home Consultations Polyneuropathy of the upper extremities: causes, symptoms, treatment. Polyneuropathy of the upper extremities: symptoms, treatment and consequences of pathology Distal sensory polyneuropathy of the upper extremities

Polyneuropathy of the upper extremities: causes, symptoms, treatment. Polyneuropathy of the upper extremities: symptoms, treatment and consequences of pathology Distal sensory polyneuropathy of the upper extremities

Neuropathy (neuropathy, polyneuropathy) is a complex of disorders that arise as a result of damage to individual parts of the nervous system, not counting the brain and spinal cord. Exercise therapy for neuropathy of the radial nerve or limbs can improve the general condition of the patient and help reduce the intensity of the symptoms of the deviation.

It is difficult to immediately say why a person develops this disease. In this case, he will experience a disruption in the functioning of individual nerves and the entire peripheral system as a whole. The pathology is dangerous because it leads to difficulty in blood circulation, which subsequently leads to loss of sensitivity in the affected parts of the body.

After conducting a series of studies, scientists were able to prove that exercise therapy for neuropathy of the facial nerve or limbs can improve muscle tissue, relieve symptoms in the form of pain and have a positive effect on blood sugar levels. Exercises aimed at treating pathology include the following types of physical activity:

strength exercises;
aerobics;
development of flexibility;
work on balance skills.

In order for the first positive aspects of this technique to appear, you need to practice it for at least 25-35 minutes at least 4 times a week. If the patient feels unsure of his abilities, it is recommended to train for 10 minutes, and then gradually increase the load. If convenient, you can distribute this physical activity into 3 parts of the day: morning, lunch and evening. Before each workout, it is recommended to take walks in the fresh air or exercise directly on the street.

Note! Before you begin the exercises, you need to do a warm-up to prepare the body and warm up the muscles.

Aerobics for neuropathy

In this case, patients engage in the following types of physical activity:

Moderate jogging or cycling every day.
Swimming in the pool and simultaneously performing various aerobic exercises in the water.
Regular walks in the fresh air.

What balance exercises are there for patients with neuropathy?

This exercise therapy is effective for neuropathy of the upper and lower extremities. To perform one of the exercises, you need to take a chair and stand behind its back. Your feet should be shoulder-width apart and your hands should hold on. Now gradually raise one leg to the sides, about 35 centimeters from the floor. You need to be in this position for 5-10 seconds, whenever possible.

The same must be done with the other leg. It is very important that your knees and back remain straight throughout. This training is carried out 2 times a day for several minutes.

Development of flexibility in neuropathy

Stretching for neuropathy helps avoid injuries that can occur from other exercises. It will keep your joints toned and promote their flexibility. You should start the exercises by stretching the calf muscle.

To do this, place one leg behind so that the toe points forward. You need to take a step forward with your other leg, bending your knee to make it more comfortable, you can lean forward, but the heels of both feet should remain on the floor. You need to stand in this position for at least 15 seconds and then change legs. It is recommended to repeat the exercise 2 times a day every day.

Strength training for neuropathy

To perform one of the exercises, you need to prepare a stable chair or a chair with armrests and sit in it. If you find one, you need to put it in front of you, put one leg under the front of the chair, and put the other in front of you and to the side about 20 centimeters.

Next, the center of gravity moves forward until both legs feel tension. Now you can begin to gradually rise and fall back, also slowly. These actions should be repeated 10-15 times, changing legs 2 times a day.

General exercises

Other exercises that can improve the patient’s condition include the following:

To improve blood circulation in the extremities, you need to take your toes with your hands and begin to pull them towards you. You need to stand in this position for several seconds. At the same time, the feet are turned in different directions and massage movements are used for each toe and sole.
Rolling from toe to heel after standing on your toes for a few seconds.
Clenching and unclenching of the hands.
For hand neuropathy, you can purchase a special rubber ball. When you have free time, you need to knead it with both hands alternately.
Rotational exercises to the left and right with your fingers clenched into a fist.

How to improve blood circulation with neuropathy?

