Causes, symptoms and treatment of various forms of polyneuritis. Alcoholic polyneuritis: symptoms, prognosis and treatment

A huge number of the most diverse infections - perhaps even any infection - can give polyneuritis as a complication. In some contagious diseases such complications occur less frequently, in others more frequently, but in general all these cases are not very numerous, if we do not take into account such exceptional pandemics as those that we have observed in recent years.

From the side of the clinic, all these polyneuritis do not present any features that would distinguish them from one another. These two circumstances deprive such cases of particularly great practical significance. Their diagnosis, if the anamnesis is known, is simple; if the anamnesis is unknown, then it is impossible in the sense of finding out the cause; they come across only occasionally; their therapy, as you will see, is nothing specific. But there are two types of infectious polyneuritis that are interesting in some respects and therefore deserve special consideration. I mean diphtheria and the so-called idiopathic polyneuritis.

Diphtheria polyneuritis

I'll start with diphtheria as more frequent. It is observed more often in children, less often in adults who have contracted diphtheria. I will describe to you the most typical case of this disease.

After the acute phenomena of diphtheria subsided, the ulcerative process in the throat healed and the temperature returned to normal, phenomena from the nervous system begin to develop. Most often it happens 1 - 2 weeks after the cessation of the main infection, less often - after 3 - 4 - 6 weeks.

The first complaints of the patient will concern phonation disorders. His voice has changed: his speech has become nasal, has acquired a nasal tone. This is called nasolaliaaperta. In addition, hoarseness appeared, as if the patient had caught a bad cold. Another category of disorders concerns the act of swallowing: it became difficult for the patient, choking appeared when eating, food "gets stuck in the throat" and also enters the nose.

Finally, the last complaint is visual impairment. The patient says that he has somehow become worse to see? that any kind of strenuous work of the eyes - like reading - became difficult for him. If your patient is in the very initial stages of the disease, then you will not hear other complaints from him.

After examining the motor sphere, you will not find any paralysis, or muscle atrophy, or a sharp change in muscle tone. But the study of tendon reflexes will somewhat unexpectedly show you their decrease or even complete extinction. Rarely will they be normal.

Sensitivity both subjectively and objectively will be quite normal.

The main changes will be in the state of the cranial nerves. By methodically examining the condition of the X pair, you will see first of all the paralysis of the soft palate. There will be no movements in it, neither voluntary nor reflex. This immobility will explain to you first of all the nasal timbre of the voice, since it appears when the soft palate does not participate in the production of sounds.

The same paralysis of the soft palate will also explain why food exits through the nose during meals. If you remember, at the moment of swallowing a food bolus, the soft palate rises up and thereby isolates the oral cavity, forms, as it were, a partition between it and the nasopharynx, where the posterior openings of the nasal passages open. If this blocking of two adjacent cavities does not occur, then food freely penetrates into the nasopharynx, and from there into the nasal passages, through which it falls out.

However, this does not exhaust the mechanism of swallowing disorder: in such cases, in addition, there is an undoubted paralysis of the esophagus. This is especially clear when the soft palate is comparatively slightly paralyzed and food is not expelled through the nose: swallowing in such cases can still be greatly disturbed.

Finally, the elucidation of the last complaint - weakness of vision - will show you that it is a matter of paralysis of accommodation, but in all other respects the entire visual and oculomotor apparatus will be quite normal. Let me remind you by the way that the accommodative muscle is innervated from the III pair.

I summarize the data of objective research. They come down to: 1) paralysis of the vagus nerve, 2) partial paralysis of the oculomotor nerve, and 3) changes in tendon reflexes.

The symptoms just described can exhaust the whole picture of the disease from the beginning to its very end. This type of disease is observed, and there is a special name for it - local polyneuritis.

It is opposed by another clinical type - the so-called general polyneuritis. In these cases, the whole disease can develop in two ways.

Firstly, the case may begin with the local polyneuritis just described, and then the usual polyneuritic phenomena in the limbs, known to you at least as an example of alcoholic polyneuritis, will join it. This means that in the future there will be paralysis of the limbs, with atrophy, a decrease in tone, loss of tendon reflexes and with a peripheral type of distribution.

