Distal polyneuropathy of the upper extremities. Symptoms of neuropathy of various localization. Diagnosis and basic principles of treatment. Prevention of peripheral neuropathy

The pathological effect on the entire body, due to an extremely large lesion of an extensive network of peripheral nerve roots, intervertebral spinal ganglia and nerve plexuses, causes a number of heterogeneous (different in genesis) diseases under the general name - polyneuropathy (PNP).

It is characterized by a symmetrical lesion of motor-sensory functions with distal localization with a gradual spread proximally.

Polyneuropathy - what is it?

It is manifested by nutritional, vascular disorders and peripheral paralysis in the form of loss of sensitivity - PNP of the lower and upper extremities (like “gloves, socks, golf, etc. in ascending order”).

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Depending on the specific functions of nerve lesions, the disease manifests itself in several varieties:

If, for example, the neurons responsible for motor functions have undergone pathological influence, this is manifested in the patient by a difficult or lost ability to move. Such polyneuropathy is called motor.
The sensory form is due to damage to the nerve fibers that control sensitivity.
A pathological effect on autonomic neurons (due to hypothermia, atony) causes a lack of nervous regulation of the functions of internal organs.

About the causes

Violations are caused by two types of nerve damage - demyelinating (the nerve sheath is affected) and axonal (violations in the axial cylinder of the nerve).

The axonal view is noted in all forms of the disease with a difference in the prevalence of motor disorders, or sensory. With this type of disease, it is often diagnosed alcoholic polyneuropathy.

It is provoked not only by the duration of the alcohol taken, but also by its quality, since it is low-quality drinks that contain many toxic substances harmful to the body.

The genesis of pathological influences that can cause extensive lesions in the peripheral nerves is due to many factors.

These may be certain hereditary genetic disorders that provoke the development of PNP;
Failures in metabolic processes. These include uremia and diabetes, characterized by a high level of protein metabolism products in the blood.
Immune disorders, manifested by increased production of antibodies that attack one's own nervous system.
Systemic pathologies that provoke the development of autonomic polyneuropathy.
Dangerous bacterial or viral infections.
Intoxication due to poisoning (drugs, alcohol, industrial solvents, etc.).

Depending on the provocative factor, polyneuropathy manifests itself in many forms:

toxic, fungal and diabetic;
inflammatory, traumatic or allergic;
diphtheria, vegetative, or serum.

It should be noted that diabetic polyneuropathy, as a complication of diabetes, is much more common than other forms of the disease.

The most characteristic symptomatology of the disease is due to peripheral disorders in the extremities (upper and lower). At the same time, a neuronal lesion can be localized only in the arms, or only in the legs, or it can manifest itself as an extensive lesion of all the nervous tissues of the limbs at the same time.

Symptoms of polyneuropathy of the upper extremities are quite characteristic - according to the genesis of development, this type of pathology may be the result of axonal and demyelinating lesions. According to the clinical course, it is manifested by signs of impaired autonomic, sensory and motor functions. In any one type of violation, it rarely manifests itself, more often there are variations of several types of symptoms, manifesting themselves:

Pain syndrome of the branches of the median, ulnar or radial nerve, according to the length of its localization. Often, the pain rises from the distant distal parts - starting as a pain syndrome from the hands and palms of the hands, gradually ascending to the wrist in the area of the forearm and shoulder. Damage to neurons provokes muscle pathologies that they innervate.
The development of muscle weakness, their convulsive contractions, or the degeneration of muscle fibers, with a decrease in the mass of muscle tissues or their necrosis.
Muscle weakness contributing to the violation of fine motor skills of the fingers, leading to problems associated with the performance of habitual physical activity.
Muscle dystrophy, which can be manifested by their shortening and reduced extensibility, which is manifested by a violation of extensor functions in certain parts of the limb.
Numbness of the skin on the hands, a feeling of "creeping goosebumps", or a complete loss of any sensitivity.
Baldness of the hands and dysfunction of hydrosis (sweating).

Symptoms of polyneuropathy of the lower extremities are caused by the influence of diabetes, alcohol intoxication, vitamin deficiency ("B1" and "B12"), blood diseases, infections and other pathological genesis.

Basically, this PNP refers to manifestations of axonal forms of the disease. Depending on the trend of the clinical course, the symptoms of various forms of this pathology can be acute, subacute, chronic and recurrent form of manifestation.

Acute symptoms develop within 2, 4 days. After a couple of weeks, the symptoms increase, passing into the stage of a subacute course.

The prolonged, progressive nature of the course of the disease is due to the development of chronic pathology. The recurrent nature of the disease is manifested by serious dysfunctions in the lower extremities.

The initial signs are manifested by loss of skin sensitivity on the soles of the feet. Patients may not feel pain from minor abrasions and wounds caused by uncomfortable shoes.
Along the nerve course, "goosebumps" and numbness are felt.
As the process develops, the loss of sensitivity of the skin is noted on the entire surface of the legs.
Symptoms of muscle disorders are noted, manifested by the development of signs of contracture of the small plantar muscles and a decrease in muscle strength in large muscles.
Functional pathologies in large muscles provoke a cardinal decrease in the patient's physical strength, due to the inability of the legs to support the weight of the patient himself.
On the skin of the legs, "vegetation" disappears, hydrosis is disturbed, pain occurs in various areas of the limbs.

In addition to these symptoms, the color of the skin on the legs may change, swelling may appear in the distal zones, and the temperature of the legs may change. With alcoholic polyneuropathy, the symptoms described above can increase over weeks and months, and last for many years. As long as you do not stop drinking alcohol, the disease can not be coped with.

Although the symptoms of upper extremity PNP are slightly different from those of lower extremity polyneuropathy, the treatment of the pathology is identical. And the sooner it starts, the more effective it will be.

Treatment of polyneuropathy - drugs and methods

Treatment of polyneuropathy of the upper and lower extremities is complex, complex and lengthy. The main factor is the restoration of impaired functions of the affected neurons and the elimination of the causative factor.

For example, in the treatment of diabetic polyneuropathy, it is necessary to normalize the level of sugar in the blood, in case of alcoholic and toxic ANP - to eliminate the damaging effect, in case of infectious pathology - to cure the underlying infection.

Used drugs for the treatment of PNP due to a different mechanism of influence on the elimination of pathology.

To stimulate regenerative processes in neurons and reduce pain, preparations based on alpha-lipolyic acid - Thiogamma or Berlition and vitamin group preparations - Kombilipen, Milgamma, Compligamma and Neurobion are prescribed.
Correction of pain in the extremities, with this disease, with conventional analgesics, anti-inflammatory and non-steroidal drugs does not give positive results. To stop it, anticonvulsants are used that inhibit the spread of pain impulses from damaged neurons - Pregabalin, Finlepsin or Gabapentin.
Antidepressants that inhibit pain impulses - "Amitriptyline", "Duloxetine" or "Venlafaxine".
Local anesthetics, in the form of ointment, plates or gel with a base of lidocaine, cream and pepper patches containing "Capsaicin". In order to avoid burns, half an hour before attaching the pepper patch, the attachment site is pre-lubricated with a cream with a lidocaine base.
With severe, prolonged pain symptoms, the action of the opioid analgesic "Tramadol" helps well. The combined remedy "Zoldiar" is very effective - a combination of "Tramadol" with "Paracetamol".
To reduce increased muscle tone, a narcotic drug is used - "Baclofen" and its analogues in strictly prescribed dosages and a certain course of treatment.

