Neuritis - Causes, Symptoms And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Neuritis: types, symptoms and treatment

Neuritis - what is it?

Neuritis is an inflammation of the peripheral nerves, which is accompanied by pain and decreased sensitivity, paralysis and paresis are possible. In addition, the disease is characterized by movement disorders.

Innervation is the provision of nerves to tissues and organs, through which the central nervous system gives them a command to perform a particular function.

Neuritis can cause partial or complete paralysis.

There are nerves that suffer from inflammation more often than others:

• Visual.
• Auditory.
• Facial.
• Trigeminal.
• Ray.
• Sciatic.

If the nerve becomes inflamed in only one place, we are talking about neuritis. When several nerves are inflamed at once, polyneuritis is indicated.

Neuritis is manifested by symptoms such as: deterioration in sensitivity, numbness, impaired motor functions, pain. In severe cases, movement of the affected area of the body becomes impossible.

A variety of infections, injuries, growing tumors, hypothermia and diseases not associated with pathogenic flora, for example, osteochondrosis or arthritis, can provoke the development of neuritis.

The mechanism of development of neuritis

The nervous system allows a person to exist. She is responsible for the mechanism of breathing, smell, thanks to her people move, hear, see, etc. The peripheral nervous system is a huge internal organization, which consists of many nerves.

The nerve itself is a unit of the nervous system. It is represented by plexuses of nerve fibers that are covered with a myelin sheath. Nerves provide communication between the brain and spinal cord with each other and with other organs.

Blood vessels run inside the nerves.

If the nerves are large, then they are called nerve trunks. Branches extend from these trunks. All nerves have a different structure.

Neuritis has a complex mechanism of development. But against the background of absolute health, it never arises. It is always preceded by any disturbances: vascular, metabolic, etc. A trauma or a tumor growing in the body can cause the development of neuritis.

Pathological factors destroy myelin and Schwann cells, which are responsible for the transmission of nerve impulses. If the violation is serious, then the axial cylinder suffers. The affected nerve is unable to function normally, which leads to disruption in the functioning of organs and tissues.

Most often, neuritis is diagnosed in women in old age.

Neuritis according to ICD-10

According to ICD-10, neuritis has a code of M79.2, and neuropathy is G60-G64.

Content:

• Symptoms of neuritis
• Complications of the disease
• Neuritis reasons
• How to distinguish neuritis, neuralgia, neuropathy?
• Classification of neuritis
• Alcoholic neuritis
• Diagnosis of neuritis
• Neuritis treatment
• Prevention of neuritis
• Diet recommendations
• What doctor treats neuritis?

Symptoms of neuritis

The symptoms of local neuritis are quite typical. These are stably dull pains with paroxysmal irradiation along the nerve. There is also a violation of sensitivity, movement disorders occur, and at the site of the lesion there is a slight muscle atrophy. In more difficult situations, the disappearance of tendon reflexes is possible, but it rarely comes to paralysis.

The first manifestations of the disease:

• Pain concentrated in the area of inflammation.
• Deterioration of the sensitivity of the affected area, its numbness.
• Tingling of the sore spot.

The symptoms of the disease will differ, depending on which nerve fibers are affected, as well as how intense the inflammation is.

In this regard, neuritis can manifest itself by such signs as:

• Feeling of crawling on the body, numbness of the affected area, tingling. All these symptoms occur when sensitive fibers have become inflamed.
• Paresis and paralysis are the main symptoms of motor fiber inflammation. The patient's muscles may atrophy, tendon reflexes will stop working.
• Loss of hair in the affected area, vitiligo, xeroderma, skin edema, deterioration of the nails, ulcerative defects, increased sweating. All these symptoms develop with damage to vegetative fibers.

Depending on which nerve is affected, the symptoms of the disease will vary:

• Inflammation of the auditory nerve. This nerve is responsible for transmitting sound to the brain. Its damage is accompanied by the appearance of tinnitus, hearing impairment. People often complain of dizziness.
• Damage to the optic nerve. The person complains of eye disorders. First of all, this concerns visual impairment, which sometimes reaches complete blindness. The patient may have flies before the eyes.
• Axillary nerve damage. The person notes that he has a decrease in sensitivity in the shoulder area, in 1/3 of its upper part. The joint in this area begins to ache, the deltoid brachialis muscle gradually atrophies. It is difficult for a person to raise his hand or take it to the side.

