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Polyneuropathy, what is it? Causes, symptoms and treatment, prognosis

In neurology, a variety of symptoms are often encountered, which are called "focal neurological symptoms." This means that some kind of misfortune has occurred with one or several functions of the central or peripheral nervous system.

An example of focal symptoms may be weakness and tremor in the upper or lower extremities, facial nerve paralysis, increased tendon reflexes, and so on.

But there is such a term that combines the defeat of many nerves at once, but at the same time they are, as a rule, most remote from the central nervous system and located on the periphery. Let us try to explain this tricky and vague definition of "polyneuropathy" in simple words.

Content

Polyneuropathy - what is it?

Polyneuropathy

Polyneuropathy - translated from Greek as "the suffering of many nerves." These nerves may be affected by external factors that affect them for a long time and disrupt functioning. Unlike a brain tumor or stroke, which cause a strictly defined set of symptoms depending on the location, with polyneuropathy, a particular clinical picture is found, which will be discussed below.

First of all, polyneuropathy causes diseases in which any substances that adversely affect the nerves accumulate in the body. Such diseases include endocrine pathology and diabetes mellitus.

A high level of glucose in the blood, which lasts a long time, contributes to impaired conduction of peripheral nerves. As a result, diabetic polyneuropathy occurs. She belongs to the group of dysmetabolic disorders.

In the event that the culprit of the disease was not an ordinary substance (after all, glucose is in everyone’s blood, it’s just too much diabetes), but an external toxin, then there is a toxic damage to the peripheral nerves, both sensory and motor ones.

This is how toxic damage to the peripheral nerves develops, and the most striking example is alcoholic polyneuropathy, which occurs in people who have been drinking heavily and for a long time.

Malignant neoplasms, which poison the entire body with the products of their vital activity and decay, can also cause nerve damage. Such polyneuropathy is called paraneoplastic, and it is a terrible sign of advanced cancer.

Sometimes serious infections cause damage to the nerves. Such polyneuropathies can be attributed to both infectious and toxic - since microorganisms often use the strongest toxins, such as diphtheria bacillus.

Finally, autoimmune polyneuropathies can occur, in which the nerves destroy the antibodies of their own body, attacking the nervous tissue “by mistake”. Such diseases include systemic scleroderma and other “large collagenoses”.

Symptoms of polyneuropathy - characteristic signs

Symptoms of polyneuropathy

The disease has an extremely characteristic clinical picture. Before reviewing the symptoms of polyneuropathy, it is necessary to mention that this damage to the nerves can be of the following types:

  • Sensitive or sensory form. There are mainly sensitive disorders: paresthesia, numbness, burning, tingling, discomfort or “crawling”.
  • Motor, or motor form. Muscle weakness, malnutrition, and muscle wasting occur.
  • Most often there is their combined option - sensorimotor polyneuropathy, which occurs in most cases, and especially in diabetes and alcoholism.
  • Vegetative polyneuropathy. In this course, the autonomic nerves, which “control” the internal organs, are affected.
  • Finally, there is a mixed form that combines all kinds of disorders.

Polyneuropathy is characterized by the defeat of small nerves, since their myelin sheath is thinner and “easier to reach” before any harmful substances. Therefore, most often there is a lesion of the hands and feet - polyneuropathy of the upper and lower extremities, the symptoms of which, as neurologists say, are of the “socks and gloves” type.

There is even a type of sensitivity disorder, which is called a polyneuritic type. Thus, polyneuropathy of the upper limbs and lower will have the same symptoms.

The next important symptom of polyneuropathy will be the symmetry of the lesion, since the disease-causing substance circulates in the blood.

For example, the symptoms of polyneuropathy of the upper extremities may include weakness of the fingers, burning pain, feeling of coldness, and marbled skin on the back of the palms (vegetative disturbances).