In addition to drug therapy, physiotherapy is prescribed - magnetotherapy, which has a therapeutic effect on nerve tissues, electrical stimulation, reflexology and therapeutic massage techniques. To maintain muscle tone, a course of physiotherapy exercises is prescribed.

The patient is selected a special diet that excludes carbohydrates and foods rich in fats. For the entire treatment and recovery period, stimulants and stimulants should be excluded from the use and smoking should be stopped.

Prognosis for PNP

Depending on the origin and clinical manifestations, polyneuropathy is able to put the patient to bed for a long time. A favorable prognosis is possible with full and timely treatment.

An exception may be polyneuropathy of hereditary genesis. It cannot be completely cured, it is only possible to alleviate the severity and severity of the symptoms.

In this case, the sensory and motor functions of the body are disturbed. Polyneuropathy is not an independent disease and develops for various reasons. This may be a violation of metabolic processes, intoxication, a violation of the distal processes of the nervous system.

Polyneuropathy of the lower extremities is more common than the upper extremities, since the legs are more subject to various loads. Sometimes it affects both the upper and lower extremities. The disease can develop slowly or very quickly, starting from the feet and gradually moving higher. It is very important to know what are the causes and how to treat polyneuropathy of the upper and lower extremities.

Signs and Diagnosis

If left untreated, neuropathy can lead to complete immobilization of the limbs and loss of sensation or hypersensitivity. Before starting treatment, doctors must determine the form of neuropathy. Depending on the type of disease and the degree of damage, treatment is prescribed. Neuropathy can be a symptom of diabetes, alcohol addiction, poisoning, so it is important to identify and treat the underlying disease in the same way.

Neuropathy has pronounced symptoms, they can vary depending on its form, but the main ones are found in everyone who suffers from this disease.

Motility disorder, paralysis.
Sharp, sharp pain.
Edema of the extremities.
Intensive sweating.
Hypersensitivity or vice versa.
Goosebumps, tingling.
Vibration sensitivity.
Deterioration of the skin and nails.
Trophic ulcers in the lower extremities.

Neuropathy occurs in acute form, subacute and chronic. Symptoms can develop within seven days in the acute form, about thirty in the subacute form, and more than a month if the neuropathy is chronic. Neuropathy is diagnosed with a comprehensive examination. Based on diagnostic data, treatment is prescribed.

Diagnosis includes examinations by an endocrinologist, traumatologist, surgeon, neuropathologist, laboratory tests, tomography and MRI.

Forms of the disease

You can treat neuropathy. Treatment must be comprehensive. In some cases, it is possible to completely cure neuropathy, and in the case of the diabetic form, to reduce the symptoms as much as possible. Neuropathy can be treated:

Some of the most common are the following forms of the disease:

The higher the experience of diabetes and blood sugar levels, the greater the likelihood of developing neuropathy. Before starting the treatment of neuropathy, it is necessary to lower the level of sugar in the blood. Diabetic neuropathy affects the area of the lower extremities.

Symptoms of diabetic neuropathy

The most common is diabetic neuropathy of the lower extremities, which develops against the background of diabetes mellitus.

How to treat an ailment

Essential oils are effective folk remedies, relieve pain, improve blood circulation, stimulate sensitivity. Well, do a daily foot massage with fir, eucalyptus and clove oil. If you decide to be treated with folk remedies, then consult your doctor, since you need to take medications, and you should be careful in the combination of medication and non-traditional treatment. As a medical treatment, the doctor prescribes vitamins, as well as stimulants that accelerate neuromuscular impulses, and drugs that improve metabolic processes.

Alcoholic polyneuropathy occurs as a result of the development of alcohol dependence. Therefore, the first condition of treatment is a complete rejection of alcohol. After treatment, you should not drink alcohol, otherwise the neuropathy may return with more severe symptoms. Alcoholic neuropathy often affects men, and if you do not pay attention to the symptoms of the disease in time, it can lead to paralysis.

Kefir cocktail is a good tool that helps cleanse the body of toxic substances. To prepare it, add sunflower seeds and chopped parsley to kefir 3.5% fat. For a glass of kefir (maybe a little more), 20 grams of seeds and 150 grams of greens are taken. Consume on an empty stomach, one hour before meals.

Carrot cocktail helps to quickly cope with alcoholic neuropathy - for half a glass of fresh carrot juice - one chicken egg, 30 grams of olive oil, 20 grams of honey, mix and consume three times a day, one hour before meals. Be sure to take a vitamin B complex, as well as preparations based on lipoic acid, tylenditraamine, penicillamine, thetamine-calcium and others designed to detoxify the body and strengthen nerve fibers.

Sensory polyneuropathy leads to limited motor function of the limbs. Symptoms may occur in only one limb or both at once. Also, sensory polyneuropathy can affect both the upper and lower extremities.

For the treatment of the sensory form, preparations with alpha-lepoly acid, vitamin complexes, antihypoxants are prescribed.

Therapeutic methods

Therapeutic treatment includes exercise therapy, physiotherapy, massage, blood purification. Massage with polyneuropathy strengthens muscles, improves their performance, promotes rapid recovery of motor functions, and prevents muscle atrophy. It is possible to carry out both manual and hardware massage, as well as acupressure. Massage is best done every other day, alternating with other physiotherapy. In case of acute pain, elevated body temperature or other acute conditions, massage is contraindicated.

No less important are the exercises that are prescribed for polyneuropathy. Exercises are performed both independently and with an exercise therapy specialist. Exercises allow you to improve and maintain muscle performance, restore mobility of the lower extremities. Some exercises can be done at home. These are flexion-extension exercises for the fingers and toes, circular movements, exercises for the feet.

Warming therapy, acupuncture is also prescribed. Only treatment with folk remedies or massage will not be able to help. With timely treatment, it is possible to completely cure the patient if he has alcoholic, toxic, infectious neuropathy, or to minimize symptoms in the diabetic form.

Neuropathy is a disease that requires long-term and complex treatment.

Symptoms of neuropathy of various localization. Diagnosis and basic principles of treatment

Neuropathy is a disease that is accompanied by degenerative or dystrophic damage to the nerves. Refers to fairly common diseases of the nervous system and has many factors that can cause it.

The onset of the disease can be indicated by the appearance of pain, numbness, a burning sensation in certain areas of the skin. Then muscle paresis develops with loss of reflexes.

In peripheral neuropathy, the symptoms depend on which nerve is affected. When the motor nerves are damaged, the work of muscle fibers is disrupted. There is muscle weakness followed by muscle atrophy. A change in sensory fibers leads to numbness of the extremities, paresthesia, and the appearance of pain. If the nerve of the autonomic nervous system is affected, then patients complain of the appearance of dry skin, the frequent development of inflammatory processes, hair loss, and discoloration of the skin.

Causes of neuropathy

There are many causes of the disease, the most common include:

Intoxication - poisoning of the body with salts of heavy metals, arsenic, mercury, side effects of certain drugs, with chronic alcoholism.
Neuropathy in diabetes mellitus - with this disease, this pathology occurs most often. In advanced cases, diabetic foot develops.
Due to trauma, hypothermia.
Lack of minerals and vitamins, metabolic disorders.
Infectious diseases, including HIV.
Multiple sclerosis is a disease in which the nerve sheath is destroyed.

Types of neuropathies

In his medical practice, the doctor often encounters peripheral neuropathy. In this form, the nerves of the arms and legs are affected. Usually the diagnosis is not difficult. With autonomic neuropathy, internal organs suffer, its symptoms are not so specific. The patient seeks medical help from a therapist and not always the disease can be associated with nerve damage.