• Radial nerve damage. Depending on where the inflammation is concentrated, the symptoms of neuritis will be slightly different:

  1. Inflammation of the axillary fossa or inflammation at the level of 1/3 of the shoulder is characterized by pain during flexion of the arm at the elbow joint. It becomes problematic to straighten the forearm, hand and thumb. The carporadial reflex is impaired. If a person stretches his arms forward, then the hand of the affected limb will hang down. The patient is unable to turn the palm up.
  2. If the inflammation is concentrated in the middle 1/3 of the shoulder, then the elbow and shoulder joints do not suffer.
  3. If the inflammation is concentrated in the lower 1/3 of the shoulder, or in the upper forearm, then the sensitivity of the back of the hand worsens, it is difficult for a person to straighten not only the hand, but also the fingers.
• Inflammation of the ulnar nerve. The disease has some features:
• Deterioration of sensitivity and paresthesia of the palm. In this case, the area of the 5th finger suffers, as well as half of the 4th finger.
• Deterioration of the sensitivity of the back of the hand. Half of the 3rd finger suffers, the 4th and 5th fingers go numb completely.
• Muscle weakness of the 4th and 5th fingers increases, their muscles atrophy. This makes the hand look like a clawed paw. In this case, the fingers at the base remain straight, and in the region of the middle phalanx they bend.
• Sometimes neuritis of this localization resembles the clinical picture of tunnel syndrome.
• The defeat of the median nerve. The violation develops acutely, the person experiences severe pain in the fingers, as well as on the inside of the forearm. Then the sensitivity of the palm worsens, while half of the 4th finger and from 1 to 3 fingers suffer. A person cannot bend them. Also, the hand does not bend in the area of the wrist joint. The person is unable to turn the hand so that the palm is directed downward. The thumb will atrophy. In appearance, the hand begins to resemble a monkey's paw.
• Carpal tunnel syndrome. Clinical manifestations of inflammation proceed as a tunnel syndrome, since the median nerve in the wrist area will be pinched. The patient is numb from 1 to 3 fingers. At first, this feeling arises from time to time, and then begins to bother the person on an ongoing basis. The pain is localized in the palm, as well as in the 1st, 2nd and 3rd fingers. It is aching, gaining intensity during a night's rest, can spread to the elbow and shoulder. If a person sets the hand in motion, the painful sensations lose their intensity. When the hand remains in a bent position for 2 minutes, the patient begins to feel how his fingers become numb (1, 2 and 3). The thumb loses its strength, sometimes its elevation undergoes atrophic processes.
• Plexitis or lumbosacral plexopathy. The lower limbs lose their normal strength. The legs lose sensitivity, the lower back and pelvis in the joints begin to hurt. Tendon reflexes become weak or disappear altogether.
• Sciatic nerve neuritis. With this disease, pains in the buttocks are observed, which radiate to the thigh, to its back surface. Painful sensations can reach the lower leg and foot. The Achilles reflex disappears. The pain is dull, but from time to time it occurs in the form of lumbago. A characteristic sign of neuritis in this localization is Lasegue syndrome, in which the pain intensifies when trying to lift a heavy object with his leg while lying on his back.
• Inflammation of the femoral nerve. A person has difficulties when trying to bend a leg at the knee or in the hip joint, the sensitivity of the thigh in its lower part worsens. In this area, muscles begin to atrophy, severe pain appears if pressure is exerted on the points under the inguinal ligament or on the exit point of the nerve in the thigh.

When the cases are not severe, recovery occurs in about 2–3 weeks, but more often it takes longer, particularly in older people, and recovery is incomplete. For the treatment of local neuritis, sympathetic methods are used.

Complications of the disease

Neuritis can lead to the development of complications such as:

• Paresis.
• Paralysis.
• Replacement of normal muscle tissue with coarse connective tissue fiber.

