Polyneuropathy is a multiple lesion of the peripheral nerves, which is accompanied by such serious symptoms as flaccid paralysis, impaired sensitivity, vegetative-vascular disorders, etc. Unfortunately, the pathology is quite common.
What does the clinical picture look like? What provokes the disease? What are its types? How is the diagnosis carried out? What is needed for treatment? This topic raises many questions, and all should be answered now.
Medical classification
First of all, it should be noted that the disease in question has a very detailed classification. There are a variety of types of polyneuropathy, they differ in etiology, pathomorphology of damage and the nature of the course. Even in the international classification of diseases, not the entire list is indicated.
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 ICD-10, the following items are reserved for polyneuropathy:
- Medicinal -G62.0.
- Alcoholic - G62.1.
- Toxic - G62.2.
- Beam - G62.8.
- No further specification (NOS) - G62.9.
Of course, the real list is much longer. But the classification says that if it is necessary to accurately identify the cause, specialists use additional codes of external causes of class XX.
Axonal polyneuropathy
Its causes, as a rule, are serious disorders of the metabolic process. Here, too, there is a certain classification. There are three types:
- Acute axonopathy. Usually associated with criminal or suicidal poisoning. The disease proceeds against the background of a picture of severe intoxication with carbon monoxide, organophosphorus compounds, arsenic and methyl alcohol. It lasts 2-4 days, then within a few weeks there is a cure.
- Subacute axonopathy. The development of this disease takes several weeks or even months. The subacute form is characteristic of many metabolic and toxic neuropathies.
- Chronic axonopathy. It takes six months or more to develop. The most common case is alcoholic polyneuropathy. The main reason, of course, is chronic alcohol intoxication. It is also found in diabetes mellitus, lymphoma, cancer, cirrhosis, amyloidosis and some other diseases.
And before talking about the treatment of this type of polyneuropathy, it is worth considering its manifestations. The following is commonly seen:
- Feeling of numbness in the distal lower extremities (feet and slightly above them).
- Pain in the calf muscles.
- Limb dysfunction that develops over time, usually lower. Expressed by weakness and paralysis.
- Injury to the nerves responsible for flexion and extension of the foot.
- Violation of skin sensitivity in the area of "gloves" and "socks".
- Mental disorders.
- Discoloration of limbs to painful.
- Excessive sweating.
- Edema of the distal extremities, changes in their temperature.
- Injury to the oculomotor and optic nerve.
If the body continues to be toxic, the symptoms continue to grow. If he is not stopped, his he alth will deteriorate significantly.
Treatment of axonopathy
First, the therapist examines and interviews the patient. Then he is sent to a neurologist, who checks the periosteal and tendon reflexes, as well as their symmetry. Then the person will have to submit his biomaterial for analysis - this is necessary to study the level of uric acid, urea and creatinine. In diabetes, blood is also donated from a vein and a finger.
If the diagnosis of axonopathy is confirmed, the doctor prescribes a comprehensive treatment that affects the symptoms and cause. Here is an approximate therapy regimen:
- With dystrophy and alcoholic polyneuropathy, B vitamins are prescribed either as part of preparations or in ampoules.
- In flaccid paralysis, the use of inhibitors is indicatedcholinesterase. These include Neuromidin, Kalimin and Neostigmin.
- To eliminate spastic paralysis, muscle relaxants and anticonvulsants are prescribed - Mydocalm, Baclofen, Sirdalud, Tizanidin.
- For polyneuropathy caused by intoxication, specific antidotes, forced diuresis, peritoneal dialysis and gastric lavage are prescribed.
- In case of heavy metal poisoning, sodium thiosulfate, tetacine-calcium and D-penicillamine are indicated.
- Glucocorticoid hormones help to cope with autoimmune neuropathies.
- Atropine-like drugs help in the treatment of organophosphate intoxication.
- Diabetic polyneuropathy is eliminated by hypoglycemic medications. These include Glibenclamide and Metformin. Also help antihypoxants, contributing to the utilization of oxygen circulating in the body. With diabetic polyneuropathy, Actovegin, Mexidol and Emoxipin help.