Post-traumatic neuropathy can also be distinguished. The main cause is trauma to the nerve trunk, damage to the spinal cord. This also includes tunnel neuropathy, which occurs as a result of compression of the nerve by muscle fibers and ligaments.

Diagnosis of the disease

The diagnosis of neuropathy can be made on the basis of complaints, questioning and examination of the patient. The level and extent of nerve damage can be determined using electroneuromyography. This method allows you to find out the presence of an inflammatory process, the degree of disturbance in the conduction of a nerve impulse, what exactly is affected - a muscle or a nerve, is there a tunnel syndrome.

Upper limb neuropathy

The radial and ulnar nerves are most commonly affected. If the radial nerve suffers, then the patient complains of a change in the sensitivity of the skin and movement disorders. Complaints and signs depend on the degree and level of the lesion.

If the nerve is damaged in the upper parts of the patient, the extensor muscles of the hand, phalanges of the fingers, and forearm do not work. When you try to raise your hand, the hand hangs, the sensitivity of the first, second and some part of the third fingers is impaired. With neuropathy of the radial nerve in the lower sections, the ability to straighten the forearm and hand remains, skin sensitivity is preserved on the shoulder while maintaining the above signs of neuropathy. To determine the level of damage to the radial nerve, there are special diagnostic tests, they are used by neuropathologists.

With neuropathy of the ulnar nerve, the doctor, when the patient is contacted, will pay attention to paresthesia and numbness of 4-5 fingers and along the nerve. As the disease progresses without treatment, the brush begins to resemble a "clawed paw" in appearance. Diagnosis is usually straightforward and diagnostic tests are used. Of the neuropathies of the upper extremities, these two nerve trunks are affected more often.

Symptoms of neuropathy of the lower extremities

Tibial nerve neuropathy has the following symptoms:

Sensitivity disorder - paresthesia and numbness of the skin on the sole, back of the leg. Intense pain may also occur.
Damage to the motor roots - paresis of the muscles that turn the foot inward, the flexors of the fingers and foot. The Achilles reflex is lost. In the future, atrophy of the posterior muscles of the lower leg develops. The foot is constantly in an extended state, which makes it difficult to walk.

Diagnosis can be made based on simple tests:

Walking with an emphasis on socks is impossible.
The patient is unable to turn the foot inward and flex the toes and foot towards the sole.

Neuropathy of the peroneal nerve is quite common. It is one of the branches of the sciatic nerve. With its defeat, motor and sensory disturbances are observed. But here you can see that the opposite muscle group suffers than with damage to the tibial nerve.

What will a specialist see with neuropathy of the peroneal nerve?

There is no way to walk and stand on your heels.
The foot hangs down, turned slightly inward, the toes are half bent.
A characteristic gait - peroneal, cock-like, stepage - a person, in order not to touch the floor with his fingers, tries to raise his leg high. Then he puts the sock on the floor, then the edge of the foot and the sole.
Atrophy of the muscles that are on the anterior surface of the lower leg.
The patient cannot straighten and turn the foot outward.
Decreased range of motion in the ankle joint.

With neuropathy of both the tibial and peroneal nerve, the treatment will differ little from the generally accepted one.

Treatment of neuropathy

The basis of therapy is the elimination of the causes that caused the disease. In addition, painkillers and agents are prescribed to restore the activity of the affected nerve fiber. In the initial stages of neuropathy, detoxification therapy, vitamins, non-steroidal anti-inflammatory drugs, vascular drugs, hormones, and antioxidants are used for treatment. If the cause is an infectious or viral disease, then antibacterial, antiviral agents are prescribed.

With a decrease in acute manifestations, physiotherapy, massage, physiotherapy exercises, reflexology can be added to the prescribed medications.

It is important to pay attention to the treatment of neuropathy of the lower extremities, because late therapy will lead to complications and, possibly, disability. The same can be said about neuropathy of the upper extremities. Depending on the severity of the disease, treatment is carried out on an outpatient basis in a polyclinic or in a hospital. The recovery period usually takes place in a sanatorium.

Neuropathy (polyneuropathy) of the lower, upper limbs: symptoms, treatment

Symptoms of polyneuropathy of the lower extremities

burning, sharp pain along the affected nerve;
swelling, numbness of the legs, goosebumps, tingling;
muscle weakness in the legs, gradual muscle atrophy;
change in gait, difficulty walking;
decreased or increased sensitivity. A person does not feel a touch on the leg, or, conversely, it causes pain;
convulsions and muscle spasms, partial paralysis.

Symptoms of polyneuropathy of the lower extremities often appear in both legs.

What is dangerous neuropathy of the upper and lower extremities

Polyneuropathy of the lower extremities can rapidly progress and become chronic. The patient's muscles quickly atrophy, trophic ulcers appear, paralysis of the legs and respiratory muscles occurs. There is a permanent change in gait that cannot be changed.

Diagnosis of polyneuritis

To prevent complications, for pain and weakness in the legs, consult a specialist. The doctor of the "Workshop of Health" in St. Petersburg will determine the cause of pain in the legs with the help of a comprehensive examination. He will conduct an examination, a survey and determine if you have polyneuritis of the lower extremities. The clinic uses the following diagnostic methods:

Treatment of polyneuropathy of the upper and lower extremities

Since 2003, doctors at the Health Workshop Clinic in St. Petersburg have been treating polyneuropathy of the lower extremities with conservative methods. Conservative treatment relieves the symptoms of the disease and restores nerve function.

The course of treatment is compiled individually for each patient. The doctor selects procedures depending on the stage of the disease, age, gender and characteristics of the patient's body. Treatment takes 3 to 6 weeks. The course includes at least 5 procedures from the list:

Treatment of neuropathy of the lower extremities in the "Workshop of Health" relieves pain, restores nerve fibers, improves tissue nutrition and metabolism. Procedures accelerate blood circulation, restore muscle strength. The patient normalizes blood pressure and strengthens the immune system.

We care about the full recovery of patients. They can get a free consultation from our doctor within a year after the end of the course of treatment.

Causes of polyneuritis of the lower extremities

Neuropathy of the lower extremities may occur after surgery or leg injury. The work of the nerves is disturbed due to diabetes, lack of B vitamins and folic acid, physical overload. Polyneuropathy of the lower extremities is caused by a metabolic disorder: due to an imbalance in the body, the impulse does not normally pass through the nerve.

Polyneuritis of the lower extremities can appear in a person if he is cold, poisoned by mercury, acetone or alcohol. Chronic compression of the nerve appears due to intervertebral hernia, inflammation. Polyneuropathy of the lower extremities can be the result of infection: influenza, malaria, herpes, diphtheria, tuberculosis.

Types of neuritis

Prevention

To prevent neuropathy, do not drink alcohol, take protective drugs when working with toxic substances. Eat fresh products, when buying, check the expiration date and date of manufacture so as not to get poisoned. Observe the dosage of medicines, do not drink them unnecessarily. Treat influenza, sinusitis, sinusitis and other infections in time, do not carry them on your feet.

Do swimming, running, dancing, fitness: playing sports improves blood microcirculation. Avoid injuries and burns, do foot baths for 15 minutes. Walk in comfortable shoes, do not wear heels higher than 5 cm.

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Panfilova Nadezhda Iovovna

Gabdrakhmanov Rustam Fanilievich

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Upper limb neuropathy

Neuropathy of the upper extremities is a very common pathology in the practice of a neurologist. Damage can affect one or several nerves, resulting in a clinical picture of the disease will be different. Regardless of the causes of the disease, the patient begins to be disturbed by a feeling of discomfort, loss of sensitivity, pain and other symptoms.