The most common signs of nerve damage are as follows:

  1. Various and very diverse pains, including with neuropathic, "burning" shade.
  2. Attachments shake fingers.
  3. The appearance of fasciculations (or muscle twitches, which are involuntary).
  4. Violations of sensitivity (not only tactile, which was written above, but also a decrease in temperature and pain sensitivity). That is why in diabetic neuropathy patients “feel bad” a pebble in a shoe, a poorly clogged shoe stud and other stimuli.
  5. Muscle weakness, impossibility or significant difficulty with large amplitude movements. Often, weakness is combined with muscular hypotension and asthenia of the patient.

A special group consists of vegetative signs of polyneuropathy. These include hot flashes and the appearance of pallor and cold sweat, impaired blood circulation (and poor healing of wounds, and all kinds of damage to the skin).

Not always the disease develops long and gradually. Thus, polyneuropathy of the lower extremities, the symptoms of which indicate a decrease in sensitivity, extinction of Achilles reflexes, the presence of trophic disorders, may indicate a long-term process, and may appear in a matter of days and weeks, for example, with a mild degree of radiation sickness or poisoning with lead and its compounds.

Sometimes surprising complaints arise in the composition of polyneuropathy. So, in case of pernicious anemia, a zadnocolic ataxia occurs due to a deficiency of cyanocobalamin (vitamin B 12). In this case, it is not the peripheral nerves that are affected, but the spinal cord, more precisely, its posterior cords (columns), in which there are conductive bundles of joint-muscular feelings, or Gaulle-Burdach bundles.

What happens when they are defeated? Each of us, no doubt, with his eyes closed, knows how his hands and feet are located, even if they are not moved. And the patient with this type of ataxia does not know. Therefore, in the dark he cannot walk, because he is confused and does not know where and how his legs are located. But in light of the presence of visual control, such a person’s walk is normal.

There are special autonomous or autonomic neuropathies that disrupt the rhythm of the heart and can even lead to sudden death, due to the occurrence of ventricular asystole or other fatal arrhythmias. Such polyneuropathy is a vegetative motor cardiac form of the disease.

Diagnosis of polyneuropathy

Diagnosis of polyneuropathy

The diagnosis is made by a neurologist with regard to complaints, anamnesis and the development of the disease. As a rule, in case of polyneuropathy, making a correct diagnosis is not difficult.

Neither MRI, CT, nor ultrasound help here. The most important method is ENMG - electroneuromyography, which allows you to fully identify the violation of conduction along the nerve fiber and determine what is affected - the axial cylinder of the nerve or myelin "insulating" sheath.

Blood tests for biochemistry often show certain endocrine disorders (glucose). In extreme cases, polyneuropathy requires a nerve fiber biopsy, which is studied using histochemical and immune methods.

Treatment of polyneuropathy, drugs

Treatment of polyneuropathy, drugs

Treatment of polyneuropathy of the lower and upper extremities of any etiology is a complex and lengthy process. Indeed, a certain morphological restructuring of their structure has already taken place in the nerves, and it is necessary to “rebuild” a new nervous tissue, and this is not always possible. Therefore, the disease is not functional, but an organic lesion of the nervous system.

First of all, you need to stop the impact of the damaging factor on the nervous system. So, with diabetes, you need to reduce the level of glucose, and with alcoholism - stop drinking. Otherwise, drug therapy will not be effective enough. In the same way, it is necessary to first perform a malignant tumor or undergo a course of radiation and chemotherapy.

Drug therapy and drugs for the treatment of polyneuropathy are represented by the following groups:

  • Vitamins of group "B", for example, "Milgamma" - a concentrate of vitamins;
  • Antioxidant preparations ("Berlition", alpha - lipoic acid);
  • Metabolic drugs that improve microcirculation (Trental, Pentoxifylline).

Polyneuropathy of the lower extremities, the treatment of which consists only of drugs, is treated longer than with the participation of physiotherapy and topical application in the form of gels or ointments.

