Polyneuritis on the hands whether surgery is needed. Causes, symptoms and treatment of various forms of polyneuritis

Defeats nervous system are diverse, and in one form or another are found in most of the world's population. Radiculopathy, neuritis and neuralgia, acute disorders cerebral circulation, children's cerebral paralysis() is just a small part of the extensive list nervous pathology. Often there is a disease such as polyneuritis.

Polyneuritis

Polyneuritis is a multiple lesion nerve fibers. This name does not quite correctly reflect the essence of the disease, since true neuritis is the result of only inflammation of the nerves. While more common causes of this pathological process is the result of the action of a toxic or traumatic factor.

modern medicine calls multiple nerve damage polyneuropathy. However, the term "polyneuritis" continues to persist and is widely used among practicing neurologists.

Polyneuritis does not develop independently, it is always a consequence and clinical manifestation some disease. What happens with this pathology?

Mechanism

The mechanism of polyneuritis, regardless of the cause that caused them, is quite complicated. In their development, they go through a number of stages:

1. The impact of toxic, inflammatory, traumatic, ischemic factors.
2. Damage to nerve fibers. The distant nerves of the extremities are more affected.
3. Destruction of peripheral nerves. Depending on the underlying disease, the body of the nerve cell, its process, or the myelin sheath can be damaged.
4. The progression of the disease, the spread of the process proximally - from the limbs to the body and head.

Causes

There are many reasons for the appearance of this pathology. The main factors that cause the destruction of nerve fibers include the following:

1. Toxic. It could be alcohol, salt heavy metals, medicines, vaccines and sera, organophosphates, products of protein metabolism.
2. Traumatic.
3. Metabolic - associated with disease internal organs, and especially endocrine system.
4. Inflammatory - in autoimmune processes.
5. Infectious - bacterial and viral infections.
6. Ischemic - the result of an acute or chronic disorder circulation.

Nerve fibers are extremely sensitive to the action of damaging factors. In addition, their distal sections are the most differentiated, which means that it is the hands and feet that suffer in the first place.

Also at this level, the elements of the blood-brain barrier are not developed, which leads to the rapid occurrence of tissue hypoxia - a violation of the supply nerve cells oxygen. What diseases are characterized by such a complication as polyneuritis?

The most common diseases

Not one disease occurs with the development of the lower and upper limbs. Sometimes it becomes the first symptom - for example, when diabetes second type. Most often it is a complication of the following pathologies:

• Alcoholism;
• Diabetes;
• Multiple sclerosis;
• Post-vaccination encephalomyelitis;
• Guillain-Barré syndrome;
• Diphtheria;
• Chronic kidney failure;
• Malignant tumors;
• Avitaminosis;
• Poisoning with arsenic, lead and organophosphates.

In practice, neuropathologists most often encounter diabetic and alcoholic neuropathy lower extremities. And if with diabetes the disease progresses steadily, and treatment only slightly slows down the process, then in the case of alcoholic polyneuritis the situation is different.

Alcoholic polyneuropathy

Chronic alcoholism in the vast majority of cases leads to the development of polyneuropathy. The action of ethanol and its metabolic products is extremely toxic to the nervous system. These substances destroy the processes of nerve cells and their myelin sheaths. The outcome of such a pathological process is motor, sensory and autonomic disorders.

Alcoholic polyneuropathy of the lower extremities develops slowly and gradually. They progress over time, however, with the refusal of alcohol, motor and sensory functions are able to recover almost completely. Ability to regress all symptoms - salient feature alcoholic polyneuritis. And in this regard, his prognosis is much more favorable than with diabetes or other diseases. However, not everyone can completely give up alcohol.

Polyneuritis in this disease is always combined with alcoholic encephalopathy, which can also regress. If it turns into dementia, the restoration of nerve cells becomes impossible.