In general, if you feel burning 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 mellitus is not a consequence or a separate disease, but a complication. The cause of the occurrence is damage to the nervous system. The disease is formed in people 15-20 years after diabetes has manifested itself. According tostatistics, the frequency of progression to a complicated stage is 40-60%.
It is important to note that this pathology has its own classification. It presents three types of disease that indicate a damaged segment in the nervous system:
- Motor - manifested in impaired movement.
- Sensory - diagnosed if a person's susceptibility to external stimuli has worsened.
- Sensomotor - combined manifestations of ailments of both types.
It is also worth recalling that regardless of the causes of polyneuropathy, it can be amyotrophic, painless, chronic and acute. This is an intensity classification. In the case of a diabetic type of disease, it is also relevant.
Symptoms can be listed as follows:
- Dagger-piercing pains.
- Enhanced sensitivity.
- Burning.
- Tingling.
- Feeling pain even with light touch.
- Unsteady when walking.
- Tingling in the limbs, followed by a feeling of deadness.
- Numbness and stiffness.
Headaches, convulsions, dizziness, urinary incontinence, diarrhea, visual and speech disturbances, and anorgasmia in women are often added to the symptoms of diabetic upper limb polyneuropathy.
Therapy for diabetic type disease
Most often, when this disease occurs and develops, the doctor prescribes the following drugs:
- Metabolic drugs. B1 has a positive effect on the synthesis of acetylcholine, which contributes to the transfer of impulses from one fiber to another. B6 prevents free radicals from accumulating. B12 helps to improve the nutrition of the nervous tissue and restore the sheath of peripheral nerves.
- Complex drugs. The most effective are Vitagamma, Milgamma, Kombilipen, Compligam B and Neurobion. As a rule, injections are prescribed first. Then, as the condition improves, tablets are prescribed. In general, the appointment lasts 3-5 weeks.
- "Actovegin". This drug deserves special attention. It is made from calf blood. Helps improve tissue nutrition, restore sensitivity, eliminate pain, stimulate regeneration processes.
- Vascular drugs. The best are Vasonite, 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. The discomfort experienced by a person with a diabetic type of illness is neuropathic in nature. Therefore, anti-inflammatory and simple painkillers will not help. Effective drugs are anticonvulsants (Finlepsin), antidepressants (Amitriptyline), opioids (Oxycodone), an anesthetic (Capsicam), and analgesics (Katadolon).
Demyelinating polyneuropathy
This is the name of an extremely rare inflammatory disease characterized by damage to the peripheral nerves. The symptoms are similar to those of the syndrome. Guillain-Barre. As a rule, with this form of polyneuropathy, the legs are most often affected. 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:
- Symmetrical distal and proximal muscle weakness lasting more than two months.
- Disappearance or weakening of tendon reflexes.
- Sensory deficit.
- Unsteady gait.
- Partial blockade of motor activity.
It should be noted that there are many forms of demyelinating polyneuropathy. Acquired motosensory, multifocal motor, distal symmetrical, isolated sensory, etc. stand out among them.
The exact diagnosis of "polyneuropathy" is made after a lot of research. The doctor examines the conduction of the patient's nerves, 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 demyelinating type disease
Therapy, which the doctor will prescribe after diagnosing polyneuropathy, will be aimed at blocking pathoimmune processes. Also, the goal of treatment is to suppress inflammation and prevent further axonal degeneration.
After the results appear, maintenance therapy is mandatory. This is necessary to reduce the frequency of exacerbations andprevent the progression of the disease. The result of the treatment can be seen in the improvement of the sensitivity and motor skills of the patient. A person is considered to be in remission if they can resume daily activities.
Typically, treatment for this type of polyneuropathy includes:
- Taking corticosteroids. The most effective are Prednisolone, Nycomed, Medopred and Prednisolone Gemsuccinate.
- Passage of the course of the drug "Gamunex-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 he althy donors.
- Plasmapheresis. This procedure involves taking blood, further cleaning it, and then returning it back to the bloodstream.
- Intravenous administration of immunoglobulins.
This therapy helps prevent secondary destruction of axons and prevent the progression of the disease. According to statistics, in 60-80% of people, the condition improves even when using one of the methods listed.