  • From physiotherapeutic methods, electrophoresis is shown with vitamin B1, dibazol.

Forecast

Polyneuropathy of the upper and lower extremities, the treatment of which has proved ineffective - is progressing. As a result, a person becomes disabled because his hands and feet simply refuse to serve him. But the most dangerous situation in which there are sudden formidable arrhythmias, which can be fatal.

In diabetes, the most serious is poor wound healing, the accession of a secondary infection and septic complications.

Finally, in rare cases, the development of ascending paralysis (similar to Landry's paralysis) with respiratory failure is possible. In this case, the patient is urgently hospitalized in the intensive care unit with a transfer to artificial lung ventilation.

Fortunately, this situation is usually resolved safely.

Interesting
2016-11-24 19:43:12
Specifically, how and how to treat polypathy? Is there a second chance in this world?
Andrew
2016-11-26 09:27:41
Anonymous, more specifically, "on the Internet" no one will tell you. Even the reason is unknown. Need to see a doctor.
Pivovarova Catherine
2016-12-15 04:23:59
I have type 2 diabetes since 2005, as well as recurrent cerebral infarction and myocardial infarction. And the last time was exactly one year ago. Now it manifested itself sharply, or rather, polyneuropathy worsened. Steel * hollow hands, difficult to breathe in the heart area. I am not * off * And I don’t even know which specialist to contact ... Can someone give advice?
2016-12-15 11:09:55
Hello, Catherine! In the event that polyneuropathy has worsened in you, then its treatment is performed by a doctor-neurologist. But first, it will require that you normalize (or reduce as much as possible) blood sugar, since it is the toxic effect of glucose that damages nerve endings. You did not report which medications you are taking, but believe me, polyneuropathy treatment will be ineffective if sugar is not reduced to at least 6-7 mmol / l. After reducing the sugar is usually carried out intravenously a course of infusion "Berlition-600". This is the best, but also the most expensive drug. His analogs are thioctacid, Thiogamma, Espa - Lipon. They can reduce the symptoms of polyneuropathy, such as burning, "cerebral pain" and a decrease in sensitivity. Then, after infusions, they are transferred to tablet preparations. Also prescribed are the B vitamins: B1, B6, B 12., or the course Milgamma Compositum. Also in your case, it is necessary to conduct necessarily the secondary prevention of cerebral infarction and myocardium. All drugs, ranging from acetylsalicylic acid, must be coordinated with your doctor, as well as infusion of drugs for diabetic polyneuropathy. It is necessary to monitor the pressure, cholesterol levels and also reduce excess weight.
Pivovarova Catherine
2016-12-15 14:59:19
She was treated in the hospital in October. Prokapali Berlition-600. I accept besoprolol and lorista, cardiket, berlition-300 - twice a day, finlepsin, cardiogram and rosartan. For the last ten days, she began to feel rather bad, her hands involuntarily repeat the last movement, * hollows *, her chest feels as if her muscles are very tired, you have to breathe under control. And then I accept the treatment and even be hospitalized - meaningless?
Stas
2016-12-16 16:13:49
You didn’t say about sugar level now. You need to go for an examination, no one will prescribe a course of treatment on the Internet. And the general direction above indicated.
Pauline
2016-12-18 15:06:53
Hello))) My grandmother had a headache for half a year ago (she had never had anything like that before), a neurologist diagnosed diabetic polyneuropathy ... Today, in the treatment of finlepsin, berlithione, betahistine ..... By past this veroshpiron, bisoprolol, acecardol and insulin (4 times). The last time we were in the hospital was discharged droppers: ceraxon, teaktotsid, fun duff ... Mexidol was pricked before droppers) but on the fifth day it began to fall, the day was worse and the left hand became numb .... They called the ambulance and the therapist, said they were treating and do what the neurologist prescribed))) Could this not be due to an oversupply of drugs or anything else? Maybe it's better to stop the dropper? The neurologist said to come after treatment, that is, we are only recorded for the next week and, especially, the grandmother is not transportable now, coordination is completely broken (before that it was better) ..... I don’t know what to do ...