Clinical picture

The clinical picture of polyneuritis is diverse, and as the disease progresses, the manifestations increase. The leading symptoms of this pathology are as follows:

• Usually gradual onset, unless acute intoxication.
• Initially, the predominant lesion of the lower extremities and especially their distal parts - the feet.
• Changes in sensitivity in the type of "socks" and "gloves" - it primarily decreases in the hands and feet.
• Unsteady gait associated with loss of sensation in the feet. The feeling of support disappears. The patient has a feeling that he is walking on a soft floor.
• A kind of "cock" gait - the patient raises his legs bent at the knees high. This is due to muscle weakness, which causes the foot to hang down.
• The appearance of paresthesia - a sensation of tingling, crawling insects, shooting pains, feeling.
• Weakness in upper limbs. It is difficult for patients to do ordinary things - fasten buttons, tie shoelaces, hold a pencil.
• Decrease in temperature and pain sensitivity, as well as a deep muscular feeling, which makes it difficult for a person to feel his body in space.
• Intermittent intense burning pains in limbs.
• Thinning and darkening of the skin due to a violation of trophism, the appearance of trophic ulcers, fragility of nails.

Over time, motor and sensory disturbances increase and spread closer to the body. The patient stops getting up and is unable to serve himself. These symptoms are especially characteristic for alcoholic polyneuropathy.

Diagnostics

Which doctor establishes this diagnosis? The diagnosis of polyneuropathy of any origin is finally established by a neuropathologist. Although any specialist can suspect him. Most often, the therapist and endocrinologist face the symptoms of neuropathies.

How to confirm polyneuropathy? As a rule, this is enough for the usual neurological examination, symptoms and relevant history data - alcoholism, diabetes mellitus, contact with dyes, heavy metals.

The neuropathologist evaluates the sensitivity in the limbs and body, muscle strength, range of motion. If necessary, a detailed examination can be carried out - CT, MRI, blood and urine tests for infections and toxins, glycated hemoglobin in diabetes, a complete biochemical blood test, needle electromyography.

Treatment

Can polyneuritis be cured? Because this pathological process only a manifestation of the disease, then treatment is directed primarily at the underlying disease. It is important to eliminate completely or at least reduce the influence of the provoking factor.

The most favorable prognosis for exogenous intoxication ( external influence). This applies to alcoholism and poisoning various substances. After a while, sometimes quite long time after the cessation of contact with the substance, the functions of the nerve fibers are restored, and further treatment not required.

Recovery can also occur in the case of infectious diseases. However, when viral lesions the forecast is not so optimistic. They are difficult to treat and often lead to complications.

In diabetes, it is important to strictly control blood glucose levels and periodically undergo preventive treatment.

However, therapy for polyneuritis is aimed not only at combating the damaging factor, it also strengthens the nerve fibers and prevents their destruction.

Neuroprotective treatment

Neuroprotectors are drugs that protect the nervous system. With polyneuropathies of various genesis, the following groups of drugs are used:

• Piracetam and its analogues.
• Actovegin.
• B vitamins (Milgamma, Neurorubin).
• Medicines based on lipoic acid (Thiogamma, Berlition).

They are quite effective and are widely used in neurology and endocrinology. However, it should be remembered that the courses of neurotropic therapy should be long and constantly repeated. And this treatment alone does not get rid of the symptoms of polyneuropathy. The underlying disease must be carefully monitored.

Polyneuritis is a common pathology, but this does not make it less dangerous. It is important to contact a neurologist in a timely manner and follow his recommendations.

It is desirable to know the symptoms of polyneuritis for every person, since this disease is now not uncommon. In order for a person to be able to move normally and perform certain functions, there is whole system nerve endings. Nerve endings transmit signals from the brain and control the body's adaptation to external environment. The signs of polyneuritis are in the failure of the functionality of the peripheral nerves, which ultimately delivers to the person pain and can lead to disability. Acute polyneuritis of the lower extremities in most cases develops due to mechanical and toxic factors. The causes of development may also be infections such as influenza, diphtheria, dysentery, typhoid, alcohol poisoning, arsenic, lead, chlorophos. Often, provocateurs of a malfunction in the work of nerve endings are harmful conditions work, vitamin deficiency.

Signs of the development of the disease

Like any disease, polyneuritis has characteristics, which can point to it. The disease manifests itself sharply and suddenly, although it develops inside the body for a long time. For the first symptoms to appear, the disease must be present in the body for at least 2 weeks. The nature of the manifestation of the disease directly depends on the age of the patient; in people of retirement age, the disease develops much more pronounced.