Neuritis reasons

Neuritis can be caused by such reasons as:

• Injuries received. These include cracked bones, soft tissue bruises, muscle and tendon tears, fractures, electric shocks, exposure to radiation, etc.
• Inflammation of the internal organs.
• Tumor growths growing inside the body.
• Viral and bacterial infections.
• Diseases: measles, influenza, diphtheria, osteochondrosis, kyphosis, scoliosis, lordosis, arthritis, herniated disc, VSD, atherosclerosis, hypertension, tunnel syndrome, allergies, diabetes mellitus, thyrotoxicosis, uremia, brucellosis, rheumatism, syphilis, herpes, herpes malaria, blood diseases.
• Lack of water in the body.
• Hypothermia.
• Intoxication with food, alcohol-containing liquids, medicines, chemicals.
• Vitamin deficiency.
• Congenital anatomical abnormalities.

Sometimes a person experiences neuritis symptoms if he remains in an uncomfortable position for a long time. This can happen during a night's rest, or because of the peculiarities of the profession. People who lead a sedentary lifestyle often suffer from the symptoms of neuritis.

How to distinguish neuritis, neuralgia, neuropathy?

Neuritis, neuralgia and neuropathy are different diseases that differ in the mechanism of their development, etiological factors, and clinical presentation. Therefore, it is wrong to combine them into one concept.

Neuritis is an inflammation of a nerve located in the periphery. The disease is accompanied by damage to the nerve fiber itself. The myelin sheath and the axial cylinder suffer.

Neuropathy is a lesion of the peripheral nerves, with the nerve trunks most often affected, and not its single branches. The nerve undergoes degenerative and metabolic damage. Injuries, disturbances in the blood supply system, metabolic failures can lead to neuropathy. Symptoms of the disease are: deterioration of sensitivity, suppression of reflex activity, loss of strength. Neuropathy is a concept that is appealed not only by neurologists, but also by psychiatrists. In the latter case, a disease is understood as an increased excitability of the nervous system against the background of its excessive fatigue.

Neuralgia is an inflammation of the peripheral nerves, but at the same time a person will not suffer from paralysis, paresis, or deterioration of sensitivity. The nerve itself is not severely damaged, its myelin sheath is not destroyed, or is slightly deformed. The main symptom of neuralgia is pain. It can be quite intense, concentrating in the area of the affected nerve. A person's sensitivity may worsen, sometimes vegetative disorders join.

Classification of neuritis

Depending on how many nerves were involved in the pathological process, mononeuritis and polyneuritis are distinguished. In the first case, inflammation occurs only in one nerve, and in the second case, several nerve fibers suffer at once.

Depending on the location of the inflammation, optic neuritis can be of the following types:

• Retrobulbar or orbital neuritis. The optic nerve becomes inflamed outside of the eyeball. The area from the exit of the sclera to the chiasm suffers.
• Axial retrobulbar neuritis. The inflammation will be concentrated in the maculopapillary bundle of the optic nerve. This is a serious pathology that can cause blindness.
• Interstitial retrobulbar neuritis. The optic nerve sheath is inflamed. It spreads into its deep structures towards the table.
• Peripheral retrobulbar neuritis. The inflammation starts from the optic nerve sheath and spreads to its tissues. With this type of neuritis, fluid will accumulate in the subdural and subarachnoid space.
• Transversal neuritis. With this pathology, the optic nerve suffers throughout its entire length. The disease takes its onset in the axial bundle, or at the periphery, and then spreads to other tissues.
• False neuritis of the optic nerve. This is a pathology of the development of the optic nerve. Symptoms of the disorder resemble inflammation, but the nerve itself does not atrophy, and visual function does not suffer.

In addition to optic neuritis, the following types of inflammation are distinguished:

• Axial neuritis, when the axial cylinders of nerve fibers become inflamed.
• Interstitial neuritis, in which the connective tissue structures of the nerve fibers are affected. Pathology most often develops against the background of autoimmune processes in the body.
• Parenchymal neuritis. First of all, the myelin sheath of the nerve and its axial cylinders suffer, and then the inflammation passes to its connective tissue structures.
• Vegetative neuritis. In this case, the nerve fibers located on the periphery are exposed to inflammation.
• Ascending neuritis. Such inflammation develops most often against the background of injuries to the lower or upper extremities. Then the pathological process begins to spread to the central nervous system.
• Cochlear neuritis. The auditory nerve in the cochlear part suffers. In this case, the patient begins to hear extraneous noises, his hearing deteriorates.