If exercise therapy for neuropathy for the hands or other parts of the body is not effective enough, therapeutic massages should be added to the exercises. This therapy affects soft tissues using special electrical devices or manually. Sunbathing, special oils, as well as simultaneous trips to the bathhouse or sauna are often used here.

The specialist who performs the massage performs smooth movements, causing minimal impact on the patient's skin. Strokes should be directed from the periphery to the central part.

It is also worth considering some caveats, namely:

since the patient suffers from loss of sensation, the specialist must be careful when applying pressure to the affected parts of the body;
it is necessary to carefully check the skin, as there is a high risk of injury after a massage;
If pain occurs during the massage, you should stop immediately and consult a doctor as soon as possible.

Only a highly qualified specialist should engage in such therapy, only in this case the intensity of the symptoms will decrease and the patient will feel a general improvement in his condition. If the massage is performed incorrectly, the patient may experience problems with swelling, arthritis, or infectious diseases.

How to properly massage for neuropathy at home?

For massage to be as effective as possible, the following rules must be followed at home:

Selection of a place convenient for the patient.
Monitor your feelings while constantly maintaining a conversation.
Do not massage in a hurry.
Use only moderate pressure and smooth movements.
Before the procedure, you need to prepare special oil, pillows, a blanket and a towel.
The massage therapist should also take a comfortable position in relation to the patient - standing or sitting.

Conclusion

If the patient has neuropathy of the lower extremities, it is necessary to pay attention to gymnastics. It can not only improve blood circulation, but also restore previous muscle function. To ensure that the joints receive enough nutrients, it is recommended to do rotations, flexion and extension of the legs.

The innervation of the hand is carried out by a whole system of peripheral, that is, located outside the brain and spinal cord, nerves. Their diseases of non-inflammatory origin (caused by various degenerative and dystrophic processes) are called neuropathy. It is not a separate disease, but is part of a symptom complex of various pathological conditions, therefore, to determine treatment tactics, it is not enough to establish the presence of pathology, but it is also necessary to identify the cause of its development. Neuropathy in the upper extremities is not as common as in the lower extremities, since the legs are innervated by the longest, and therefore the most vulnerable, nerve fibers. Degenerative-dystrophic changes in peripheral nerves often begin in the lower extremities, later the nerves of the arms, torso, and face are involved, although sometimes the nerves of a specific area of the body are immediately affected, in our case, the arms.

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Epidemiology

Statistics show that neuropathies of the upper extremities are not so rare. The most common type is carpal tunnel syndrome, which affects people who, due to their occupation, are often forced to make flexion movements of the hand. Of all tunnel syndromes, 2/3 of complaints are about this localization. Previously, many professions led to the development of this pathology; now they have been supplemented by the widespread use of computers - both in professional activities and in everyday life. As a result, from 1 to 3.8% of adults on the planet complain about its symptoms every year. For every man there are from three to ten women. Peak manifestation is at the age of 40-60 years.

Another vulnerable area of the median nerve is located in the upper third of the forearm; degenerative changes in this part are called pronator teres syndrome. In addition to the reasons described above, the development of this syndrome can be caused by the presence of a rare anomaly - the process of the humerus (Struzer's ligament).

Quite often the function of the ulnar nerve is impaired. This is also facilitated by compression injuries in everyday life, sports and at work.

Causes of upper limb neuropathy

The vast majority of isolated degenerative and dystrophic changes in the nerve fibers of the arm occur as a result of banal compression of one (mononeuropathy) or several nerves (polyneuropathy) innervating the upper limb. There are five such nerves: musculocutaneous and axillary, which regulate the work of the shoulder and part of the forearm, its upper and lower parts, respectively; median, ulnar and radial, controlling the work of the arm from the shoulder to the fingers.

Different areas of nerves, located both shallow under the skin and in the center of the arm, can be pinched. There can be many reasons for such an event - about two hundred.