At first, a person may complain of general malaise, weakness in the muscles of the arms and legs, depending on where the inflammation of the nerve endings occurs. Among initial symptoms, which complement general weakness and a decrease in muscle tone, dry skin, brittle nails, and increased sweating can be noted. It should be noted that at this stage, a person can feel "gloves and socks." There is a feeling on the bare foot foreign object, which pinches a certain area a little, giving the impression of rubbing the fabric in socks or gloves. On initial stage illness movement disorders No, but the sensitivity of the limbs is already noticeably reduced. There are a number of cases in which sensitivity, on the contrary, increases, and lung site A blow can form a large hematoma or tumor.

Among the symptoms that are already starting to alarm most people, it should be noted crawling and numbness of the limbs. Elderly people cannot get rid of the feeling of chilliness in the limbs and shooting pains during calmness, which can appear out of nowhere and just as abruptly disappear. Gradually, weakness in the legs joins. The gait becomes unstable, as paresis of the feet begins. The so-called cock's gait can develop, in which a person steps on his toe and falls on his heel.

Further, the person ceases to feel the touch of cold and hot objects, and this is a signal that the degenerative changes in muscle and bone tissue. The skin on the hands and feet becomes thinner and becomes bluish, it is difficult for the patient to hold small items, coordination of movements is disturbed, long-healing ulcers on the skin may develop.

Symptoms depending on the type of disease

The nature of the manifestation of symptoms may differ depending on what exactly caused the polyneuritis. Today, polyneuritis is distinguished:

• infectious;
• diphtheria;
• lead;
• arsenic;
• alcoholic;
• diabetic;
• professional.

Each of the species has its own characteristics, for example, infectious develops against the background of diseases of the upper respiratory tract accompanied by an increase in temperature and general malaise. The diphtheria type appears due to insufficient treatment this disease, characteristic symptom is a paralyzed palate, a nasal voice, and it is also difficult to eat food due to vagus nerve. Can provoke polyneuritis and medical preparations needed for treatment infectious diseases. A hypersensitive organism may have a reaction to large dose drug, or improper injection.

The lead form of the disease is very common in everyday life. You can catch a similar ailment by eating sour berry jam. In the lead form of the disease, it is affected radial nerve the patient feels sharp pains, colic in the abdomen, there is abundant white coating on gums and tongue.

Arsenic itself is a rather dangerous substance, respectively, arsenic poisoning is a pathological process due to which a person experiences vomiting, diarrhea, dizziness, and paralysis of the limbs. You can get poisoned with arsenic not only in chemical industries, but also in everyday life, especially during the treatment of the city with pesticides and other harmful substances from insects.

The diabetic form develops, as the name implies, in people with this autoimmune disease as a response to systemic disorders in the body. The nerve fibers of the lower extremities are more often affected, less often the nerves of the hands and face.

Occupational pleurisy occurs during work that requires constant muscle tension, as well as regular use vibrating instruments. These are not necessarily welders and drillers, this category also includes seamstresses who regularly use mechanical machines, milkmaids who repeat the same movements every day. As a result of such repetitions, the symptoms are constantly increasing, vibration in the limbs is felt even during sleep.

Separately, it is worth noting the alcoholic type of polyneuritis - this is the most common option, it develops in people suffering from chronic alcoholism. The person in the background alcohol intoxication paralysis of the lower extremities occurs, in rare cases, the nerves of the diaphragm, hands, face, entire top part the trunk is rarely affected. It is important to note that the patient rarely pays attention to similar symptoms, as it considers side effect alcohol. IN this case polyneuritis is the first symptom of another, no less serious disease, which is called Korsakov's syndrome.

Therapy Method

In order to get rid of the symptoms, the disease must be treated before it leads to irreversible changes in the tissues.

The disease will be treated based on the cause that caused it, on the duration of the manifestations of negative symptoms. The sooner therapy is started, the more favorable prognosis. Sometimes complex various symptoms complicates the diagnostic procedure. Therefore, it is very important that the patient can recreate the order of manifestation of symptoms and the duration of symptoms, this is very valuable information for the doctor.

For people who are ignorant of medicine, but have already encountered this problem, the question will be natural: “Polyneuritis of the lower and upper extremities, what is it and why is it dangerous?”