Symptom classification

There are three types of neuritis:

• Gombo's neuritis in which the myelin sheath surrounding the nerve is destroyed. The axial cylinders do not suffer in this case.
• Dejerine-Sott's hypertrophic neuritis. With the disease, hypertrophy of the sheath of nerve fibers occurs. First, the adductor part of the nerve is compressed, and then it begins to collapse and loses its functionality.
• Rossolimo's neuritis. This is a type of Dejerine-Sott's neuritis. The disease is aggravated, then subsides. Most often, children suffer from this pathology.

By etiological factor

Depending on what exactly caused the development of neuritis, the following types are distinguished:

• Traumatic neuritis. The disease develops against the background of a previously received injury to the nerve fiber.
• Professional neuritis. Pathology is a consequence of the characteristics of a person's profession. So, inflammation often occurs in people who come into contact with heavy metals, chemical vapors. The effect of radiation on the body is negatively reflected.
• Infectious neuritis. Inflammation of the nerve fiber occurs due to the defeat of the body by infection.
• Alcoholic neuritis. Nerves suffer due to the fact that a person abuses alcohol. At the same time, vitamin B is washed out of the body, which is responsible for the normal functioning of the nervous system. In addition, when alcohol is consumed excessively, the nerve cells themselves die.

Alcoholic neuritis

The most common type of polyneuritis is alcoholic neuritis. Obviously, it is associated with a lack of vitamin B, which is typical for people with alcoholism. The first signs of the disease are numbness, tingling, weakness in the extremities, namely in the hands and feet. Over time, the pain increases, the skin's sensitivity increases, it becomes smooth and dry. Keratosis (excessive keratinization) of the palms and feet is often observed. Deep reflexes disappear, muscle weakness becomes stronger (sometimes before paralysis), while the functions of the bladder and rectum are not disturbed.

Symptoms are usually bilateral. The most commonly affected muscles are those innervated by the peroneal and radial nerves. Disorders of tactile and deep sensitivity are often detected. Nails become brittle, break, deform, hair becomes thinner. Severe cachexia (exhaustion), severe muscle atrophy, and vasomotor disorders occur. Alcohol consumption leads to blindness. During treatment, bed rest, prevention of contractures with the help of splints and massage, maintenance of normal temperature of diseased extremities, analgesics and a diet rich in vitamins are recommended.

Diagnosis of neuritis

To confirm the diagnosis of neuritis, the patient will be referred for examinations such as:

• Electromyography
• Electroneurography
• Functional tests

They, in turn, can be as follows:

• Diagnosis of radiation neuritis. A person puts his hand on the table, but at the same time he cannot put 3 fingers on the fingers next to him. The brush is placed with its back on the table and the person is asked to remove the thumb. He cannot do this. The patient is then asked to stand up and put his hands down. In this position, he cannot turn the affected hand with his palm forward and is unable to move his thumb.
• Diagnostics of the ulnar nerve neuritis. The patient puts the brush on the table. In this position, he cannot perform scratching movements with his little finger. The hand continues to lie on the table, the person is asked to spread his fingers apart. Particular difficulties arise with the 4th and 5th fingers. Also, a person cannot clench them into a fist and will not be able to hold a strip of paper with his index and thumb. The fact is that none of them bend to the end.
• Diagnostics of the median nerve neuritis. A person cannot perform scratching movements with a finger on the surface on which his hand lies. The patient is unable to clench his fingers into a fist. This is especially true for 1 and 2 fingers, and 3 fingers are partially bent. A person cannot oppose the thumb to the little finger.

Neuritis treatment

To cope with neuritis, it is necessary to direct efforts to eliminate the cause that led to its occurrence.

The main directions of therapy:

• Elimination of the etiological factor of neuritis.
• Taking medications.
• Physiotherapy treatment.
• Operation.

It will not be possible to cope with neuritis if the cause that led to its development remains unresolved. In parallel, efforts should be directed towards the treatment of chronic diseases, if any.

List of medicines

Only a doctor can prescribe drugs for the treatment of neuritis. Self-administration of any medication is an unacceptable measure.

If neuritis develops against the background of an infectious process, then efforts should be made to eliminate it. When germs are the cause of the disease, antibiotics are prescribed to the patient. If the infection is of viral origin, then the patient is prescribed antiviral drugs.

