Infectious polyneuropathy
Infectious polyneuropathy refers to polyneuropathic diseases caused by infections. Polyneuropathies caused by infectious diseases also include polyneuropathy in HIV infection, leprosy, polyneuropathy in tick-borne borreliosis and others. After suffering acute respiratory infections, acute polyneuropathy occurs, which is also called Guillain-Barré syndrome.
Symptoms of infectious polyneuropathy vary depending on which subspecies of polyneuropathy the infectious disease has led to. Approximately 20 - 35% of patients with HIV infection show different types of polyneuropathies. The first and main symptoms are severe pain, changes in the sensitivity of the feet, paresthesia. Over the next months, the symptoms of the disease continue to gradually increase, smoothly passing to the upper limbs.
One of the symptoms of such polyneuropathy in HIV infection is a decrease in the superficial appearance of sensitivity, the Achilles reflex drops out. At the late stage of this dangerous disease, muscle atrophy and weakness of the feet can be observed. Severe symptoms of polyneuropathy are sometimes absent in a certain number of patients, therefore, the diagnosis can be made only after a neurological examination, which, in the presence of symptoms, would be one of the means of establishing a final diagnosis.
Polyneuropathy with tick-borne borreliosis (Lyme disease), most often occurs at about the second of the three stages of the disease. Most often, movement disorders are more pronounced than sensitivity disorders. The symptomatology of the disease in this case is most often asymmetric rather than symmetric, as in cases with other types of polyneuropathies, including those caused by infections.
Leprosy (aka leprosy) is an infectious disease, susceptibility to which depends on various factors, including the state of the immune system. Symptoms accompanying polyneuropathy in Lepré: impaired sweating of the extremities, hair loss, decreased temperature, tactile and pain sensitivity. When treating, special attention is always paid not only to medicines, but also to hygiene measures, consultation with an orthopedist, and daily examination of the feet.
Diphtheria polyneuropathy
Approximately 20% of patients who have had diphtheria develop diphtheria polyneuropathy and is considered a typical complication, while most often occurring when the underlying disease was not particularly acute. Long-term recovery from severe diphtheria polyneuropathy should include physical therapy, massage therapy, and special exercises. In the case of timely detection of the disease, complete recovery occurs faster than with Guillain-Barré polyneuropathy.
In diphtheria polyneuropathy, the cranial nerves are affected first, followed by paralysis of the soft palate, impaired sensitivity of the pharynx, paralysis of its muscles may even develop, damage to the auditory or facial nerve is possible, paresthesias of the distal extremities are often noted, in most cases, tendon reflexes fall out. Significant damage to the diaphragm is also possible. The patient must be constantly monitored to avoid possible respiratory arrest.
Symptoms develop and may peak within 2 to 10 weeks. With diphtheria polyneuropathy, a tendency to spontaneous regression is characteristic. From 2 to 15% of cases of diphtheria polyneuropathy are fatal; in survivors, recovery is most often complete and takes 6 months or more. In the acute stage of infection (the first two days), it is necessary to administer a special antitoxic serum, which will reduce the likelihood of development and the severity of complications.
Intravenous immunoglobulin, plasmapheresis and corticosteroids used to treat other types of polyneuropathies, in this case, with an already developed disease, are not effective. In this case, treatment will be based on therapy designed to maintain a stable condition and prevent symptoms from developing.
Perhaps the most common type of infectious polyneuropathies is Guillain-Barré syndrome, the main causative factor of which is considered to be the transferred viral or infectious diseases. The first symptoms usually appear a couple of weeks after the infectious disease that triggered the development of the syndrome, but there are cases when it develops as if from scratch, which indicates that there is some kind of asymptomatic infection.
Treatment can be based on getting rid of the consequences of the causes that caused the syndrome, or on symptomatic therapy, in all cases, treatment will be problematic in the presence of symptoms such as respiratory failure. With adequate treatment, 75% to 85% of patients recover well.
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".