In addition, sensitivity disorders may appear. It is necessary, however, to emphasize one feature of diphtheria polyneuritis: superficial sensitivity is most often slightly affected. Pain and other phenomena of irritation are weakly expressed, and in this respect diphtheria polyneuritis is somewhat like lead polyneuritis. But on the other hand, deep sensitivity can be upset quite strongly, and then ataxia will sharply come to the fore in the clinical picture of the disease. It is called atactic form polyneuritis.

The second type of development of the disease is somewhat different: the phenomena of local polyneuritis and damage to the limbs develop approximately simultaneously.

I said that diphtheria polyneuritis is a fairly common disease. Indeed, if we take into account mild local neuritis, then according to some statistical studies, this suffering is observed in 20% - and even more - of cases of diphtheria.

Once formed, the disease proceeds approximately in the same way as any polyneuritis in general, that is, it lasts quite a few months and generally gives a good prediction.

Cases where the case is limited to local polyneuritis give the best prediction - they often end in recovery in a few weeks.

But on the other hand, there is a special category of cases that gives an extremely difficult prognosis: death in the vast majority of patients. This happens when polyneuritis develops even in the presence of an ulcerative process, in the midst of diphtheria.

This fatal imprint, lying on such cases, gave grounds to some authors to distinguish them into a special type and call it "diphtheria polyneuritis" in the narrow sense of the word.

The same cases where polyneuritis develops some time after the healing of the ulcerative process, it was proposed to call post-diphtheria polyneuritis.

Alcoholic polyneuritis is observed mainly in persons who chronically consume alcohol in all its forms. Any surrogates of alcohol are especially harmful: hypocrisy, denatured alcohol, etc. The disease occurs most often in middle age and is more common in men than in women. It is extremely rare in childhood.

Pathological anatomy and pathogenesis

Alcoholic polyneuritis can affect almost all nerves, most of the lesions are parenchymal in nature. Various stages of degeneration are observed, from mild periaxillary neuritis to severe changes with the disappearance of the membrane. Primary rebirths are often joined by secondary ones - rebirths of the distal segments. Degenerative changes in muscles are also frequent, which depend not only on damage to the motor nerve fibers, but also on myositis, which appears from the direct action of alcohol.

Course and forecast

Alcoholic polyneuritis always proceeds acutely or subacutely. Rapidly, with a high temperature, occurring cases give an unfavorable prognosis. Death sometimes occurs in 10-14 days. If the course is less rapid, then the prognosis is based on the general condition and intensity of the spread of paralysis as well as on the involvement of the cranial nerves.

With only one lesion of the legs, the prognosis is more favorable than with the defeat of more arms or torso.

Chronic forms are very rare. There are recurrent forms, for example, annually at the same time. In most cases, the course is favorable, either complete recovery occurs, or partial with defects. Until all the phenomena of paralysis disappear, a year may pass, and as an exception, several years.

Symptoms

The most common symptoms:

numbness of the limbs;
soreness of the calves and nerve endings;
decreased sensitivity of the feet;
tiresome hiccups;
insomnia;
weakness and fatigue.

Alcoholic polyneuritis is often accompanied by fever, rarely delirium tremens. Paresthesias and pains appear - a feeling of itching, loss of sensitivity at the ends of the legs and arms, lancinating pains in the limbs. Often the pains are insignificant in strength, but sometimes they are very intense, and can also be aggravated by movement, by pressure on the nerves and muscles, and sometimes only by touching the skin.

Weakness soon sets in, chiefly in the legs, aggravated over days or weeks, rarely months, so that the patient cannot walk at all. The psyche of the patient at this time is either normal or disturbed; there are gastrointestinal disorders, tremor. Further, weight loss appears from the side of the legs, which does not occur in the early periods.

Pressure on the muscles and nerves is painful, passive movements are free, but also painful.

Tendon reflexes are either very weak or completely extinguished; at the beginning of the disease, they can be enhanced. Paralysis is usually not complete, not of the entire limb, but only of a certain muscle group supplied with a diseased nerve; but not all the muscles of this group get sick, but only one or several of them. Another distinguishing feature is the presence of either a complete or partial rebirth reaction, or a decrease in electrical excitability. The upper extremities are often not affected at all.

In general, the disease can affect either one limb, or both, or all, and it affects either the nerves of the same name, or opposite ones. Ataxia is often associated with motor weakness, which in some cases occurs at the onset of the disease, sometimes ataxia occurs on its own without movement disorders. Coordination disorder also occurs in the upper limbs.

