Causes, signs and symptoms of polyneuropathy, diagnosis and treatment
Definition of disease
Polyneuropathy is a particularly serious disease in which severe damage to the peripheral parts of the human nervous system is diagnosed. Such a unique disease is mainly characterized by one important characteristic, when the distal nerves are first affected, then the disease takes on a different ascending character, gradually spreading proximally. Peripheral paralysis is considered the main manifestation of polyneuropathy.
It should be noted that in many areas strongly innervated by numerous affected nerves, one can always distinguish serious vegetative-vascular disorders, signs of poor trophism of all tissues and impaired sensitivity. Along with this, symmetrical areas are often affected.
In medicine, polyneuropathies are always classified according to several criteria, the main types, depending on the cause of the process, are inflammatory, toxic, traumatic and allergic. Depending on the pathomorphology, such types as demyelinating polyneuropathies and axonal polyneuropathies can be noted.
Acute axonal polyneuropathies are often the main consequence of severe poisoning, which pursue the main goal of suicide, and sometimes occur as a criminal phenomenon. The disease usually proceeds against the background of an overlapping clinic of typical acute poisoning. That is why all medical measures are primarily directed by physicians to the rapid detoxification of the body.
Significant clinical signs of the presented disease in most cases appear only after a few days, and the restoration of the human body occurs within a few weeks.
Subacute polyneuropathies can be caused by metabolic processes in the body and serious toxic damage to the underlying nervous tissue. This type usually develops over a period of about 18-20 days, and it usually lasts for several months. In contrast to subacute, chronic polyneuropathies can often develop over a longer period of time. Chronic intoxication is considered the main cause of this type.
In many cases, intoxication is detected due to ethyl alcohol. Other causes are various systemic diseases, among which experts include diabetes mellitus, collagenoses, liver cirrhosis and all kinds of oncological diseases.
The rare Guillain-Barré syndrome is a fairly acute inflammatory demyelinating polyradiculoneuropathy. It usually develops as a result of serious or long-term infectious diseases. It should be mentioned that to date, the exact cause of this unique ailment has not been established by doctors. Some experts classify this type of disease as a large autoimmune group. In this case, segmental demyelination is characteristic.
The cause of diphtheria polyneuropathy is considered to be a toxin secreted by a dangerous pathogen of diphtheria. It is he who affects many of the cranial nerves, which can often be accompanied by serious disorders of a different nature. These include speech disorder, impaired vision and swallowing, as well as breathing and many others. Some patients develop paresis, tendon reflexes fall out, and even sensitivity is impaired.
A form such as diabetic polyneuropathy is very common in the modern world, since every year the number of people seriously ill with various types of diabetes mellitus increases. In this case, it appears in about half of all people with diabetes. Often, this particular ailment can be the initial clinical manifestation of serious diabetes.
Subacute demyelinating neuropathies can often have different origins. For the presented types of diseases, as a rule, a special undulating course is characteristic, the main difference of which is periodic relapses. This ailment often develops within a few weeks. However, it should be noted that there are no specific provoking factors.
The reason for the development of chronic demyelinating polyneuropathies is the same reasons as in chronic axonal types. Experts have found that a wide range of certain drugs can be a major factor in the development of the disease.
Reasons for the development of polyneuropathy
If we combine all the possible causes of the development of different types of polyneuropathies, we can note various acute poisoning with methyl alcohol, arsenic, carbon monoxide and numerous organophosphorus compounds such as malofos and dichlorvos. Other important factors are serious chronic intoxication, diphtheria, vitamin deficiency and diabetes mellitus. Systemic pathologies include uremia, liver cirrhosis, collagenoses, hypothyroidism, and dangerous oncological diseases;
Often, certain drugs are the cause of the development of polyneuropathy. the main ones are amiodarone, isoniazid and metronidazole. Other drugs are also not excluded.
Symptoms of polyneuropathy
The most important symptoms of polyneuropathy, experts identify muscle weakness in important distal parts of the extremities, breathing disorders, a significant decrease in all reflexes or their absence, paresthesias - prolonged creeping sensations throughout the skin, a significant decrease in the sensitivity of pain, skin or tactile, as well as severe damage to proprioceptors in the joints leading to violations of stability.
You can also mention various trophic disorders, muscle atrophy, burning pains without a specific clarity of localization, noticeable violations of perspiration in humans, changes in temperature and standard color of the extremities, as well as edema of their distal parts. important symptoms are all kinds of problems with speech and swallowing, as well as serious visual impairments, which include spasm of accommodation and disturbances in the movements of the human eyeballs.
Diagnosis of polyneuropathy
Polyneuropathy must be accurately differentiated from other dangerous diseases that strongly affect the human nervous system. Numerous lesions of some nerves have special clinical features that are very similar to polyneuropathy. But in this case, they are considered mononeuropathies. In addition, the correct collection of the necessary anamnesis plays an important role in modern diagnostics of polyneuropathy.
As a rule, in most cases, the main criterion indicating a given disease is a certain concomitant disease that causes it.
It is recommended that a wide range of studies be performed to help identify this dangerous pathology.
Unique electrophysiological studies will quickly differentiate axonal polyneuropathies from typical demyelinating ones. A complete blood count makes it possible to detect the existing toxins, due to which an accurate diagnosis is justified. Modern magnetic resonance imaging will help identify all foci of demyelination, and then judge by them the volume and level of certain lesions.
A nerve biopsy is an extreme method when specialists have not been able to find a specific pathology, possibly the main cause of polyneuropathy. A special histological examination is intended to obtain information about the immediate state of the nerve. Neurological status assessment is also often carried out.
Treatment of polyneuropathy
After establishing the main cause that caused the polyneuropathy, special therapy is always carried out, aimed at its early elimination. As a rule, modern treatment of diabetes mellitus, thyrotoxicosis, diphtheria and other possible pathologies is prescribed. In most cases, a number of specific areas and innovative techniques are also used in the necessary treatment of polyneuropathy. Therapy with certain drugs helps to improve the conduction of impulses along all fibers.
Among other things, the doctor may prescribe suitable hormone therapy based on the use of glucocorticoids or vitamin therapy. It is believed that it is vitamin therapy that is especially effective for certain types of polyneuropathy, which are provoked by vitamin deficiency. However, in the treatment of other common types of this disease, a wide range of vitamins impresses with exceptional antioxidant properties, helping to protect the nerve from severe damage by active radicals.
Reflexology is preferred by many European specialists. Plasmapheresis is always effective for polyneuropathy, if it is caused by toxic damage. In combination with drug treatment, special massage and the necessary physiotherapy exercises are indicated, which will help maintain a person's muscles in good shape. Magnetic therapy and electrical stimulation of the spinal cord, as well as individual nerves, also give good results with long-term treatment.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".