Perhaps, most often, neuropathies of one of these nerves or multiple ones arise due to the awkward position in which the working hand remains for a long time, monotonous movements performed with one or both hands. And if previously the working hand of a person engaged in monotonous and hard physical labor suffered, then with the advent of the computer era, office workers joined the risk group. The compressive nature of neuropathies in half of the cases of its occurrence is associated with professional activity. One of the most common pathologies is carpal tunnel syndrome (associated with compression of the median nerve at the point where it passes to the hand), which affects people who spend a lot of time at the computer every day, tailors, musicians, dentists and other specialists or athletes who perform multiple monotonous flexion movements. hand movements.

Also, median nerve neuropathy is often caused by unusually high loads on the wrist, dislocations of the wrist joint and injuries to the forearm.

Cubital tunnel syndrome, associated with monotonous flexion movements of the elbow and compression of the ulnar nerve, is often encountered. The reason for this is the habit of constantly resting your elbow on a hard surface, including in everyday life, for example, when talking on the phone, or bending it in weight, for example, putting your elbow out the window, while driving a car or hanging from the edge of a table, which again concerns office workers.

Ulnar nerve neuropathy is manifested by Guyon's canal syndrome - in this regard, professions associated with vibration are dangerous; cycling, motorcycle racing; constant reliance on a cane (the innervation of the palmar muscles suffers).

Neuropathy of the radial nerve can occur due to incorrect position of the arm during prolonged sleep (“sleep paralysis”), in conductors, runners and representatives of activities in which one often has to make monotonous movements in the elbow bend, in case of fractures of the clavicle and shoulder joint, habit carry a heavy bag on the elbow.

The axillary or radial nerve is damaged by prolonged movement with crutches and so on.

In addition, hand injuries can lead to neuropathies of the upper extremities - fractures, dislocations, leading to direct damage to nerve fibers, adjacent muscle or bone tissue, blood vessels (lack of nutrition due to poor circulation, compression between swollen tissues, injury from the sharp edges of broken bones).

Operations involving the nerve in the process of scar tissue formation, development of ischemia, edema; continuous intravenous infusions; inflammatory diseases - arthritis, bursitis, lymphadenitis and others; cervical osteochondrosis; Tumors of either the nerve tissue itself, such as interdigital neuroma, or those located adjacent to the nerve, often cause compressive or ischemic neuropathy.

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Risk factors

Risk factors for its development include: frequent hypothermia, physical overexertion, contact with toxic substances, inflammatory complications of infectious diseases, systemic pathologies - endocrine, autoimmune, liver diseases, renal failure, deficiency of B vitamins due to nutritional causes or diseases of the gastrointestinal tract , vaccinations, heredity, alcoholism, hormonal fluctuations.

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Pathogenesis

The pathogenesis of damage to peripheral nerves is varied; it is always based on a degenerative-dystrophic process caused by compression, metabolic, ischemic disorders, or starting as a result of direct injury (bruise, rupture, cut, puncture) of nerve fibers. The structure of peripheral nerves is similar to an electrical wire - nerve cells (axons, neurites) are enclosed in a myelin sheath that resembles an insulating one. According to its pathogenesis, neuropathy is divided into axonal, when the axons themselves (nerve cells) are destroyed, and demyelinating, when the membrane is destroyed.

When pinched, sprained, squeezed, or ruptured, the axon is usually damaged. With minor compression, the anatomical structure of the nerve is preserved, and it is restored quite quickly and completely. In case of severe injuries, complete regeneration of the nerve is impossible even if the myelin sheath is intact.

In the second case, the myelin sheath, which acts as an insulator and conductor, is disrupted. The pathogenesis of demyelinating neuropathy includes genetic predisposition, rheumatoid arthritis, various forms of diabetes, liver and kidney dysfunction, and hypothyroidism. Isolated lesions of the nerves of the upper extremities in such pathologies are rare, however, this cannot be completely excluded. Damage to a single nerve can be caused by tuberculosis, polyarthritis, and poisoning with toxic substances, including alcohol and medications.

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Symptoms of upper limb neuropathy

Peripheral nerve fibers are divided into motor (motor), sensory (sensitive) and autonomic. