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Defeats of a peripheral nervous system. Polyneuropathies
March 6, 2013
In an organism peripheral nerves are responsible for communication of a certain body and the central nervous system. All movements which are done by the person are quite so carried out. If there is a failure in ensuring such communication, then at the person morbid condition which is called a polyneuropathy is shown.
Structure of a peripheral nervous system
The peripheral nervous system of the person connects bodies and extremities of the person to the central nervous system. Neurons of PNS are located in an organism outside TsNS, that is back and a brain.
The peripheral nervous system of the person actually has no such protection as TsNS therefore it can be affected by toxins, and also mechanically be damaged. Therefore, diseases of a peripheral nervous system – the phenomenon rather frequent. Their treatment, as well as therapy of diseases which the central nervous system is surprised it is necessary to make immediately. It is accepted to subdivide a peripheral nervous system into a somatic nervous system and a vegetative nervous system.
The peripheral part of the nervous system of the person has a certain structure. It is made a ganglion, by nerves, and also nerve terminations and specialized sense bodys. A ganglion is accumulation of neurons which make the small knots of various size which are in different places of a body of the person. Two look a ganglion — cerebrospinal and vegetative are classified.
Nerves of PNS are supplied with a large number of blood vessels. It is made by nerve fibrils, and, each of nerves consists of different number of such fibers. Defeat of any of the PNS components conducts to the fact that its functions are broken. As a result, diseases of a peripheral nervous system develop.
Defeats of a peripheral nervous system
The following versions are distinguished from diseases which affect a nervous system: multiple mononeuropathies, focal mononeuropathies, polyneuropathies.
At development of focal neuropathies the separate nerve, a texture, its part or a root is surprised. Such defeat happens because of an injury, strong squeezing or influence of other factors. As a result, in a zone of defeat disturbances of motive, sensitive and vegetative character are observed.
At a multiple mononeuropathy not one at the same time is surprised, and several nervous trunks. Defeat happens not symmetrically. As a rule, such pathology is observed at patients with a vasculitis, neurofibromatosis, hypothyroidism, sarcoidosis, etc.
At a polyneuropathy the symmetric defeat of peripheral fibers having diffusion character is observed. Among the reasons of manifestation of a polyneuropathy inflammatory defeat of a nervous system, serious violations in food and a metabolism, endogenous intoxications is defined. Polyneuropathies develop also at patients with system and infectious illnesses as a vaccination effect. This general disease is often observed at patients with a diabetes mellitus and alcoholism.
The acute polyneuropathy is provoked by a number of different factors. Most often the acute form of a disease arises under the influence of bacterial infections which are followed by toxicosis. Also as the reasons of an acute polyneuropathy autoimmune reaction, poisoning, the use of a number of medicines, in particular, of antibiotics, and also those drugs which are used during chemotherapy is defined. The illness can develop at the people having oncological diseases which are followed by injury of nerves.
The chronic polyneuropathy develops under the influence of a diabetes mellitus, systematic alcohol intake, lowering of functions of a thyroid gland, liver dysfunction, a lack of an organism of B12 vitamin or excess of B6 vitamin.
Most often now the chronic form of an illness develops as an effect of constant high level of sugar in blood of the patient who does not take measures for his decrease. In this case the separate form of a disease — a diabetic polyneuropathy is defined. Establishing the diagnosis and appointing the patient treatment of a polyneuropathy, the doctor surely considers also those factors which influenced its development.
The main clinical manifestation of a polyneuropathy is existence of motive disturbances, and also disturbances of sensitivity and vegetative disturbances. In most cases at a polyneuropathy nerve fibrils of the greatest are surprised are long. For this reason initially symptoms of an illness appear in distal departments of extremities. In view of diffusion nature of defeats of nerve fibrils symmetric manifestation of symptoms is noted.
In development of a polyneuropathy the person has a sensitivity disturbance, manifestation of vegetative and motive signs. The most frequent disturbance of motive function at the patient of a polyneuropathy is the paresis which is followed by hypotonia and a hypotrophy of muscles. Paresis is most often noted in extremities. At heavy disease the muscles of a trunk and skull are involved in process. It is accepted to distinguish two types of symptoms at a polyneuropathy: negative and positive symptoms. Negative symptoms is the hypesthesia, weakness and the subsequent muscles, a sensitive ataxy (coordination of movements is broken), the weakened motility of a gastrointestinal tract, fiusirovanny pulse, strong or weak sweating, impotence. Positive symptoms are the tremor, a neyromiotoniya, fastsikulyation, paresthesias, display of pain and a syndrome of uneasy legs, supertension, tachycardia, intestinal colic.
Disturbances of sensitivity at a polyneuropathy can be very various. So, sensitivity can how to decrease, and to be absent completely. Paresthesias (feeling of a pricking and "goosebumps"), and also pain of different character are periodically observed. So, pain can be shown as response to not painful incentive. Besides, pain can be spontaneous.