The reasons

Many patients, faced with the problem of neuropathy of the upper extremities, attribute them to fatigue and lack of sleep, believing that appropriate rest will help eliminate them and restore strength.

In fact, the so-called mononeuropathies (damage to one nerve fiber) usually develop when the nerve is compressed at the site of its superficial passage under the skin, or in narrow bone canals.

Dozens of causes can lead to polyneuropathy of the hands. The most common of them are:

previous operations (in the place where there was a surgical intervention, over time, the blood ceases to circulate normally, which contributes to the formation of edema and muscle atrophy, as well as to compression of the passing nerve bundles);
limb injuries, in which edema develops, leading to nerve compression;
regular hypothermia;
exposure;
strong and excessive physical exertion on the muscles of the limbs;
endocrine diseases, including diabetes mellitus;
intoxication of the body;
lack of vitamins of certain groups in the body (most often group B);
tumor diseases;
various past infections, such as influenza, HIV, malaria, herpes, diphtheria, tuberculosis, etc.;
long-term use of drugs containing phenytoin, chloroquine.

Types of disease

There are three main nerves in the human hand:

Accordingly, the defeat of each of them will have its own characteristic manifestations, which we will consider below.

Radial nerve neuropathy

The radial nerve is damaged most often as a result of compression (compression). This can happen during deep sleep when the shoulder and radial nerve are compressed by the head or trunk ("sleep paralysis"). Often, compression occurs as a result of a fracture of the humerus, compression by a tourniquet or other hard matter, improperly injected, after squeezing the shoulder with a crutch ("crutch" paralysis).

The clinical picture of neuropathy of the radial nerve depends on the location of the damage.

If the nerve is damaged in the axillary fossa, a symptom of a hanging hand appears: when the patient tries to raise his arm up, the hand hangs helplessly. With compression in the middle brachial third, the symptoms are mild or absent at all. If the lower third is damaged, then the patient is only concerned about the inability to straighten the fingers and the hand as a whole, as well as the lack of sensitivity of the back of the hand.

Below is a video about radial nerve neuropathy - a fragment of the program "Live healthy":

median nerve neuropathy

The cause of neuropathy of the median nerve can be trauma, a violation of the technique of administering an injection into the cubital vein, wounds of the palmar surface of the forearm, as well as overexertion of the professional brush in musicians, seamstresses, and carpenters.

With damage to the median nerve, the patient is not able to rotate the hand, bend the hands, as well as the first three fingers. The sensitivity on the palmar surface decreases, with time atrophy of the muscles of the hand develops. As a result, the patient cannot clench his fist or move his fingers, which significantly impairs his quality of life and ability to self-care.

Ulnar nerve neuropathy

Neuropathy of the ulnar nerve is observed in persons who work for a long time with their elbows resting on a machine, a desk, or simply like to lean on the armrests of chairs. The causes of damage are also sprains, tears of the ulnar nerve, as well as diseases such as: rheumatoid arthritis, deforming arthrosis, chondromalacia, chondromatosis, deformation of the bones or connective tissue, thickening of the tendon sheaths

In the case of a complete rupture of the nerve trunk, the patient is concerned about the loss of sensitivity of the skin of the little finger and half of the ring finger, paralysis (dysfunction) of the muscles of the thumb. In the case of incomplete (partial) damage, the disease is accompanied by:

weakness of the muscles of the hand;
a decrease in muscle volume in the area of \u200b\u200bthe thumb and forefinger;
tingling sensation and paresthesia on the inside of the palm;
numbness and loss of sensitivity of the last two fingers (little and ring fingers);
pain along the ulnar nerve.

Symptoms common to neuropathies of the upper extremities

Symptoms can be divided into main and concomitant. The main ones are characterized by burning pain sensations that haunt the patient throughout the day, and a feeling of numbness of the fingers, hand and arm as a whole. Associated appear:

puffiness;
convulsions, spasms, involuntary muscle contractions;
unpleasant sensations of "goosebumps";
decreased temperature sensitivity;
impaired coordination of movements;
difficulty moving the arms.

Pay also attention to the detailed material on encephalopathy of the brain.

Read about the characteristic symptoms of intercostal neuralgia here.

Diagnosis of the disease

To select the correct method of treatment, a complete neurological examination of the patient, assessment of reflexes, muscle strength, and special tests and tests are very important.

Instrumental diagnostic methods are:

These methods allow you to detect a damaged nerve, find out the cause and degree of conduction disturbance. If necessary, the doctor may refer the patient for additional laboratory tests to rule out another pathology. Only after the obtained results can a diagnosis be made.

Treatment

The main goal of treatment is to eliminate the cause that led to damage to the nerve fibers, as well as to restore the motor and sensory functions of the fingers, hand and hand. During the treatment of neuropathy of the upper extremities are prescribed:

non-steroidal anti-inflammatory drugs,
drugs with analgesic action;
vitamins;
anticonvulsants, which are good at relieving burning neuropathic pain.

In case of violation of the integrity of the nerve trunk, surgical intervention is performed.

Prevention

Prevention of neuropathy of the upper extremities consists in the normalization of metabolic processes and the timely treatment of systemic and infectious diseases. It is also important to regularly devote time to physical exercises, not to sit for a long time in an uncomfortable position, to do minute “warm-ups” at work.

How we save on supplements and vitamins: probiotics, vitamins intended for neurological diseases, etc. and we order on iHerb (link $5 discount). Delivery to Moscow only 1-2 weeks. Much is cheaper several times than to take in a Russian store, and some goods, in principle, cannot be found in Russia.

Sensory polyneuropathy is systemic disease of the nervous tissue unclear etiology. It manifests itself as a disorder of motor activity and a violation of sensitivity. In advanced cases, a strong pain syndrome is connected.

The success of the treatment is completely depends on the cause that gave rise to this pathology, as well as from the timeliness of contacting a specialist.

Causes of the disease

There is no consensus among experts that would fully reveal the cause of the onset of sensory-type polyneuropathy. But there are the most common diseases and factors that, according to medical observations, can cause the development of the disease:

Autoimmune processes- when, due to disturbances in the functioning of the immune system, the body's own nerve cells begin to be perceived as foreign and are attacked by macrophages ("devouring" immunity cells). Otherwise, we can say that the reaction of self-destruction of the nervous tissue is triggered, and as a result, polyneuropathy is formed.
Toxin poisoning- they can be found both in poisons and in food products: low-quality alcohol and preservatives. This also includes heavy metal poisoning, which instantly provoke the onset of symptoms of neuropathy.
Diabetes- with an increase in the level of glucose in the blood, the permeability of capillaries and the blood supply to peripheral tissues are disturbed. This leads to a lack of proper nutrition and the natural death of the cells of the nervous system.
Avitaminosis- this is the most "harmless" and easily corrected cause of the development of polyneuropathy. It is necessary to correct the intake of vitamins B1 and B12, which are responsible to a greater extent for the active conduction of nerve signals to the muscles.
Oncology- cancerous tumors, in some cases growing to large volumes, compress the nerve fibers and partially block the conduction of the nerve impulse to the peripheral regions. Symptomatic polyneuropathy occurs and cannot be cured until the tumor is removed.
hereditary factor- recognized as the most dangerous. If the cause of the development of symptoms of polyneuropathy is associated with it, then the treatment will be mostly ineffective, because there is no way to eliminate the root cause of the development of the pathology - genetic disorders in this area have not yet been studied

In the case of polyneuropathy of a toxic nature, the cause of the poisoning must first be clarified - that is, the substance, as a result of which pathological changes occurred in the body.