Types and features of polyneuritis

Polyneuritis is multiple disorder nerve endings, which are characterized by paralysis, paresis, decreased sensitivity (or its complete loss) in the hands and feet, weakening of memory, trophic disorders.

Allocate the following types pathologies:

• infectious;
• toxic (caused by exposure to toxic substances).

Polyneuritis caused by infection are:

• primary (viral) - damage the peripheral nerve trunks (including the spinal and cranial, their roots), its duration is 1-3 months;
• secondary - are formed as a consequence of transferred diphtheria (eyes, nose, ears, pharynx). In girls - with pathology of the genital external organs.

Alcoholic polyneuritis

The causes of alcoholic polyneuritis are:

• effect on the nervous system ethyl alcohol(alcohol), which destroys her cells;
• lack of vitamin B1 in the body.

Characteristic signs: mobility, sensitivity are lost, cyanosis of the extremities occurs.

When sick, prescribe complex therapy, drugs that improve metabolic processes(to restore damaged nerve fibers). Prescribe refusal to drink alcohol, massage, physiotherapy. The patient is cured completely within 3-4 months.

Acute polyneuritis

The disease develops during (or after) a viral illness.

Characterized by:

• weakness in the limbs;
• a slight increase in temperature;
• speech disorder.

Diabetic polyneuritis

It is caused by the root cause - diabetes mellitus; affects large peripheral and cranial nerves, the autonomic system. There is a decrease muscle mass arms and legs, eye movements are paralyzed, problems arise in the functioning of the kidneys, heart and other organs.

Chronic polyneuritis

Develops gradually, with constant exposure negative factors. Characterized muscular atrophy, inflammation of the brain, speech disorders may occur.

Infectious polyneuritis

The cause is an infection.

There is pain and numbness in the legs, which spread quickly from the feet to the knees, the body temperature rises.

Alimentary polyneuritis

This type of disease is caused by a lack of vitamin B1, some minerals. Differs in violations in the cardiovascular system.

Causes of polyneuritis

The development of the disease is caused by:

• infections (flu, tonsillitis, typhoid, dysentery);
• external intoxications (alcoholic, poisoning with arsenic, chlorophos);
• diabetes;
• kidney pathology;
• oncology;
• dysfunction of the thyroid or pancreas;
• working conditions (when exposed to cold, instrument vibration, prolonged muscle tension);
• beriberi;
• metabolic disorders;
• encephalopathy.

The risk group also includes people suffering from diabetes, diseases of the hematopoietic system, arterial hypertension, multiple sclerosis.

Disease symptoms and diagnosis

The disease has the ability to manifest itself in the following symptoms:

• soreness in the arms and legs, numbness;
• sensitivity is lost;
• muscle weakness occurs;
• increased sweating in the limbs;
• skin color changes (pallor appears, it becomes thinner, swelling appears);
• motor functions are upset;
• there is a change in the structure of the nails.

The doctor makes a preliminary diagnosis already during the examination of the patient. To confirm it, a number of additional studies are being carried out:

• general urine and blood tests (to detect toxins);
• examination of internal organs and thyroid gland;
• electroneuromyography method (determine the degree of passage of electrical impulses along nerve endings and assesses the condition of the muscles).

Traditional treatment

When treating a disease with traditional medicine patients are prescribed anti-inflammatory, analgesic drugs, as well as drugs that stimulate motor activity and improving metabolic processes.

Massage, physiotherapy, mud baths are prescribed.

Patients with polyneuritis should remember and follow the following mandatory recommendations:

• eliminate the source of intoxication;
• adhere to bed rest (during periods of exacerbation);
• drug treatment (for infectious polyneuritis, it is administered antiviral drugs, detoxification solutions (hemodez); the diphtheria form involves the use of anti-infective serum, with the influenza form - interferons and gamma globulins);
• taking vitamins, fortified complexes (with beriberi);
• taking diuretics to reduce swelling, as well as magnesium sulfate, glucose;
• perform physiotherapy, massage, take mud baths;
• follow a diet (include foods fortified with vitamin B1, fruit and vegetable juices in the diet).