Also a sign of a polyneuropathy is the neuralgia which is shown pain in the place of an innervation of a nerve. As a rule, it is usually penetrating or shooting pain. Also the kauzalgiya is shown. It is burning and persistent pain which develops in the place of an innervation of a nerve in connection with its damage. At the same time various vegetative frustration often develop, food of fabrics is broken.
One more manifestation of a polyneuropathy connected with a vegetative nervous system is erectile dysfunction at men which is characterized by disturbances of an erection and impossibility to carry out normal sexual intercourse.
Estimating the course of a disease, specialists allocate acute, subacute and chronic polyneuropathies. At an acute form of an illness its symptoms become the most expressed several days later or weeks after an onset of the illness. Subacute polyneuropathies are characterized by increase of symptoms for several weeks. But at the same time they take place no more than two months. Chronic polyneuropathies can develop for several years.
Also toxic polyneuropathies (other name of an illness — a syndrome to Giyena-Barra) are allocated at which the monophase current is noted. Therefore, symptoms are aggravated once then the illness gradually regresses. Initially the patient can have symptoms of an infectious gastrointestinal or respiratory disease.
Also porfiriyny polyneuropathy, inflammatory demiyeliniziruyushchiya a polyneuropathy proceeding with periodic recurrence and remissions is allocated. When there is the next exacerbation of a disease, neurologic defect every time becomes Bol deep.
At axonal polyneuropathies the illness develops gradually, and first of all, distal departments of legs are involved in it. At this type of a polyneuropathy in the patient's muscles very quickly there are trophic changes, pain, disturbance of vegetative functions disturbs. At the patient touch and motor insufficiency is noted.
At demyelinating polyneuropathies at the patient tendon jerks are early shown. Sensitivity of muscles and joints is broken. Both proximal, and distal departments of extremities are involved in process, at the same time paresis is more expressed, and here the atrophy of muscles is shown less.
At the correct approach to establishment of the diagnosis it is simple to define existence of a polyneuropathy at the person. As a rule, specialists experience difficulties at establishment of an etiology of an illness. To receive an exact picture, to the patient carrying out the clinical analysis cuts is appointed and wet, determination of content in blood of glucose, urea, liver enzymes. Also the thorax X-ray analysis, an electrophoresis of proteins of plasma is carried out. In certain cases carrying out ultrasonography of an abdominal cavity is appointed sick. In the presence of indications carrying out tool researches of urinogenital system, a gastrointestinal tract, a fence of a lumbar puncture, tests for existence of rheumatic diseases is possible.
Appointing the scheme of therapy of a polyneuropathy, the doctor surely in a complex approaches this problem. Considering the fact that at this illness autoimmune processes very often take place, the patient should appoint at once reception of glucocorticoid means (Prednisolonum), and also drugs which are capable to suppress immune processes in an organism. Besides, at treatment of a polyneuropathy high doses of vitamins, mainly groups B and vitamin C, potassium salts are applied. In the course of therapy the proteinaceous diet to which the patient has to adhere strictly some period is appointed. Also use of antihistaminic drugs and means which action assumes improvement of neuromuscular conductivity practices. Also disintoxication therapy is appointed. For this purpose to the patient a lot of liquid is entered to provide removal of toxins from blood. Blood is also purified by means of hemosorption and a plasma exchange.
It is important to consider also the fact that treatment of a polyneuropathy is appointed taking into account the reasons which provoked such frustration. So, if the factor which influenced development of an illness is too high content in a B6 vitamin organism, then after normalization of its level such symptoms disappear. The diabetic polyneuropathy is slowed down, and its symptoms become less noticeable if constantly to control the content of sugar in blood. At treatment of dysfunction of a liver, kidneys, oncological diseases also polyneuropathy symptoms gradually disappear. If the patient with some oncological illnesses the tumor is removed surgically, then pressure upon a nerve in certain cases is eliminated and, as a result, symptoms of a polyneuropathy stop. At a hypothyroidism therapy by hormonal means practices. At an alcoholic polyneuropathy in an organism the lack of vitamin B and folic acid is observed. If to eliminate toxic influence of alcohol, and also to fill a vitamin deficiency, then the condition of the patient is normalized.
But sometimes to define what reason provoked display of an illness, is impossible. In that case therapy of neurologic frustration provides simplification of a pain syndrome and reduction of weakness of muscles.
Reception of the anesthetizing drugs practices, some methods of physical therapy are also effective. If tactics of treatment of a disease was built correctly, and therapy was applied timely, then in most cases the illness successfully recovers.
Rehabilitation methods after the postponed disease include physical therapy, remedial gymnastics, massage sessions. It is important to carry out rehabilitation step by step and fully.
National methods of treatment of a polyneuropathy assume reception of vegetable collecting with the high content of vitamins and the strengthening influence, use of adequate exercise stresses, thermal procedures.
Not to allow development of this illness, it is important to treat the main diseases at once after their identification, and also to prevent toxic influence in case of work with harmful substances.