity.
- 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 warm.
- The development of hyperpathy, that is, a perversion of sensitivity, manifested by an increase in the threshold of perception during irritation. At the same time, there is no exact localization of sensations.
- The development of allodynia, that is, pain in case of exposure to stimuli that usually do not cause it.
The appearance of sensitive symptoms doctors associate with the restoration of the processes of nerve cells. Against the background of damage to the fibers that conduct strong sensitivity, there is a sensitive ataxia. With this disease, patients often experience unsteadiness when walking, aggravated in the dark and with closed eyes.
What other symptoms of polyneuropathy of the upper and lower extremities are there?
Positive motor symptoms
Positive motor symptoms include:
- Neuromyotonia, which is a pathological condition in which there is constant tension, spasms, or delayed relaxation of the muscle fiber immediately after contraction.
- Development of fasciculations. In this case, we are talking about the reduction of one or several fibers at once.
- The appearance of myokymia, that is, the disconnected contraction of individualmuscles.
- Occurrence of periodic cramps in the calf muscles.
- Development of restless leg syndrome.
Vegetative symptoms
The manifestation of positive motor symptoms is associated with spontaneous shifted generations of nerve impulses during regeneration. Such symptoms manifest themselves as a result of damage to the fibers of the autonomic nerves, it is divided into visceral, vasomotor and trophic manifestations. Visceral symptoms are a manifestation of diabetic, amyloid, porphyria, alcoholic and toxic polyneuropathies. Among the visceral symptoms are:
- Cardiac manifestation in the form of a decrease in pressure against the background of a change in body position.
- Urogenital manifestation, when there is a violation of the functions of sphincters and erectile dysfunction.
- Digestive dysmotility.
- The appearance of respiratory disorders.
- Violation of sweating, failure of thermoregulation and pupillary response.
Vegetative trophic symptoms
The vegetative trophic symptoms of the disease include nail deformity along with the formation of ulcers on the extremities, thinning of the skin and the development of neuroarthropathy. Vegetative 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 marbled color and swelling.
Diagnosis of polyneuropathy
The diagnosis of polyneuropathy is considered primarily syndromic. His doctors establish by the predominance of clinical symptoms. At the same time, attention is paid to sensory, motor and vegetative manifestations. No less important is the nature of the disease, 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 the pathology and prescribing adequate treatment. Neurologists differentiate between 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, doctors use the following methods of instrumental and laboratory diagnosis:
- Electroneuromyography.
- Performing CBC.
- Taking a patient's liver samples.
- Establishing the level of urea, glycated hemoglobin and creatinine.
After receiving the result of the examination, a diagnosis of polyneuropathy of the extremities is established, and at the same time, specialists take into account the symptoms of the disease and prescribe adequate therapy.
Principles of treatment
In the treatment of polyneuropathies of the upper extremities, which are caused by somatic pathologies, neurologists prescribe etiological therapy aimed at treating the underlying disease that caused damage to the peripheral nerves. In addition, pathogenetic treatment is additionally carried out, whosethe goal is to correct the underlying mechanism leading to the development of limb polyneuropathy. Used by doctors and drugs 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 does the treatment of polyneuropathy of the lower and upper extremities involve? In order to improve microcirculation and blood supply in the structure of the nervous system, a drug called "Actovegin" is used. It is used in diabetic polyneuropathy. The mechanism of action of "Actovegin" is to optimize the process of energy metabolism, improve microcirculation and lower glucose levels.
Correction of pain syndrome
The basis of symptomatic treatment is the correction of pain. The treatment of neuropathic disease is a very difficult task. Local anesthetics are used to control pain along with opioid analgesics and anticonvulsants. In the group of carbamazepines, Gabapentin is considered the most promising. In the complex therapy of pain syndrome, 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 disordersconductivity.
- On the background of obstructive disease of the genitourinary tract.
- If the patient has glaucoma.
- On 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 help restore myelin (we are talking about B vitamins and lipoic acid preparations). Such funds significantly improve the conduction of nerve impulses.
Symptoms and treatment of polyneuropathy of the upper and lower extremities are interrelated.
Patient testimonials
According to patients' reviews, when treating polyneuropathy of the extremities caused by 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 additionally undergo pathogenetic treatment, the purpose of which is primarily to correct the main mechanism that leads a person to the development of the disease.
We looked at the symptoms of upper limb polyneuropathy treatment.
