Demyelinating neuropathy
Neuropathy is a dangerous nerve disorder that is directly related to severe damage to various parts of the spinal cord. The disorder can be divided into sensory and motor disorders. Sensory neuropathy is characterized by movement disorders, and motor neuropathy affects the thin and thick fibers of the spinal cord.
The physical condition of the body with demyelinating neuropathy is often characterized by a slowdown in reflex activity, increased weakness, significant atrophy of muscle tissue, as well as involuntary muscle contractions. Mention should be made of the loss of sensations of movement and vibration, decreased response to the direct position of body parts, various tingling sensations and itching, changes in the perception of pain and temperature.
The causes of various types of neuropathies lie in arthritis with typical rheumatoid symptoms, hypothyroidism, tumors, various forms of diabetes, as well as dangerous renal and hepatic failure. Symmetrical disorders of motor reflexes and hypersensitivity can also be the causes of this disease.
Due to pathological conditions such as tuberculosis, diabetes mellitus and polyarthritis, a single nerve is often damaged, which in most cases is accompanied by rather severe pain. In addition, in modern medical practice, there are specific cases when the disease manifested itself due to a serious lack of folic acid in the body, various B vitamins.
The causes of demyelinating neuropathy can be hidden in mercury poisoning, all kinds of poisonous substances. If you do not pay attention to contraindications to certain medications, you can also provoke this disorder.
The clinical picture of demyelinating neuropathy
The value of typical Schwann cells for simple axons is great. It can be compared to the main role of oligodendroglia in the central nervous system. Axons perform the necessary isolating and trophic functions. Between all Schwann cells, there are always a kind of Ranvier interceptions, which are designed to provide an abrupt conduction of each excitation along the axon. The loss of such cells leads to a decrease in the rate of propagation of excitation directly along the nerve.
Axons are primarily affected by damage to Schwann cells. For them, the affected cells always act as a kind of insulator. The thick myelin fibers are designed to propagate arousal. This is often manifested by early severe sensory disorders. Demyelinating neuropathy is characterized by uneven impairment of all types of sensitivity.
At the same time, typical tendon reflexes are lost quite early. In many cases, the motor and all sensory nerves are severely affected. As a rule, serious sensitivity disorders prevail in the clinical picture of this disease, and paresis fade into the background. Many patients are worried about spontaneous pain, which is characteristic not only of neuropathy, but also of other muscle diseases.
Chronic demyelinating inflammatory neuropathy is considered an autoimmune disease that is similar in pathogenesis to Guillain-Barré syndrome. Moreover, it differs only in the course, which is stepwise progressive or steady. This type often proceeds in the form of separate exacerbations, usually separated by some remissions.
The main symptoms of inflammatory demyelinating neuropathy often reach their maximum after about 2 months. In this case, a more important role is always assigned to immunogenetic hereditary factors. The disease can begin subacutely, and then it acquires a progressive recurrent or monophasic chronic nature. The severity and severity of symptoms are always different, depending on the specific phase of demyelinating neuropathy.
Diagnosis of the disease during the examination of the patient allows you to objectively examine all the necessary sensitive pain points. When diagnosing general disorders of sensitivity, the entire nerve, its condition and the location of the proximal sections are examined. Depending on the degree of disorder, various instrumental and laboratory methods are used.
They contribute to the accurate disclosure of all additional nuances in order to quickly make a final diagnosis. These methods include electromyography, computed tomography, and neuromuscular transmission.
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".