Folk methods of treatment

Non-traditional methods are used when the disease does not have acute manifestations. Treat polyneuritis herbal preparations and decoctions, compresses.

In order to get rid of the disease, they take the stems and leaves of raspberries already chopped (1 tbsp.) And pour boiling water (1 cup), leave for one hour, consume 3 tablespoons before meals.

For the same purposes, Ivan-tea grass is brewed (1 spoon per 1.5 liters of boiling water, the decoction is infused for 8 hours, drunk during the day). In the same proportions, an infusion of nettle and birch is made.

TO problem areas they apply a mixture of red clay and vodka, they also practice rubbing with bear fat.

Such a remedy is also used: a lingonberry bush is poured with a glass of boiling water, kept in a water bath for an hour and a half. You need to use the medicine in a tablespoon several times a day (3-4).

Consequences and prognosis

Polyneuritis is successfully treated, provided that the patient is promptly provided with qualified health care appropriately selected therapy. Unfavorable outcome possible only in case of damage to the vagus nerve, which can lead to the death of the patient.

The recovery period after the disease is quite long (about several months), it involves the strict implementation of all doctor's prescriptions. Rehabilitation recommended.

Prevention measures

TO preventive measures, warning polyneuritis include:

• proper nutrition;
• use enough vitamins;
• prevention of infectious diseases;
• healthy lifestyle (walking fresh air, sports, natural fabric for clothes, no bad habits);
• avoidance of stress and overwork;
• strengthening immunity, hardening.

Polyneuritis of the lower extremities is a disease that has a multiple nature. Its treatment is quite complicated, the recovery period is long. Therefore, the main and most necessary way to avoid it is the timely implementation of preventive measures.

Polyneuritis - damage to the structure of multiple nerve fibers can develop at any age. In rare cases, the disease occurs and develops as an independent disease, but most often it is a secondary complication. toxic poisoning, trauma, diabetes, alcohol addiction. First possible signs polyneuritis is considered the appearance of a feeling of numbness and "running" goosebumps in the limbs, recorded for several weeks, then there is a decrease in the physiological tone of the muscles, insufficiency of tendon reflexes.

Types and features of polyneuritis

The disease is characterized by a predominant pathological lesion of the distal, that is, distant parts of the nervous system of the extremities, this is manifested by a decrease in sensitivity and strength in the hands and feet, while in the higher located parts, these signs characteristic of the disease appear already in advanced cases.

The treatment of the disease depends on the influence of the primary cause, therefore, in the diagnosis, it is necessary to identify this provoking factor.

Polyneuritis primarily covers nervous departments limbs, therefore, the symptoms of the disease are associated with this area of ​​the human body.
Polyneuritis of the extremities usually begins with a sensation of a decrease in temperature in the area of ​​​​the feet and hands, later a violation of sensitivity joins.

Pathological reactions occurring in the nerves are characterized by the presence of dystrophic changes, their inflammation in this disease is not typical.

The course of polyneuritis and its prognosis depend on the cause of the disease, so the attending physician must determine the etiology of the disease before treatment.

Alcoholic polyneuritis

It is characterized by the simultaneous appearance of sensory and motor pronounced disorders. For this type of disease, the characteristic defining symptom is the presence of mental disorders, the most obvious of which is pathological memorization - the patient does not remember the events that have occurred, can distort events and facts.

The patient fills in memory gaps with fiction, which sometimes has a clearly fantastic plot. Polyneuritis of the lower extremities is added to this. Legs or hands acquire a bluish tint, lose sensitivity and mobility.

Polyneuritis of the kidneys

It develops in severe glomerulonephritis and pyelonephritis. The disease is associated with glomerular filtration. Edema appears on the lower extremities, weakening of the arms and legs.

Acute polyneuritis

Usually develops during or after ailments with a viral nature of origin. After the root cause has been eliminated, subfebrile temperature, "ache" in the limbs, strong, burning pain along the nerves. All symptoms increase in a matter of hours or days.

Diabetic polyneuritis

It develops in patients with diabetes mellitus. In some cases, violations in the limbs that are noticeable to the patient are recorded earlier than the symptoms of the underlying disease.

