Demyelinating polyneuropathy is a serious disease that is accompanied by inflammation of the nerve roots with the gradual destruction of the myelin sheath. With proper and timely treatment, you can get rid of the disease, avoiding serious consequences. That is why it is important to know about the main causes and signs of the disease in order to see a doctor in time.
What is disease? General information
Immediately it should be noted that this disease is quite rare - for 100 thousand people, only 1-2 suffer from such a disease. Adult men are more prone to this disease, although both women and children can face such a diagnosis. As a rule, demyelinating polyneuropathy is accompanied by symmetrical damage to the nerve roots, resulting in weakness of the muscles of the distal and proximal extremities. By the way, quite often this disease is associated with Guillain-Barré syndrome. And to this dayit is not known whether chronic inflammatory demyelinating polyneuropathy is a separate disease or one of the forms of the aforementioned syndrome.
Main causes of disease development
Unfortunately, the causes and mechanism of the development of the disease are not fully known today. Nevertheless, many years of research have shown that inflammatory demyelinating polyneuropathy is an autoimmune disease. For one reason or another, the immune system begins to perceive the cells of its own body as foreign, as a result of which it produces specific antibodies. In this case, these antigens attack the tissues of the nerve roots, causing the destruction of the myelin sheath, provoking an inflammatory process. Accordingly, nerve endings lose their basic properties, which leads to disruption of the innervation of muscles and some organs.
In this case, as in almost any other autoimmune disease, there is a genetic inheritance. In addition, there are a number of factors that can change the functioning of the immune system. These include metabolic disorders and hormonal imbalances, severe physical and emotional stress, trauma, constant stress, serious illness, infection of the body, vaccination, surgery.
Demyelinating polyneuropathy: classification
In modern medicine, there are several classification schemes for this disease. For example, depending on the causes, allergic, traumatic, inflammatory,toxic and some other forms of the disease. According to pathomorphology, it is possible to distinguish the actual demyelinating and axonal varieties of polyneuropathy.
It is worth talking separately about the nature of the course of the disease:
- Acute demyelinating polyneuropathy develops rapidly - sensory and motor impairments develop over several days or weeks.
- In the subacute form, the disease develops not so rapidly, but relatively quickly - from several weeks to six months.
- Chronic polyneuropathy is considered the most dangerous, as it can develop hidden. The progression of the disease can last for several years.
Main symptoms of the disease
The clinical picture with such a disease depends on many factors, including the form of the disease and the cause of its development, the characteristics of the patient's body and his age. Demyelinating polyneuropathy, as a rule, is accompanied by the appearance of muscle weakness and some sensory disturbances in the initial stages. For example, patients sometimes complain of a decrease in sensation in the limbs, a burning sensation and tingling. The acute form of the disease is characterized by the appearance of severe girdle pain. But if we are talking about chronic destruction of the nerve roots, then the pain may not be too pronounced or even absent.
As the process progresses, parasthesias of the extremities appear. During the examination, you can notice a decrease or absence of tendon reflexesor their complete disappearance. Most often, the process of demyelination covers precisely the nerve endings of the limbs, but damage to other nerves is not excluded. For example, some patients complain of numbness of the tongue and the area around the mouth. Paresis of the palate is much less common. In this condition, it is difficult for the patient to swallow food or saliva.
Axonal demyelinating polyneuropathy: types and symptoms
Destruction of axons is usually caused by toxic effects on the body. The axonal form of the disease is divided into several main types:
- Acute polyneuropathy in most cases develops as a result of serious poisoning of the body (for example, arsenic oxide and other dangerous toxins). Symptoms of disruption of the nervous system appear quite quickly - after 14-21 days, the patient can notice paresis of the lower and upper extremities.
- Subacute form of the disease can be caused by both poisoning and serious metabolic failures. The main symptoms may develop over several weeks (sometimes up to 6 months).
- Chronic axonal polyneuropathy develops slowly, sometimes the whole process takes more than five years. As a rule, this form is associated with the presence of a genetic predisposition, as well as prolonged intoxication of the body (observed, for example, in chronic alcoholism).
Diagnostic Methods
Only an experienced doctor candiagnosis of demyelinating polyneuropathy. Diagnosis of this disease is a complex process that includes several key points. To begin with, a routine physical examination and the collection of the most complete anamnesis are carried out. If a patient has sensorimotor neuropathy that has been developing for at least two months, then this is a good reason for a more accurate diagnosis.
In the future, as a rule, additional studies are carried out. For example, measurements of the speed of conduction of nerve impulses along the motor nerves can demonstrate a decrease in the main indicators. And in a laboratory study of cerebrospinal fluid, an increase in protein levels is observed.
What treatment does modern medicine offer?
What kind of therapy does demyelinating polyneuropathy require? The treatment in this case consists of several main stages, namely the removal of the inflammatory process, the suppression of the activity of the immune system and the support of the result.
In case of exacerbation and the presence of severe inflammation, patients are prescribed hormonal anti-inflammatory drugs, namely corticosteroids. The most effective is "Prednisolone" and its analogues. Therapy begins with a large dose, which is reduced as the symptoms disappear. As a rule, muscle strength begins to return after a few weeks. But it is worth noting that long-term use of this medication is fraught with serious side effects.
Chronic patientsdiseases often recommend plasmapheresis, which gives good results and even achieve remission. Also, patients are prescribed drugs that can suppress the activity of the immune system - they need to be taken in courses for almost their entire lives. One of the new methods of modern therapy is the intravenous administration of immunoglobulin.
Prognosis for patients with polyneuropathy
The outcome in this case largely depends on the form of the disease, the quality of the treatment, as well as some individual characteristics of the organism. For example, people with an acute form of the disease, who quickly received the necessary therapy, endure the consequences of the disease much more easily. And although full recovery is not always achieved, many patients return to their usual way of life.
But chronic demyelinating polyneuropathy, which developed slowly and over several years, can lead to irreversible disorders in the functioning of the nervous system, disability and even death. By the way, this disease is most severely tolerated by elderly patients.