Ask your question to a neurologist for free

Irina Martynova. Graduated from the Voronezh State Medical University. N.N. Burdenko. Clinical intern and neurologist of BUZ VO \"Moscow Polyclinic\".

Treatment without its preliminary neutralization will be ineffective.

Pathogenesis

Sensorimotor polyneuropathy is a disorder in which structural damage to nerve cells.

These cells are usually responsible for motor (motor) activity. When their structure is disturbed, then along with it, the conduction of a nerve impulse is also disturbed. As a result, motor activity is disturbed, and there may be a partial or complete disappearance of skin sensitivity.

Damage to nerve cells can be of a dual nature: myelin sheaths (membrane through which nerve impulses are conducted) and axons, the nuclei of nerve cells, can be damaged.

Recovery of the nuclei is much slower, and long-term treatment is required to achieve even minimal results.

Symptoms

In this disease, the symptoms will appear gradually(the condition can sharply worsen only with an acute toxic form - more on that below). Sensory polyneuropathy begins to manifest itself with burning and tingling (local symptoms of a violation of the conduction of a nerve impulse and blood circulation), and subsequently it can reach the development of paralysis and paresis, which is already much more difficult to treat.

All these manifestations are due to damage to muscle innervation, that is, the absence of an impulse from the nerves to the muscles, and a violation of their motor activity.

And in the absence of contraction and movement, the blood flow instantly stops, stagnation occurs, and the vessels are deprived of nutrition and oxygen.

So, with sensory polyneuropathy the following symptoms develop:

Itching, burning, tingling in the muscles;
Numbness of muscles or limbs (with damage to peripheral nerve fibers);
Loss of skin sensitivity (syndrome of "gloves" and "socks");
Loss of muscle strength (syndrome of "cotton legs" - when, when walking, the muscles cannot cope with the physical load to which they are exposed, and the legs give way), which manifests itself most often with additional load: walking uphill, climbing stairs, etc .;
Cutting pains in the muscles that occur during spontaneous contraction;
Vegetative-vascular manifestations: peeling and dryness of the skin, the formation of ulcers and weeping wounds, etc.

These symptoms can also appear with a sedentary lifestyle and lack of movement.

Normalization of lifestyle and the inclusion of daily adequate loads will help to completely get rid of negative symptoms and return to good condition.

Forms

This disease is classified based on multiple factors: the nature and localization of damage, the intensity of the development of symptoms, etc. Let us consider in more detail each variant of the classification of sensory polyneuropathy.

Depending on the depth of damage to the nervous tissue, polyneuropathy is classified into:

Demyelinating(mostly the membranes of nerve cells are damaged - their myelin sheaths);
axonal(the central core of the nerve cell - the axon) is damaged.

The demyelinating form is much easier to treat, and therapy takes less time.

According to the intensity of the development of symptoms, polyneuropathy is divided into:

acute(symptoms develop progressively over 2-3 days, and reach their maximum on the fourth day);
Subacute(the period of development of productive symptoms lasts several weeks);
Chronic(sluggish with a slowly progressive course - easily treatable).

The acute nature of the development of the disease most often occurs with a toxic form of the disease - poisoning with heavy metals or alcohol of inadequate quality. A subacute picture is typical for patients with diabetes mellitus. It develops with a sharp jump in blood sugar. Symptoms may return to their original state when hypoglycemic drugs are prescribed.

Chronic polyneuropathy often manifests itself in people with hereditary pathology. It lasts all life, moderately manifesting itself. The disease can be activated with the active influence of adverse factors from the outside.

Another classification of sensory polyneuropathy is based on the nature of the symptoms present:

Hyperalgesic- manifested by pain syndrome, sharp pain at the slightest touch, decreased sensitivity, numbness in the muscles, etc .;
Atactic- manifested by muscle weakness, lack of coordination of movements, numbness and inability to keep balance;
mixed- is characterized by the manifestation of various symptoms.

Depending on the nature of the manifestation of the disease and the cause that gave rise to it, an individual treatment regimen will be prescribed that is right for you.

Diagnostics

Sensory polyneuropathy of the upper and lower extremities is diagnosed in various ways, depending on the nature and location of the damage. Consider the most commonly used diagnostic methods.

Clinical Methods

Clinical diagnosis of sensory neuropathy is to determine the level of skin sensitivity in the patient. Improvised means can be used:

pins;
Medical "skewers";
Needles etc.

The doctor gently presses on the skin with the tip of the needle and waits for the patient's reaction.

A characteristic sign of the development of sensory polyneuropathy will be the lack of sensitivity. The patient simply does not feel that he was pricked and passed through the skin with a needle.

In addition, clinical diagnostic methods include the collection of an anamnesis of the disease from the patient. Data on working conditions (its harmfulness), diet, predominant foods in the diet, addiction to alcohol, smoking and many other factors that could provoke the development of this pathology are being clarified.

Clarifying tests are always prescribed for the alleged patient: a general blood test, a blood test for glucose levels, an immunogram - if necessary. The more information about a person in the hands of a specialist, the more objectively he will be able to assess the disturbing manifestations of the disease and make the correct diagnosis.

Study of pain sensitivity

When conducting this study, the doctors of the clinic first of all want to find out the level of damage to the so-called C-fibers (unmyelinated type). Unlike the general clinical diagnosis of the level of sensitivity, there is a certain technique here that allows you to identify the nature of the damage to a certain segment of the nervous system.

To begin with, the doctor finds out by questioning whether the patient is worried about pain at the site of the alleged lesion. If yes, then the patient is asked to describe the nature of the pain: dull, sharp, cutting, etc. After clarifying this circumstance, they proceed to the procedure itself. Two objects are taken from the same material: blunt and sharp. Alternately, without a definite sequence, one or another object leans against the patient's skin. In this case, the patient is asked to determine when the blunt leans against, and when the sharp one leans.

Punctures with a sharp object should not be sharp, strong and deep. A light pressure and a small puncture are enough to make the sensations barely perceptible. Otherwise, it will be difficult to determine the damage to the surface ability to feel.

To obtain accurate and reliable data, skin exposures are carried out not only on the “sick” part of the body, but also on a healthy one.

Most often, they begin to explore the sensitivity of the skin in the damaged area, gradually moving to a healthy one and noting the difference in the nature of the sensations.

Temperature sensitivity

Determination of temperature sensitivity is intended for diagnosing damage to thin weakly myelinated fibers of the peripheral nervous system. They are responsible for the pain threshold and are well defined by the diagnosis of temperature sensitivity.

For the procedure, medical test tubes are most often used. They contain water of different temperatures: +5С and +25С.

Alternately, the leg (or other affected area) of the patient is touched different test tubes, offering him to determine what touched: cold or hot?

Tactile sensitivity

The determination of tactile sensitivity is carried out using the Frey apparatus and horse hairs of different thicknesses. Myelinated thick A-fibers are responsible for the sensitivity of the skin to light touch. It is their condition that is determined during this procedure.