At successful treatment the underlying disease, the symptoms of polyneuritis can persist for a long time, manifested by difficulty in walking, the inability to perform precise finger manipulations, muscle atrophy and paresis.

As already mentioned, the cause of polyneuritis can be various diseases. This can lead to the manifestation of symptoms of polyneuritis. You can read about it in this article.

Symptoms and manifestations of hydrocephalus or dropsy of the brain are quite extensive and varied. about the disease.

Chronic polyneuritis

Gradually develops with constant exposure to a disease-provoking factor. Slowly, pronounced weakness and atrophy in the muscles located in the lower and upper extremities increases, then there are signs of changes in the functions of the head and spinal cord, speech disorders and inflammation of the meninges can be recorded.

Toxic polyneuritis

It develops under the influence of alcohol, salts of heavy metals. Depending on the amount of toxin that has entered the body, it can be acute or subacute.

Acute poisoning is accompanied obvious symptoms intoxication - vomiting, pain in digestive tract, diarrhea.

Then, the noticeable signs that determine polyneuritis and the deterioration of the general condition join.

Vegetative polyneuritis

Occurs with intoxication, thyrotoxicosis, negative professional setting labor. This form of the disease is characterized by burning pains throughout the body, deterioration of tissue trophism, expressed as a change in temperature, excessive or insufficient sweating.

Infectious polyneuritis

Caused by an infectious agent and considered a distant consequence diseases. It starts with fever, lesions in the limbs are usually recorded in two at once and develop along an ascending path, that is, from the feet to the higher located nerve fibers.

Alimentary polyneuritis

It is caused by a lack of vitamin B in food or its improper absorption by the body. In addition to the signs of a pathological lesion in peripheral nerves limbs are registered serious violations cardiac activity.

Differences between polyneuritis and neuritis

The main difference between polyneuritis and neuritis is the generalization of the entire pathological process. With neuritis, one nerve can suffer, which is manifested by the presence of pain in its location.

With polyneuritis, nerve damage is usually defined as symmetrical and captures several groups at once, which only aggravates the severity of the disease and the patient's well-being, gait and performance are disturbed.

The cause of local neuritis can be tumors, injuries or arthritis, while polyneuritis has an infectious and toxic etiology of origin.

Causes of polyneuritis

The reasons leading to the development of polyneuritis are conventionally divided into several groups:

• Infections - tonsillitis, diphtheria, influenza, different types typhoid infection, severe dysentery.
• Exogenous intoxication factors - poisoning with alcohol substitutes, lead, chlorophos, arsenic.
• Endogenous intoxications developing in diabetes mellitus, thyroid pathologies, nephritis.
• Avitaminosis is a lack of B vitamins.
• Professional working conditions - Full time job in the cold, the vibration of the instruments.
• Chronic metabolic disorders.

In addition, the development of polyneuritis can be facilitated by the presence of a disease such as. They are inextricably linked and are characterized by loss of sensation and motor functions of the limbs, both upper and lower.

Symptoms are similar to those of polyneuritis. It is very important, at the first detection of symptoms, to immediately seek qualified help.

Prognosis in the treatment of alcoholic encephalopathy in late stages most often unfavorable. Why, learn from

Symptoms of the disease

Patients report the following symptoms:

• Periodic goosebumps, burning sensation and numbness.
• On examination, the skin of the extremities is pale, sometimes marbled, colder to the touch than the rest of the body, and damp from excessive perspiration.
• Weakness in the muscles begins to manifest itself as discomfort when doing the usual work - patients cannot fasten buttons, it is difficult to hold small objects in their hands.
• On the feet, the muscles that take part in the dorsiflexion weaken, this leads to the fact that the leg seems to hang down and when walking the person is forced to raise the limb high.
• Sensitivity is disturbed - many patients do not feel touch, changes in external temperature, injections with sharp objects. At the same time, burning and severe pain are expressed.
• Changes in deep-seated muscles lead to movement disorder, unsteady gait, trembling of the hands.
• Over time, the skin on the limbs becomes thinner, becomes swollen and acquires a dark purple hue, the structure of the nails changes.

In unfavorable cases, vagus nerve fibers may be involved in the pathological process, which manifests itself functional disorder the act of respiration and cardiovascular activity.