Inflammatory polyneuropathy
Under 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 because it affects not one, but several peripheral trunks. In addition, the lesion usually destroys their myelin sheath.
It is not completely clear why this type of disease occurs. Many believe that it is formed as a result of an autoimmune process. Atdiagnostics can detect accumulations of mononuclear cells, detect macrophage activation 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 the nerves.
Serum neuropathy deserves special attention. It usually develops after a person has been given an injection against tetanus. 7-10 days after the injection, the disease begins to manifest itself. Symptoms cannot 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 muscles of the arms. Often diagnosed with arthralgia (articular pain of a flying nature), loss of sensitivity in the axillary nerve. Purulent inflammation of the lymph nodes may also develop.
As part of the diagnosis, a complete blood count, serum protein electrophoresis, electroneuromyography, as well as laboratory studies of the composition of blood serum are performed. It is mainly eliminated by drugs such as Diphenhydramine and Prednisolone. It is not prohibited to carry out alternative treatment for serum polyneuropathy. Your doctor may also prescribe antihistamines, corticosteroids, and plasmapheresis.
Peripheral polyneuropathy
This disease also needs to be told separately. The person who was subjected to it suffers from damage to the distal sections of both the upper and lower extremities.
Except abovesymptoms, note the following signs:
- Night cramps.
- Muscle weakness leading to atrophy.
- Thinning skin.
- Fragility and fragility of the nail plates.
- Violation of sensitivity in the oral region.
- Hand tremor.
The development of this disease is facilitated by the use of reverse transcriptase inhibitors. The most famous representatives of this group of drugs are Zalcitabine, Stavudine 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 that provoked the development of this disease.
Treatment of peripheral disease
The doctor may prescribe any of the previously listed medications. But in this case, in addition to standard appointments, it is necessary to follow specific recommendations. In particular, taking alpha-lipoic acid. It is an endogenous antioxidant, the action of which is aimed at binding free radicals. The acid takes part in metabolic processes, and also acts as coenzyme Q, which helps the absorption of substances with a pronounced antitoxic effect.
Actually, alpha lipoic acid prevents the destruction of nerve cells. And it is this process that most often leads to disorders. In addition to acid, the doctor may prescribe medications that improve tissue nutrition, glucose utilization, and also provide venotonic, vasodilating anddiuretic action. It should be noted that all of these properties combines a drug called "Instenon".
Folk remedies
The most effective treatment for polyneuropathy is medication. But folk remedies can also be helpful. They can be used as adjuvant therapy. Here are some popular recipes:
- Cocktail to eliminate alcoholic polyneuropathy. To prepare it, you need to beat olive oil (2 tablespoons) with chicken yolk. Then add freshly squeezed carrot juice (100 ml) and honey (2 tsp). Drink two hours before meals. Should be consumed twice a day.
- Remedy for diabetic polyneuropathy. Pour chopped bay leaf (1 tablespoon) and fenugreek seeds (3 tablespoons) into a thermos. Pour in a liter of boiling water. Let it brew for 2 hours, strain. Drink throughout the day when thirsty.
- Drug for the treatment of polyneuropathy of the lower extremities. Pour half a glass of chopped wild rosemary into 9% vinegar (0.5 l), close, shake and let it brew for 10 days. Shake periodically. After the time has passed, you can use: 1 tbsp. l. the resulting infusion diluted in 1 tbsp. l. of water and rub the resulting mixture on the legs three times a day.
- Universal remedy with ginger and St. John's wort. Loosely pour crushed St. John's wort into a 0.5 liter jar. Pour vegetable oil heated to 60 ° C. Infuse for 20 days in a dark place. Strain, add dry ginger root (1 tablespoon), mix. Oiluse to massage and wrap limbs twice a day.
- Drug to eliminate sensory polyneuropathy. Crushed leaves of ginkgo biloba (4 tbsp.) Pour into a thermos and pour a liter of boiling water. Let it brew for 3 hours. Then strain and drink throughout the day.
Also, with polyneuropathy of the extremities, you can take various infusions to remove toxic substances from the body and cleanse the liver. There are many recipes, but before you start taking the remedy you like, you should consult with your neurologist.