Deep Sensitivity

The work of deep thick myelinated fibers is evaluated. There are several diagnostic methods:

Vibration sensitivity assessment- carried out with the help of special medical tuning forks. They are calibrated for a certain frequency and duration of vibration. The device is installed on the surface of the patient's bone notch (depending on the location of the bone damage, different ones can be used), and the patient is asked to determine the moment the vibration starts and its end. Usually the vibration lasts about 9-12 seconds. It is considered normal if the patient noted at least a third of the entire time the vibration continued.
EMG- electromyography is the main tool for diagnosing the state of the segments of the nervous system responsible for muscle contraction. It is carried out using an electromyograph - a special device that notes the level of activation of muscle-tendon reflexes. The object of EMG research is the motor unit (MU). It represents the whole complex of neuromuscular conduction: motor neurons of the anterior segments of the spinal cord, the nerve impulse conduction system (axons and fibers), as well as the muscle itself, which is innervated by the above fragments of the nervous system. EMG assesses the state of the muscle, the intensity of its contraction, and if a pathology is detected, the device also determines the level and localization of MU damage.

EMG needle

With the help of needle EMG, the spontaneous motor activity of muscle fibers during the period of rest (lack of load) is examined. If such an effect occurs, then this indicates a deep disturbance of nerve conduction.

Most often, this method is used for sensory polyneuropathy of the lower extremities.

Consider the main indicators that appear in this study, and the levels of damage to the nerve fiber, which they indicate.

Positive sharp waves (POS) are spontaneous, sharp muscle contractions that occur involuntarily. This indicator indicates irreversible damage to the nerve fiber or group of fibers (with an enlarged SOV value).
Fibrillation potentials (PF) is an indicator for a single muscle fiber. One MU and the place of damage are evaluated in case of deviations.
Fasciculation potentials (PFc) - a sharp unreasonable reduction in the entire DE, the appearance of its spontaneous activity. Occurs with central disorders of the nervous system, requires additional diagnostic measures.
M-answer - the state of a single muscle fiber is assessed, and if there are deviations, the entire MU is further examined and the site of damage is located.

The method is very popular and allows the diagnosis to accurately determine the degree of damage to the nerve fiber and its localization.

Late neurographic phenomena: F-wave and H-reflex

By studying the F-wave, it is possible to determine the intensity of the work of motor neurons of the central horns of the spinal cord, that is, the initial localization of the motor unit (MU). This wave is marked on the device and means the impulse sent from the neurons of the spinal cord to the peripheral muscle fibers. If the intensity and activation time of the wave coincides with the boundaries of the norm, then this means that the problem, if any, is not in the initial links of the DU, but is located lower - in the axons or myelin sheaths. The F-wave is not a reflex.

H-reflex is monosynaptic reflex, in an adult, it is caused by contraction of the calf muscle. This indicator (in comparison with the M-response) can reveal the localization of the lesion in the reflex arc. The reflex arc is a mechanism for conducting a nerve impulse, the result of which will be a contraction of the calf muscle. It begins with stimulation of the tibial nerve fiber, which is subsequently transmitted to the posterior horns of the spinal cord, through them to the anterior ones, and along the course of the nerve fiber, the impulse enters the muscle. When the impulse passes up to the posterior horns of the spinal cord, it goes through the sensitive nerve tissues, and down through the motor tissues.

The calculated ratio between the H-reflex and the M-response will provide information about the location of the damage to the reflex arc - the sensitive or motor department.

Nerve action potential study

This diagnostic method reveals structural lesions of sensory fibers. They are diagnosed using a parameter called somatosensory evoked potentials (SSEPs). It is determined by intense pain and temperature effects. Upon receipt of the data, they are compared with the norm indicators, and the specialist makes a conclusion regarding the condition of the sensory fibers in the patient.

Diagnosis can be difficult due to concomitant therapy with painkillers.

Biopsy

The biopsy is taking microscopic doses of tissue material, which is mainly used to diagnose structural lesions. With the help of a biopsy, it is possible to assess the depth of damage to the nerve fibers, as well as to determine which particular structural part of them is damaged - the axon or the myelin sheath.

It is not uncommon to diagnose superficial sensory neuropathy of the skin when a sample is taken for examination.

Confocal microscopy

Confocal microscopy is one of the modern methods for diagnosing structural damage to C-fibers without outside intervention. The method is absolutely painless, and thanks to it, in addition to damage to the nervous tissue, it is also possible to diagnose the state of conduction in the cornea. The method has no analogues in the study of defects in the outer thin nerve fiber in diabetics.

Treatment

Treatment of sensory type polyneuropathy of various localizations is always multi-stage scheme, which consists of the following areas:

drug therapy;
Physiotherapeutic methods;
Surgical intervention (for neuropathy caused by a tumor).

They should be carried out in a complex and for a long time, in order to avoid unpleasant consequences of the disease.

Which doctors treat?

The treatment of polyneuropathy is mainly handled by a neurologist, but the patient will still have to visit other doctors. And which ones - will depend on which group of diseases caused this symptom.

If polyneuropathy is caused by diabetes mellitus, then the supervision of an endocrinologist will be required, who will conduct the main treatment of the underlying disease. With polyradiculoneuropathy, when disorders are localized in the neurons of the spinal cord, and polyradiculoneuropathy, in which the transmission of a nerve impulse along the nerves of the reflex arc suffers, the surgeon will observe the patient.

In any case, you will have to visit several specialists at once and treat the disease with all possible methods, otherwise there is a risk of complications.

Medical preparations

Medical treatment is currently main body of therapy polyneuropathy. Several groups of drugs are used at once, we list the most commonly prescribed:

Corticosteroids are hormone therapy. If autoimmune diseases have become the cause of the development of polyneuropathy, then in this case steroid hormones are prescribed that suppress the immune system. In addition, they have a powerful anti-inflammatory effect, which is necessary in the treatment of inflammation of the nervous tissue. The following drugs are most often prescribed:

Prednisolone- a substance completely analogous to the steroid hormones of the human body. Contraindications: hemophilia and other diseases of the blood coagulation system, fractures in the joints, osteoporosis, age under 2 years. The cost is about 100 rubles.

Tamoxifen- inhibits intracellular biochemical reactions in tumors associated with folic acid. The cell stops receiving food and dies. The cost is about 100 rubles. Side effects: digestive disorders, depression, migraine, retinopathy, cataracts, embolism, fluid metabolism disorders, etc.

Immunoglobulins are natural human antibodies obtained artificially and placed in a solution. They are powerful stimulants of their own immunity and help in the fight against antigens (foreign inclusions). In polyneuropathy, they are effective during an exacerbation, but the mechanism of action is still not clear. Gamma immunoglobulins are used for the demyelinating form of sensory polyneuropathy, as well as for polyneuropathy caused by diphtheria bacillus. In this case, antidiphtheria immunoglobulin is used.

Physiotherapy

Physiotherapeutic methods enhance the effect of medication and are always prescribed as an additional treatment. Among them the most popular are:

Physiotherapy exercises - helps to restore muscle activity and the very structure of nerve cells by increasing blood flow and nutrition.
Massage - is prescribed at the first stages of therapy for polyneuropathy of the vegetative-vascular form, in which tissue trophism is disturbed, and non-healing ulcers and wounds appear on the skin. Due to the increased blood flow during massage, the blood supply to the small vessels of the skin increases, and it is restored.
Magnetic therapy - acts selectively on nerve fibers, contributing to their self-healing.
Electrophoresis - stimulation of a nerve impulse and blood supply with a low power current.

Plasmapheresis

This is a modern method of blood purification from foreign impurities and toxins. It is carried out with the help of special expensive equipment. Effective against sensory type polyneuropathy caused by autoimmune and infectious processes.

The method is used only as a last resort strictly for the purpose of a specialist.