Severely flowing pneumonia with severe shortness of breath and tachycardia are recorded. Without proper treatment, this condition can be fatal.

The photo shows the lesion of the lower extremities with polyneuritis:

Diagnostics

Diagnosis is usually not difficult. The doctor examines and interviews the patient.

Among additional methods research importance have:

• Determining the presence of toxic substances in biological fluids- urine, blood.
• Examination of internal organs and endocrine system.
• Exclusion of oncological pathologies.
• Electromyography is a study aimed at studying the electrical impulses of muscle fibers. This survey it is recommended to carry out the period of treatment as a control over the improvement of the course of the disease.

Treatment

All forms and types of polyneuritis begin to be treated according to the same scheme:

• In the acute period is assigned bed rest and peace.
• It is necessary to eliminate the influence of intoxication, if laboratory diagnostics acute poisoning antidotes are administered, that is, drugs aimed at neutralizing toxins.
• With infectious polyneuritis, 4% Urotropin or 1% Tripaflavin is administered for several days. With the diphtheria form, the introduction of anti-diphtheria serum is indicated, with the influenza form - interferons and gamma globulins.
• Detection of beriberi requires course application vitamin complexes, especially from group B.
• To reduce swelling on the nerve fibers, magnesium sulfate, glucose, diuretics are prescribed.
• They improve microcirculation and metabolism using Aminalon, Nootropil, Trental, potassium preparations.
• Pain therapy is selected based on the severity pain symptom and the presence of comorbidities.

After acute period shows physiotherapy, massage, mud therapy, physiotherapy, reflexology. To prevent the development of contractures with severe atrophy and weakness in the limbs, they are put on splints.

The recovery period lasts several months, during this time good effect provides sanatorium - spa treatment, constant massage and gymnastics, a specially formulated diet.

Nutrition should be especially rich in B vitamins - pork, buckwheat and oat groats, eggs, dairy products, liver, kidneys, brewer's yeast.

Non-traditional methods of treatment

Alternative methods of treatment can be considered only after elimination acute signs diseases. The patient is advised to drink decoctions of herbs that improve metabolic processes in the body and use compresses.

• Shredded stems and leaves of garden raspberries in the amount of a tablespoon are poured with a glass of boiling water and insisted for a little less than an hour. Take three tablespoons before meals.
• A spoonful of Ivan tea grass is poured with half a liter of boiling water, placed in a thermos and infused for 8 hours. Drink the infusion throughout the day.
• The leaves of nettle and birch improve metabolic processes. They can be brewed separately or together at the rate of one spoonful of collection per half liter of boiling water. The prepared broth is drunk for a day.

For the preparation of compresses or baths, plants such as wormwood, birch and eucalyptus branches, pine shoots are taken. To prepare a bath, 100 grams of a plant and a liter of boiling water are enough, the resulting infusion is poured into water.

Consequences and prognosis

Timely treatment polyneuritis usually ends favorable outcome, it must be borne in mind that the restoration of nerve fibers occurs for months.

Therefore, in recovery period it is necessary to fully comply with all the recommendations of the doctor, undergo physiotherapy and pay attention to nutrition.

It is also necessary to exclude contact with substances that cause intoxication - their repeated exposure leads to relapses, the treatment of which will be difficult and long.

With the involvement of sections of the vagus nerve in the process and with untimely assistance in this condition, the outcome of the disease can be fatal.

Frequent and prolonged should not go unnoticed. Any pain must be properly diagnosed and treated in order to avoid serious consequences in the future.

All about the symptoms and treatment of neuralgia occipital nerve detailed in .

Prevention measures

Polyneuritis can develop in any person, the main measures for its prevention include the following:

• Exclusion of the influence of toxic substances.
• Prevention of viral infections.
• Compliance with safety precautions when working with poisons.
• IN special conditions labor - compliance with all recommendations for the performance of work.

Of great importance in the prevention of disease is a balanced and balanced diet, treatment of chronic diseases.

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 researching motor sphere, you will not find any paralysis, or muscle atrophy, or abrupt change 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 couple, you will see first of all the paralysis 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 food bolus the soft palate rises upward 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 in clinical picture disease, ataxia will come to the fore sharply. 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.