Sensitivity

As for the sensitive sphere, it is less disturbed than the motor one. This disorder is localized mainly along the periphery of the limb. Often all kinds of sensitivity are dulled. Sometimes there are combinations of anesthesia for tactile and hyperesthesia for pain sensitivity. Hyperesthesia is especially common on the sole and can give rise to difficulty in gait. Like motor disorders, sensory disorders are more pronounced on the legs.

Skin reflexes

Skin reflexes for the most part are either reduced or absent, but with hyperesthesia in this area, they can be increased. Vasomotor, secretory and trophic disorders are not uncommon in this disease: edema, thickening of the joints, the skin turns red, becomes glossy. The bladder and rectum are usually unaffected, which may distinguish it from spinal cord disease.

Mental disorders

Mental disorders accompanying alcoholic polyneuritis relate mainly to confusion and weakening of memory for recent events and the appearance of false memories - "Korsakov's polyneuritic psychosis". Of the cranial nerves, the nerves of the eye muscles are more often involved. It should be noted that there is never a reflex immobility of the pupils, in contrast to chronic alcoholism. Diseases of the optic nerve are rare. Sometimes there is a central scotoma.

Treatment Methods

The main treatment is:

medication;
physiotherapy exercises (LFK);
phytotherapy;
special limb massage.

Thanks to these methods, some nerve endings are restored, as well as muscle strength.

The following procedures are also applied to the treatment:

acupuncture;
taking B group vitamins;
muscle and nerve stimulation;
taking antiviral drugs;
neurolysis of nerve endings, etc.

Almost every patient has a chance for recovery.

Basically, the recovery of the patient depends on the complete refusal to use alcohol, in any of its manifestations. If this condition is met, as well as complex and long-term (3-4 months) therapy, the clinical prognosis is favorable.

Polyneuritis is a multiple lesion of the nerves. Polyneuritis can occur after infection (flu, diphtheria, dysentery, typhoid), exogenous intoxication (poisoning with alcohol, arsenic, chlorophos), endogenous intoxication (diabetes, nephritis), with (working in the cold, with vibrating instruments), beriberi.

The disease begins with a feeling of crawling, coldness and numbness in the hands and feet, aching or shooting pains in the limbs, a feeling of chilliness in the hands and feet, even in hot weather. Gradually, weakness in the legs, unsteady gait joins, paresis of the feet develops, it becomes difficult to hold objects in the hands, and later comes atrophy of the muscles of the limbs. The patient ceases to feel the touch of sharp and hot objects, as a result of which poorly healing ulcers develop. Sensitivity disorders are observed more often in the distal extremities of the "gloves and socks" type. The skin on the hands and feet becomes thinner, takes on a purple-cyanotic color, flakes off, swelling of the feet and hands appears. Nails become brittle, dull, striated.

Infectious polyneuritis occurs against the background of catarrh of the upper respiratory tract, influenza, tonsillitis, accompanied by general malaise, fever, inflammatory changes in the blood.

Diphtheria polyneuritis can develop with late or insufficient administration - at the 2-3rd week from the onset of the disease or with a toxic form on the 5-6th day of illness. There is paralysis of the soft, nasal, choking when eating as a result of damage to the vagus nerve. The nerves of the extremities can be damaged. In the hypertoxic form of the disease, paralysis of the respiratory muscles and damage to the heart fibers of the vagus nerve are possible.

Lead polyneuritis often occurs with household poisoning when using sour jam (cranberries, lingonberries) stored in glazed earthenware. It is manifested by damage to the radial nerves (hanging brush), combined with pain in the abdomen, anemia, lead border on the gums.

Arsenic polyneuritis can be professional and domestic (improper handling of seed dressing, poisoning with pesticides). Manifested by vomiting, pain in the stomach, paralysis of the limbs.

Diabetic polyneuritis is quite common. The nerves of the legs are usually affected, less often the arms and face.

Patients experience a burning sensation and pain in the legs, chilliness and coldness of the feet, swelling of the feet, itching, peeling of the skin.

Occupational polyneuritis occurs in people working with vibrating tools, in the cold, in professions that require strong muscle tension (milkmaids, seamstresses, laundresses). There are pains in the hands, a burning sensation, tingling, coldness, excessive sweating, blanching of the ends of the fingers. Symptoms increase at rest, at night, decrease with movement.