Folk remedies

Alternative methods of treatment for polyneuropathy should be used only after consultation with a specialist, because this is an additional, and not the main method of treatment. Here are the most commonly used ones:

Olive oil and raw yolk are beaten together, and to this mixture is added carrot juice and 2 tsp. honey. The solution is mixed until a homogeneous mass is formed and drunk inside twice a day 20 minutes before meals.
The bay leaf is ground into powder, 1 tsp is taken. of this powder and mixed with 3 tbsp. l. dry fenugreek powder. The mixture is transferred to a thermos and poured with one liter of hot water. After 2 hours have passed, it can be taken orally. Drink in small quantities throughout the day.
Brine. To half a bucket of warm water add a glass of salt and 2/3 cup of vinegar. Soar legs for 20 minutes every day for a month (for diseases of the limbs).

Treatment prognosis

The main factors that determine the result of the treatment of this disease are:

Immediate contact with the doctor when the first symptoms appear;
Completed and disciplined treatment.

In any case, sensory polyneuropathy requires long-term therapy, and most often a positive result is a temporary remission.

A full return of the original sensitivity is possible only at the beginning of treatment at the earliest stages of the disease, and the restoration of vegetative-vascular functions will be successful only with prolonged exercise therapy and massage.

Complications and consequences

The most common complications of sensory polyneuropathy will be paralysis and paresis, which develop as a result of a complete loss of innervation of the muscle fiber. Two factors - the lack of a nerve impulse and motor activity - cause the muscles to atrophy and "shrink", in some cases the changes are irreversible.

All these processes are the result of an untimely visit to the doctor. Timely initiated therapy is guaranteed to protect a person from such consequences.

In sensory-type diabetic polyneuropathy, the most common complication is tissue necrosis, ulcers, gangrene, and sepsis. The skin of a diabetic and the tissues adjacent to it are prone to the development of vegetative-vascular disorders.

There are ulcers, wounds of a non-healing type, and this is dangerous due to the penetration of bacterial and other types of infections.

Further prevention

To completely eliminate the likelihood of a relapse of the disease, you need to follow a few rules:

To bring the started therapy with medicines to the end;
Complete a course of physiotherapy;
Engage in physical therapy and self-massage on an ongoing basis;
Take B vitamins constantly (in an adequate daily dose).

Watch a video on this topic

Conclusion

Sensory polyneuropathy is a dangerous disease that can result in severe complications. The only way to prevent them is to seek help from a specialist in time and complete the course of treatment.

Main symptoms:

Polyneuropathy is a complex of disorders characterized by damage to motor, sensory and autonomic nerve fibers. The main feature of the disease is that a large number of nerves are involved in the pathogenic process. Regardless of the type of disease, it manifests itself in weakness and atrophy of the muscles of the lower or upper limbs, their lack of sensitivity to low and high temperatures, and in the occurrence of painful and uncomfortable sensations. Paralysis is often expressed, complete or partial.

At the first stage, the distal parts of the nerves are affected, and as the disease progresses, the pathological process spreads to the deeper layers of the nerve fiber. Sometimes hereditary polyneuropathy occurs. It begins to manifest itself in the first or second decade of a person's life. When diagnosing, the causes of this disease are taken into account, a neurological examination and a laboratory study of blood tests are carried out. The main goals of treatment are to reduce the manifestation of symptoms and eliminate the main factor that caused this disorder to manifest itself.

Etiology

Such a disorder can develop from the influence of various factors:

genetic predisposition;
immune disorders, when the body begins to attack its own muscles and nerve fibers, while producing immune antibodies;
chemical elements, drugs or alcoholic beverages;
infectious processes of the body, for example, with or;
malignant neoplasms;
systemic ailments, including;
lack of B vitamins in the body;
autoimmune diseases, such as Guillain-Barré syndrome.

Varieties

Depending on the mechanism of damage to the nerves of the muscles of the lower and upper extremities, polyneuropathy is divided into:

demyelinating - development occurs against the background of the breakdown of myelin, a specific substance that envelops the nerves and ensures rapid transmission of impulses. This type is characterized by the most favorable prognosis, subject to timely access to a doctor and effective treatment;
axonal - the disease develops against the background of damage to the axon, which is the core of the nerve that feeds it. The course of this type of ailment is more severe. Treatment - successful, but long;
neuropathic - a disease is formed due to the pathological effect on the bodies of nerve cells.

According to the violation of a particular function of the nerve, polyneuropathy is:

sensory - due to the pathogenic process, the sensitivity of the nerves is disturbed. Outwardly, this is manifested by a burning sensation and numbness of the extremities;
motor - there are signs of damage to motor fibers. The symptom is muscle weakness;
sensory-motor - symptoms of the two above forms appear;
vegetative - in this case, damage to the nerves responsible for ensuring the normal functioning of internal organs and systems is expressed. Signs by which this can be detected are increased sweating, a rapid heart rate, and;
mixed - there are signs of damage to all types of nerves.

According to the etiology, this inflammatory disease is divided into the following types:

idiopathic - the causes of its manifestation are not fully known, but violations of the immune system are not excluded;
hereditary;
diabetic - develops against the background of a complicated course of diabetes mellitus;
dysmetabolic - as a result of metabolic disorders;
toxic - occurs against the background of chemical poisoning;
post-infectious - expressed due to a person suffering from HIV infection or diphtheria;
paraneoplastic - development occurs in parallel with oncological disease;
systemic - occurs during the course of systemic disorders of the connective tissue.

Symptoms

Various causes that cause polyneuropathy, first of all, lead to irritation of the nerve fibers of the muscles of the limbs, and as they progress, they lead to disorders in the functioning of the nerves. The first symptoms of polyneuropathy include:

pronounced trembling of the hands or feet;
involuntary twitching of muscle structures, noticeable to people around;
the occurrence of painful cramps;
expression of pain of varying intensity;
sensation of "goosebumps" on the skin;
an increase in blood pressure.

Symptoms of nerve dysfunction include:

muscle weakness;
muscle thinning;
decreased muscle tone;
bouts of severe dizziness;
cardiopalmus;
dryness of the skin of the affected limbs;
the occurrence of constipation;
significant hair loss in the pathological area;
decreased or complete loss of sensation in the tips of the fingers and toes.

Complications

If you do not turn to a specialist for qualified help in time, the following consequences may develop from the inflammatory process in the nerves of the upper and lower extremities:

violation of motor functions - observed with severe weakness, especially with diabetic polyneuropathy;
damage to the nerves responsible for the respiratory process, which can lead to oxygen deficiency;
sudden cardiac death - caused by abnormal heartbeats.

Diagnostic measures

An important step in establishing a diagnosis is the discovery of the cause that led to the appearance of polyneuropathy. This can be achieved through the following activities:

collecting detailed information about the course of the disease. This is necessary in order to identify a predisposing factor. For example, in the hereditary or diabetic form of the disorder, symptoms develop rather slowly;
neurological examination, with the help of which it is possible to determine the location of the localization of unpleasant signs in the form of burning or numbness;
a blood test, thanks to which it is possible to detect the presence of chemical elements, as well as to establish the level of sugar, urea and creatinine;
electroneuromyography is a technique that allows you to evaluate the speed of the impulse along the nerves of the lower and upper extremities;
nerve biopsy - performed for microscopic examination of a small part of the nerve;
additional consultations of such specialists as a therapist and an endocrinologist, in cases of the appearance of such a disease in pregnant women - an obstetrician-gynecologist. If the patient is a child, an additional examination by a pediatrician is necessary.

After receiving all the test results, the specialist prescribes the most effective tactics for treating the inflammatory process of the upper and lower extremities.