A drug is selected depending on the sensitivity of the pathogenic flora to it:

• Amoxicillin, Vancomycin, Clarithromycin, Erythromycin, Oxacillin. These drugs are prescribed for staphylococcal infections.
• Erythromycin, Azithromycin, Doxycycline, Levofloxacin, Ceftriaxone, Cefotaxime - these drugs are prescribed for streptococcal infection.
• Sulfamoxol and Sulfanilamide are drugs from the sulfonamide group that can be used to treat neuritis.
• Betaferon, Interlock, Laferon, Neovir, Reaferon and gamma globulins are indicated for admission if neuritis is of a viral nature.

The pathogenic flora that multiplies in the human body poisons it. Because of this, the patient may feel sick and even vomit, his body temperature rises, weakness increases, and overall health worsens. Intoxication increases with the mass death of bacteria and viruses.

To remove them from the body, a person is prescribed detoxification therapy, which can be carried out in the following directions:

• Use of sorbing agents: Atoxil, Polyphepan, Enterosgel.
• Drinking large volumes of fluids. It is good if it is fortified with vitamin C.
• Taking diuretics: Furosemide and Diacarb.
• Intravenous administration of glucose solution, polysaccharides, water-salt solutions.

To reduce inflammation and relieve pain, the patient is prescribed drugs from the NSAID group. In severe neuritis, glucocorticosteroids (Prednisolone) can be used. Representatives of NSAIDs - Ibuprofen, Diclofenac, Nimesil, etc.

If a child's body temperature rises with neuritis, then it can be wiped off with water and vinegar.

In case of tunnel syndrome, injections with Novocaine or Hydrocortisone are performed to eliminate inflammation. They are injected directly into the affected canal. If the disease was caused by a disturbance in the nutrition of the nerve against the background of ischemia of the blood vessels, then the administration of vasodilators is indicated. For this purpose, Euphyllin or Papaverine can be used.

Neuritis is accompanied by a number of symptoms that can worsen a person's life, reduce its quality. Therefore, the patient is shown taking medications aimed at eliminating these symptoms. So, in order to reduce the likelihood of developing muscle spasms, the patient is prescribed Persen or ankylosing spondylitis.

In order for the damaged nerve to recover faster, a person must receive vitamins. Therefore, with neuritis, B vitamins, vitamin E, ascorbic acid, nicotinic acid, milgamma, neurobion, neuroubin are prescribed.

Ancillary drugs that can be used at the discretion of the doctor are: antihistamines, antiplatelet agents, angioprotectors, proteolytic enzyme inhibitors. Gravitational treatments can also be applied.

Physiotherapy

Physiotherapy methods may be recommended for patients with neuritis such as:

• Plasmapheresis.
• Mud treatment.
• Massage the muscles in the area of inflammation.
• Hyperbaric oxygenation.
• Treatment with currents.
• UHF.
• Muscle electrical stimulation.
• Ultraphonophoresis with hydrocortisone.
• Electrophoresis with novocaine, neostigmine and hyaluronidase.

Often, patients with neuritis are selected physiotherapy complexes. Exercise depends on where the inflammation is concentrated. Physiotherapy begins to be implemented 6-7 days from the start of neuritis treatment.

When is the operation done? An operation for patients with neuritis is prescribed if he has suffered an injury that has led to inflammation of the nerves. The help of the surgeon may be required, provided that medical correction has been ineffective, or there are no signs of improvement in well-being.

Prevention of neuritis

In order to prevent the development of neuritis, it is necessary to observe such preventive measures as:

• Protect yourself from injury.
• Observe the rules of personal hygiene.
• Prevent hypothermia of the body.
• Treat all diseases in a timely manner, prevent them from becoming chronic.
• Do not take medications that the doctor has not prescribed.
• Eat foods that are rich in vitamins and nutrients.

Diet recommendations

A person suffering from neuritis should eat well, food should be rich in vitamins, mainly of group B, which are most of all in brewer's yeast, pork, cereals - oatmeal and buckwheat, - peas, beans, wheat bread; vitamin B6 is found in yeast, beef liver, kidneys, meat, yolk, cheese, milk.

The patient is advised to drink plenty of fresh vegetable juices, especially carrot juice.

What doctor treats neuritis?

If symptoms of neuritis appear, you should consult a neurologist.

Author of the article: Sokov Andrey Vladimirovich | Neurologist

Education: In 2005 completed an internship at the IM Sechenov First Moscow State Medical University and received a diploma in Neurology. In 2009, completed postgraduate studies in the specialty "Nervous diseases".