Treatment. Intravenous 40% glucose solution with 5% thiamine chloride solution (vitamin B1) - 1 ml, intramuscularly cyanocobalamin () 200 mcg daily, 20 injections, inside nicotinic acid 0.03-0.05 g with ascorbic acid (vitamin C) 0.3 g 3 times a day, (vitamin B15) in tablets of 0.05 g 3 times a day inside. It is useful to use yeast, liver, rye, which contain a lot of vitamin B1. For pain, intravenous administration of a 0.25-1% solution of novocaine, 5-10 ml, 10 injections. Massage, therapeutic gymnastics, 4-chamber baths, paraffin, mud are shown. With diphtheria polyneuritis, treatment with massive doses of antidiphtheria serum, subcutaneously 0.1% solution of 1 ml daily. In diabetic polyneuritis, a restricted diet and insulin treatment.

Depends on timely treatment, in most cases favorable.

Prevention measures include a reasonable body, classes, proper organization of work, compliance with sanitary measures in enterprises that use arsenic and other toxic substances.

Polyneuritis (from Greek poly - many + neuritis; synonym: symmetrical peripheral neuritis, multiple neuritis) - multiple inflammation of the nerves. In the past, inflammatory damage to the nerves (primary) was denied due to the prevailing idea of the absence of blood vessels in the nerves. Kryuvele (J. Cruveilhier) for the first time admitted the possibility of inflammation of the nerve sheaths (epineuria).

In various etiological forms of polyneuritis, either the spinal cord and peripheral nerves are affected simultaneously, or sequentially, in which the peripheral nerves are the site of the primary and, in certain phases of the disease, the dominant lesion. Guillain and Barre (G. Guillain, J. A. Barre) identified a special nosological form of polyneuritis, which was called the Guillain-Barré form. A very frequent simultaneous lesion of the roots and peripheral nerves is called polyradiculoneuritis. There are almost no pathological and clinical differences between polyneuritis and polyradiculoneuritis.

Etiology and pathogenesis. The causes of polyneuritis are varied. They can be divided into two groups: intoxication and infection. Intoxications can be exogenous (lead, arsenic, etc.) and endogenous, resulting from metabolic disorders in the body, diseases of internal organs (diabetes, diseases of the kidneys, liver, gastrointestinal tract, intoxication of pregnancy and lactation, exhaustion in chronic diseases ). Great importance is attached to avitaminosis in the etiology of polyneuritis. Alcohol is obviously only one of the factors causing chronic liver and gastrointestinal disease.

Most often, polyneuritis occurs with diphtheria, dysentery, purulent diseases. In some infections, polyneuritis is caused by toxins secreted by bacteria (diphtheria, dysentery) or released during their massive decay [at the critical end of the disease (typhoid, pneumonia, etc.)]; in other infections, penetration into the nerves of the infection itself should be assumed. Viral polyneuritis, in which the virus selectively affects the peripheral nervous system, has not yet been proven, although polyneuritis has been described as a component in some lesions of the nervous system in a number of viral diseases (lethargic encephalitis, poliomyelitis).

A special group is made up of allergic polyneuritis, which develops after the administration of sera, vaccines during anti-rabies vaccinations and as a result of a number of infectious diseases that give allergic forms of reactions. Allergic also includes polyneuritis resulting from the action of certain chemical (medicinal) substances, more often sulfanilamide preparations, less often penicillin, etc. Polyneuritis is also described in blood diseases (anemia, myeloid leukemia).

The variety of etiological factors of polyneuritis does not give grounds for isolating this disease into a nosological unit. Polyneuritis should be considered as a kind of symptom complex, in the occurrence of which a complex of various causes plays a role. So, a lack of vitamin B1, in itself, can cause polyneuritis (beriberi). In other cases, its insufficiency in the body, which is created either due to external conditions or due to internal reasons, is a paraetiological moment, which, in combination with others, leads to the occurrence of polyneuritis. This is confirmed by a significant increase in the incidence of polyneuritis in conditions of malnutrition of the population. This is the origin of the epidemic of polyneuritis during the wars in different countries.