Treatment

With hereditary polyneuropathy, treatment is aimed only at eliminating unpleasant symptoms, and in cases of diabetic, alcoholic or drug-induced, at reducing the manifestation of symptoms and slowing down the development of the process. Comprehensive treatment of polyneuropathy includes:

prescribing medications. Depending on the cause, these can be - glucocorticosteroids, immunoglobulins, painkillers and blood sugar-lowering drugs;
the implementation of a kidney transplant with a dysmetabolic type of disorder;
limiting contact with toxins;
surgery to remove malignant neoplasms;
taking antibiotics to eliminate inflammatory or infectious processes in the body;
injections of B vitamins;
wearing orthoses to support the lower or upper extremities with severe weakness.

Prevention

In order for a person not to develop such a disease as polyneuropathy, it is necessary to follow simple rules:

lead a healthy lifestyle, stop drinking alcohol;
how best to protect yourself from toxins when working with them;
to control the level of sugar in the blood;
take medicines only as prescribed by a doctor;
undergo preventive examinations at the clinic several times a year.

In most cases, the prognosis after recovery is positive. Exceptions are patients with a hereditary inflammatory process of the lower and upper extremities, for whom it is not possible to achieve a complete recovery. People with diabetic polyneuropathy are more likely to relapse.

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Polyneuropathy is a group of diseases that affects a large number of nerve endings in the human body. The disease has various causes. The factors that cause the appearance of the disease, first of all, irritate the nerve fibers, and only then lead to a disruption in their functioning. The characteristic signs of the disease are weakness in the muscles and pain in the affected area of the body.

The disease is manifested by paralysis, impaired susceptibility to tactile touch, various disorders in the work of the upper and lower limbs of the human body. Signs of the disease and the intensity of their manifestation completely depends on the form and type of the disease. Usually polyneuropathy causes a lot of suffering to patients, the treatment is protracted. The course of the disease is progressive and the process can be chronic. Most often, this disease occurs in the lower parts of the body.

Polyneuropathy can proceed in a sluggish form, and also have lightning-fast development.

Etiology

The causes of polyneuropathy are different. The main ones include:

poisoning with pure alcohol, gas, arsenic (chemical poisoning);
chronic diseases ( , );
systemic pathologies of the body;
long-term use of certain groups of pharmaceuticals;
alcoholism;
impaired immunity;
hereditary factor;
metabolic disorder;

The pathology may be:

inflammatory. In this case, there is intense inflammation of the nerve fibers;
toxic. It develops as a result of the ingestion of a large amount of toxic substances;
allergic;
traumatic.

Nowadays, the most common type is diabetic polyneuropathy. It should be noted that polyneuropathy is a rather dangerous pathology that requires timely and adequate treatment. If it is not there, then the progression of the disease can lead to muscle atrophy and the appearance of ulcers. The most dangerous complication is paralysis of the legs or arms, followed by respiratory muscles.

Varieties

According to the mechanism of damage, the disease is divided into the following types:

demyelinating polyneuropathy. The development of the disease is associated with the breakdown in the body of a protein that envelops the nerves and is responsible for the high speed of impulse conduction along them;
axonal. This type is associated with a violation in the work of the nerve rod. This type is accompanied by heavy treatment and a long recovery;
neuropathic. With it, damage is directly observed to the bodies of nerve cells;
diphtheria and diabetic polyneuropathy;
polyneuropathy of the lower extremities;
alcoholic polyneuropathy.

According to the primacy of nerve damage, polyneuropathy occurs:

touch. Manifested as numbness or pain;
motor. Motor fibers are affected, which is accompanied by weakness in the muscles;
sensory-motor. The characteristic symptoms of the lesion are a decrease in sensitivity and motor activity of muscle structures;
vegetative. There is a violation in the work of internal organs due to inflammation of the nerves;
mixed. Includes all features of the above types;
polyneuropathy of the lower extremities.

Depending on the cause of development, polyneuropathy can be:

idiopathic. The occurrence is associated with disorders in the immune system;
hereditary. Passed down from one generation to another;
dysmetabolic. Progresses due to metabolic disorders;
toxic polyneuropathy develops from the ingestion of toxic substances;
post-infectious. Occurs during infectious processes in the body;
paraneoplastic. Development goes hand in hand with oncological diseases;
in diseases of the body, develops as part of the disease;
alcoholic polyneuropathy.

By the nature of the flow:

acute. Development time is two to four days. Treatment lasts several weeks;
subacute. It develops in a few weeks, the treatment takes months;
chronic. It progresses from six months or more, has an individual treatment term for each person.

Symptoms

Regardless of what type of disease a person has, whether it is alcoholic or diabetic, hereditary or toxic polyneuropathy or demyelinating, they often have the same symptoms.

A wide range of factors that cause the disease often affect the nerve first, and then lead to a violation of the function of their work. The main symptoms of the disease are:

weakness in the muscles of the arms and legs;
violation of the respiratory process;
decrease in reflexes and sensitivity, up to their complete absence;
prolonged feeling of "goosebumps" all over the skin;
increased sweating;
tremor or seizures;
swelling of the hands and feet;
cardiopalmus;
unsteady gait and dizziness;
constipation.

Complications

In fact, there are not many complications of polyneuropathy, but they are all cardinal. Complications of the disease are as follows:

sudden cardiac death;
violation of motor functions, complete immobilization of the patient;
violation of the respiratory processes.

Diagnostics

It is impossible to independently diagnose any of the above types of polyneuropathy only by symptoms in a person (many symptoms are similar to the manifestation of other diseases). If you find one or more of the signs, you should see a doctor as soon as possible. To make a diagnosis, specialists will conduct a wide range of studies, which include:

initial examination and interview;
neurological examination and testing of basic nerve reflexes;
complete blood count;
radiography;
biopsy;
consultations of the patient with such specialists as the therapist and endocrinologist.

Treatment

Primary treatment of polyneuropathy is aimed at eliminating the cause of its occurrence and symptoms. It is prescribed depending on the type of pathology:

treatment of diabetic polyneuropathy begins with a decrease in glucose levels in the body;
with alcoholic polyneuropathy, you must strictly refrain from taking alcoholic beverages and everything that may contain alcohol;
cessation of all contact with chemicals to prevent the occurrence of a toxic type of disease;
taking a large amount of fluid and antibiotics for infectious polyneuropathy;
surgery for paraneoplastic type of disease.
the use of painkillers for severe pain syndrome.

Among other things, you may need a complete blood purification, hormone therapy or vitamin treatment (this type of therapy, in medical circles, is considered the most effective).

Physiotherapy is a good treatment for polyneuropathy. It will be especially useful in chronic and hereditary forms of the disease.

Prevention

Preventive measures of polyneuropathy are aimed at eliminating the causes that adversely affect the nerve fibers. Prevention methods:

complete rejection of alcoholic beverages;
if the work is related to chemicals, perform it only in protective clothing;
monitor the quality of food consumed;
do not take medications without a doctor's prescription;
timely treat diseases of any nature and complexity;
include vitamins in your diet;
perform physical exercises;
constantly monitor blood sugar levels;
periodically go for therapeutic massages.

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Diseases with similar symptoms:

Guillain-Barré syndrome is a group of acute autoimmune diseases characterized by rapid progression. The period of rapid development is approximately one month. In medicine, this disorder has several names - Landry's palsy or acute idiopathic polyneuritis. The main symptoms are muscle weakness and lack of reflexes, which occur against the background of extensive nerve damage (as a result of an autoimmune process). This means that the human body accepts its own tissues as foreign, and the immune system forms antibodies against the affected nerve sheaths.