STANISLAV (MEDICAL CONSULTANT)
2016-12-20 06:44:49
Hello! Your situation is not easy. A person may fall down in old age and with diabetes mellitus for various reasons, all the more suddenly. Usually in advanced age, type 2 diabetes develops, in which insulin is usually not prescribed. But if he was prescribed, it could be justified by resistance, for example, to oral hypoglycemic drugs. Therefore, after an insulin dropper, hypoglycemia could develop during an overdose, and a fall could be caused by this. In addition, the grandmother is treated with hypertension, and drugs are prescribed that “dilute” the blood, for example, Wessel-Duee F. It belongs to anticoagulants. This means that your grandmother has a high risk of thrombosis, in particular, ischemic stroke. The indications for this drug in your case, most likely, is the vascular lesion that occurs in diabetes (angiopathy), since an excess of sugar affects not only the nerves, but also the vessels. Numbness in the arm can be either a symptom of polyneuropathy, or a consequence of “long droppers”. But it seems to me that it was nevertheless a small, “lacunary” stroke, which could well complicate the course of diabetes. You need to invite a knowledgeable neurologist for a home inspection, or bring a grandmother to him to correct the therapy and confirm the diagnosis. Remember that reducing the level of sugar is one of the most important conditions for the normalization of well-being. It is possible that if the grandmother did not receive the prescribed treatment, a more difficult situation could develop.
Pauline
2016-12-20 08:14:24
Thanks for the comment))))) After I called 3 ambulances who said that there were no reasons for hospitalization .... I called the fourth, and the doctors who came were shocked that she wasn’t taken immediately, the first day))))) as a result, ischemic stroke, as the doctor said “moderate severity”, the left arm and part of the leg .... I do not know what will happen next, but it seems to be talking already, feels the arm, but cannot move , but most importantly, it is encouraging - she said she was dying of hunger:) so, I hope for the best and thanks for the answer))))
Nikolay
2017-01-10 10:48:41
exclude strassa smoking alcohol reduce physical stress check blood sugar feet rub with cologne alcohol containing preparations eg gerbaton plus fir oil ointment
Valentine
2017-04-09 13:56:46
Half a year ago, when walking for a long time, there was a feeling of heaviness in the legs, in the places of the ankles it seemed as if they were compressing the hoops, in the spring they put diapneuropathy, there is no diabetes, I don’t consume alcohol
Valentine
2017-04-09 14:01:23
Tell me, what drugs can relieve heaviness in the legs, hardly move my legs, please help.
Medical Consultant
2017-04-12 05:05:01
Hello, Valentine! Drugs that facilitate the course of any polyneuropathy are alpha - lipoic acid preparations, for example, Espa - lipon, Thioctacid. But the benchmark is considered "Berlition". It is more expensive, but better. The ideal option is a course of several droppers (usually 10). Then they switch to preparations of the thiogamma type and the B vitamins, which also improve the nervous trophism. The only question is where does polyneuropathy come from, and how was it delivered? Did the ENMG, or electroneuromyography, and how was the reason explained?
Natalia
2017-04-28 19:41:54
Hello! My mother was diagnosed with polyneuropathy 3 years ago. Her legs were immobilized, but after completing a course of plasmapheresis, other medications and physical exercises, her mother was able to fully recover and even go to work. But about a year later, the same symptoms began, even worse. Again he was treated, but not fully recovered. Went with a stick, there were lapses in memory. This is the same story. Only much worse. This time she was not sent to the regional hospital, plasmapheresis was not obtained. And she practically does not get up. Tremendous weakness. Tell me, is there a chance at least to serve herself, to walk with the help of a walker? What should we do? Local treatment did not give any results. Can plasmapheresis help again?
Natalia
2017-04-28 19:42:50
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