A significant role in the pathogenesis of polyneuritis is played by external influences (which disrupt the normal activity of the nervous system, in particular its peripheral link), functional load (leading to its depletion), temperature influences, trauma, etc. Reactions of the nervous system to hazards, their course and The outcome depends on a number of conditions. Among the most significant of these conditions are the course of biochemical processes in the body and endocrine functions, the main background of nervous activity, concomitant diseases and the above external influences. It can be noted that with infections and allergic forms of reaction, polyradiculoneuritis is more often observed.

Pathological anatomy. With polyneuritis, parenchymal (degenerative) and interstitial (inflammatory) changes are observed in the nerve trunks. The former should be considered as a subsequent stage of the inflammatory process in the interstitium. But it is possible that in some etiological forms, parenchymal changes occur without a previous inflammatory component, or the latter is very short-lived, leaving no noticeable changes. So, apparently, the situation is with some neurotropic poisons (chemical), avitaminous polyneuritis, diphtheria intoxication.

Parenchymal changes are limited to either the breakdown of the myelin sheath (periaxial neuritis) or degeneration of the axial cylinders (axial neuritis). Changes in the myelin sheath are often intermittent, segmental in nature (segmental periaxial Gombo polyneuritis).

With periaxial polyneuritis, axial cylinders are not always destroyed, then the conductivity along them is preserved, but qualitatively changes. With axial polyneuritis, the degeneration of axial cylinders occurs according to the Wallerian type (the death of all elements of the nerve fiber downwards from the site of nerve damage). In the affected areas, usually not all nerve fibers of the bundle undergo disintegration; along with the damaged fibers remain intact, in some fibers only myelin decay occurs, in others the axial cylinders also die. The most persistent are sympathetic fibers. Along with the degeneration of nerve fibers, their regeneration occurs quite quickly in the form of splitting of the axial cylinders into separate fibrils, the formation of club-shaped swellings, lateral processes, and Perroncito spirals. If the action of the disease-causing poison continues, the regenerating fibrils die.

With interstitial polyneuritis, the inflammatory reaction from the side of the mesenchymal formations of the nerve - the membranes and vessels - is most pronounced. In those cases when the above-described changes in nerve fibers join the reaction from the connective tissue, the terms interstitial-parenchymal polyneuritis or inflammatory-degenerative polyneuritis are used. Morphologically, inflammation is characterized either by an exudative reaction with accumulation of leukocytes and edema, or by an infiltrative-proliferative process. The consequences of the completed process are the growth of fibrous tissue in the epineurium, thickening of the perineurium and vascular walls with sclerosis and hyalinosis of the latter. Quite often, inflammatory phenomena are also found in the radicular nerves, in the spinal nodes, occasionally in the soft membranes adjacent to the roots or in the spinal cord (myeloradiculopolineuritis).

The clinical picture of polyneuritis and polyradiculoneuritis consists of motor, sensory and trophic disorders; they are often accompanied by disorders of the autonomic nervous system. Motor disorders are characterized by paresis or paralysis, accompanied by muscle atrophy, decreased muscle tone and a reflection (flaccid paralysis); sensitive - pain, paresthesia and switching off sensitivity; trophic disorders are localized in the skin, nails and joints of the extremities. Depending on the etiology of the disease and the degree of damage, these disorders are combined in various ways. In relatively rare cases, cranial nerves are involved in the process: vagus (often with diphtheria paralysis), oculomotor, facial, motor branches of the trigeminal nerve; these lesions are bilateral or unilateral. In some etiological forms of polyneuritis (mainly with endogenous intoxications and beriberi), peculiar mental disorders are observed (see Korsakovsky syndrome). The process rarely spreads to the spinal nodes (polyganglioradiculitis) and to the spinal cord (myeloradiculopolyneuritis).

Polyneuritis almost always has a mixed type (sensory and motor), but one or another symptom may dominate. Quantitative dissociations are sometimes observed within individual types, mostly sensitive ones. In some cases, the conductors of skin sensitivity are affected with relatively intact musculo-articular, in other cases, vice versa. This last type of polyneuritis is characterized by a violation of the statics and gait of the tabic type, the absence of reflexes, pain (pseudotabes neurotica, polyneuritis atactica) and is observed more often in diphtheria paralysis. Individual cases are described where trophic and vasomotor disorders dominated the picture of the disease in comparison with sensory and motor disorders; usually these were chronic polyneuritis with a slow and progressive course.

In some cases, paralysis of the limbs is unilateral, or the process is localized in the proximal parts of the limbs, in the dorsal muscles. Sometimes the disease begins with damage to the cranial nerves, and paralysis of the limbs joins a little later. With serum and vaccine polyneuritis, sometimes the nerves of the area where the serum is injected are affected, but then the lesion spreads. In most cases, the upper and lower extremities are simultaneously affected, but the onset of the lesion from the lower extremities (ascending nature of the process) occurs in about half of the cases. A special form of an ascending type of paralysis with a hyperacute or acute onset, often ending in death, is the form described by Landry (see Landry ascending paralysis). The so-called ascending neuritis is also distinguished, starting from one limb, then moving to the other.

The cerebrospinal fluid in polyneuritis has a normal composition. With polyradiculoneuritis, it is almost always changed. The changes are in the nature of protein-cell dissociation with an increase in the amount of protein and are quite persistent. This is the only convincing sign that establishes the spread of the process to the radicular part of the nerves. Occasionally, moderate pleocytosis (6-30 cells per 1 mm 3) is found in the cerebrospinal fluid, indicating swelling of the membranes or the spread of inflammation to the membranes (meningoradiculitis).

The diagnosis of polyneuritis is not very difficult. Only with significant deviations from the classical type and with abortive forms, polyneuritis has to be differentiated from the initial phases of poliomyelitis (see), with chronic poliomyelitis of adults, muscle diseases (see. Myositis), neural forms of muscle atrophy (see. Muscular atrophy), with hypertrophic neuritis Dejerine - Sotta (see Dejerine - Sotta disease). The etiological diagnosis of the disease is not always easy. The nature of infection and intoxication (exogenous) is evident when polyneuritis develops shortly after or during infection. In cases where the cause of the disease is unclear, a thorough study of the entire life history of the patient, diseases that he has suffered in the past and recently (infectious), and the nature of their treatment, help; a detailed examination of the internal organs, especially the liver and gastrointestinal tract, nasopharynx, genital organs; familiarization with the conditions of life and work, nutrition of the patient.

Treatment in the first place should be aimed at eliminating the infection or intoxication that caused the polyneuritis. Its nature is determined by the type of infection. To remove toxins from the body, an infusion of glucose, saline, heavy drinking, diaphoretics, indifferent warm baths or light baths are used. The nature of the body's reaction to infection determines the methods of treatment. With a sluggish reaction, it is desirable to use tonics: strychnine injections, nonspecific vaccine therapy. In case of violent and allergic reactions, it is necessary to use desensitizing agents: infusions of calcium chloride, injections of diphenhydramine (1% 2-5 ml or orally 0.05 g 2 times a day), chlorpromazine (2.5% 1-2 ml) and sedatives (bromides, sleeping pills).

From the very beginning of the disease, it is necessary to use vitamins B, and C: B, in the form of intramuscular injections (1-2 ml of a 5% solution, No. 30), vitamin C can be infused into a vein along with glucose. As symptomatic pain relievers, in addition to various kinds of analgesics, intravenous infusions of novocaine (1-2% in an amount of 5-10 ml) can be recommended, as well as physiotherapy: a positive pole of galvanic current, ultraviolet irradiation, diathermy.

For the treatment of motor disorders - massage, gymnastics, electroprocedures: 4-chamber baths, iontophoresis with the introduction of phosphorus, calcium, iodine. In order to prevent the formation of contractures and inconvenient fixations in the joints for the patient, the limbs are given the most advantageous position: splints, splints, sandbags, elastic bandages are applied. With significant muscle atrophy, injections of aloe extract, ATP are successfully used.

In the recovery period and for the treatment of residual effects, Matsesta baths, mud are useful; inside give phosphates (glycerophosphates, phosphrene), lecithin, lipocerebrin. Treatment is shown at resorts with hydrogen sulfide, thermal, radon waters, as well as at mud resorts. In the event of persistent contractures in the limbs, one has to resort to surgical intervention.

Prevention of polyneuritis follows from the etiology and pathogenesis of the disease. It is necessary to avoid any kind of intoxication - domestic and industrial; make sure that there is sufficient vitamin nutrition, especially in those conditions where carbohydrates are the main type of food or working conditions, the climate, the need for vitamins is increased (hard work, hot climate, work in hot shops); the same is required in acute infections. It is necessary to carefully treat all diseases, especially the liver, stomach and intestines, and local chronic infections; in case of industrial intoxication - the correct organization and implementation of labor protection measures, automation of manual work, compliance with the rules of personal and industrial hygiene, additional nutrition (milk). Regular dispensary examinations of workers are required to identify early forms of chronic poisoning.

Description:

Polyneuritis is a disease predominantly of the nerves of the extremities. Polyneuritis can occur as an independent disease, as well as a complication of an infectious disease, for example, dysentery or diseases of the endocrine glands with metabolic disorders, for example, in diabetes mellitus.

Symptoms:

The disease begins with a feeling of crawling, coldness and numbness in the hands and feet, a feeling of chilliness in them even in hot weather, the appearance of aching or shooting pains in the limbs.
Gradually, weakness in the legs joins, unsteady gait, it becomes difficult to hold objects in the hands. The muscles of the limbs decrease in volume (atrophy). Sensitivity is disturbed, especially in the hands and feet - like "gloves" and "socks".

Causes of occurrence:

Polyneuritis can begin in people with a disease of the stomach and intestines due to malabsorption of substances necessary to nourish the nervous tissue and assimilate vitamins. A special group is toxic polyneuritis - with chronic poisoning with arsenic, mercury, lead, with improper use of household chemicals.

Polyneuritis can develop in chronic alcoholism due to the toxic effect of alcohol on the nervous system and metabolic disorders.

Treatment:

For treatment appoint:

Treatment is carried out according to the prescription and under the supervision of a physician. It is important to eliminate the cause that caused the disease.
In the acute period, bed rest is necessary. In addition to drug treatment, physiotherapy procedures, therapeutic & nbsp & nbsp physical education can be prescribed; in chronic course - resort treatment. It is possible to prevent polyneuritis in common infectious diseases and metabolic disorders if the underlying disease is treated in a timely manner.
To prevent toxic polyneuritis, strict safety rules have been developed in the respective industries. Subject to these rules, the ingress of toxic substances into the body is excluded. Polyneuritis when working with pesticides can be avoided if you follow the instructions for the use of these substances.

Polyneuritis is a disease in the form of multiple disorders of nerve endings. It can manifest itself as paresis, decreased sensitivity, or various trophic disorders. Polyneuritis leads to autonomic, motor and sensory disorders of the nerves. The disease can occur in acute or chronic form.

Types of polyneuritis

There are several types of polyneuritis:

Alcoholic. This species is characterized by sensory and motor disturbances. The defining symptom is mental disorders. The pronounced ones include memory lapses, which are replaced by fictions or a distortion of the events that have occurred. Polyneuritis begins. Legs and lose mobility and sensitivity.

Polyneuritis of the kidneys. Development occurs with pyelonephritis and severe glomerulonephritis. This disrupts glomerular filtration. First, swelling appears, then the arms and legs weaken.
Spicy. Development occurs during or after viral illnesses. After the cause is eliminated, limbs begin to break, the temperature changes and burning pains occur. Symptoms increase from a few hours to a few days.
Diabetic. Patients with diabetes mellitus are subject to it. Often, limb disorders begin earlier than the main ones. They can persist for a long time if treatment is successful. It is difficult for the patient to walk, accurately manipulate the fingers, accompanied by paresis and
Chronic. It develops gradually if the provoking factor acts constantly. Atrophy and weakness in the muscles of the limbs begin. Speech disorder and inflammation of the brain appear.
Toxic polyneuritis. It starts because of alcohol or salts of heavy metals. May be acute or subacute. Acute poisoning is accompanied by vomiting, diarrhea and pain. Then there are clear signs of polyneuritis, the general condition worsens.
Vegetative. Appears with intoxication, poor working conditions or thyrotoxicosis. The disease is characterized by burning pains all over the body. The trophism of tissues worsens, body temperature changes, excessive or insufficient sweating appears.
Infectious. It starts because of the causative agent of the infection. There is a fever, a nervous lesion of the limbs. Moreover, it develops along an ascending path.
Alimentary. It starts due to a lack of vitamins, especially B. Or its improper absorption. In addition to pathological signs, there is a violation of cardiac activity.

Features of the disease

With polyneuritis, a pathological lesion of distant nerve endings in the extremities mainly occurs. This reduces sensitivity and strength in the feet and hands. If the nerve damage began higher, this is already a neglected form. Treatment depends on the original cause.

Polyneuritis of the limbs affects the nerves, so the disease is associated with the feet and hands. At the beginning of the disease, they become cold, and later a violation of sensitivity begins. Since changes characterized by dystrophic changes occur in the nerves, inflammation is not typical.

Types of polyneuritis

Polyneuritis is of several types:

Infectious. The reason is catarrh of the upper respiratory tract. At the same time, the temperature rises, the cells become inflamed.
diphtheria. The reason is incorrect or untimely treatment. At the same time, the sky paralyzes, voice nasality appears. Eating is difficult.
Lead. Appears due to sour berry jam, not stored in earthenware. In this case, the radial nerves are affected, abdominal pain and lead plaque on the gums appear.
Arsenic. It can be domestic or professional. Symptoms are stomach pain, vomiting and paralysis of the limbs.
Diabetic type. It affects the nerve endings of the limbs or face.
Professional. Appears in those who work with vibrating tools, or who overstrain their muscles due to work. In this case, there are pains in the hands, sweating, and the tips of the fingers turn pale.

Causes of the disease

Polyneuritis is divided into two groups - axonopathy and demyelinating neuropathy. In the first case, the nerve axes suffer. Most often, this form occurs due to toxic poisoning. In the second case, nerves suffer. It can be inherited, there is an autoimmune variety.

Causes of polyneuritis:

A separate variety is alcoholic polyneuritis. Symptoms are found in patients who abuse alcohol. This form of polyneuritis affects the nerves in the kidneys, and they no longer cope with the poison entering the body.

Symptoms

Often people develop a disease such as polyneuritis. Symptoms:

Goosebumps, numbness and burning of the limbs.
When viewed on the affected areas, the skin is pale, with a marbled pattern. Much colder to the touch than the rest of the body. Wet from excessive perspiration.
Muscle weakness, manifested by discomfort during the simplest household operations - fastening buttons, holding small objects in hands, etc.
Gastrointestinal diseases often begin, symptoms are vomiting, diarrhea, etc. The reason may be a metabolic disorder.
On the feet, the dorsal muscles weaken (when flexed). As a result, the leg "hangs", when walking the patient has to raise the limbs high.
Violation of sensitivity. Patients do not feel temperature changes, sharp injections and touches. At the same time, severe pain and burning appear.
Loss of coordination, unsteady gait and trembling of the hands.
Thinning of the skin on the limbs. Puffiness and the acquisition of a dark purple hue. Changing the structure of the nails.
Severe pneumonia with pronounced tachycardia and shortness of breath.

Diagnostics

The doctor conducts a survey and general examination of the patient. Prescribes tests that help determine toxic substances in the body. The endocrine system and internal organs are examined. Testing for the presence of cancer. An electromyography is performed.

Treatment

How to treat polyneuritis? Symptoms may indicate a specific cause of the disease. After its establishment, the necessary treatment is prescribed. It depends not only on the cause, but also on the degree of sensory disturbance or nerve damage.

If polyneuritis is in the initial stage, then drug therapy is used. Medicines are prescribed:

anti-inflammatory;
painkillers;
vitamin (thiamine hydrochloride);
to speed up metabolism;
to stimulate the movements of the feet and hands.

If the disease is in an exacerbated form, UHF therapy and electrophoresis are prescribed. Often, with polyneuritis, it is necessary to treat diseases of the gastrointestinal tract. The symptoms that appear in this case will allow you to establish an accurate diagnosis and prescribe a special diet. Emphasis should be placed on foods containing vitamin B.

Doctors prescribe physiotherapy exercises, mud baths and massage. With an exacerbation of the disease, rest and bed rest are necessary. For replenishment in the body, vitamin B can be prescribed (in ampoules for intramuscular injections, capsules or tablets).

Folk methods of treatment

Folk methods can also treat a disease such as polyneuritis. Symptoms may suggest the cause of the disease. A doctor's consultation is necessary, since acute symptoms must be eliminated initially. And folk methods - secondary treatment.

Recommended decoctions of herbs that improve metabolism. As well as special baths or applying compresses to the affected areas. For them, birch branches, wormwood, pine shoots or eucalyptus are taken. Infused in a proportion of 100 g / liter of boiling water. Then the resulting infusion is poured into water or applied to the sore spot as a compress.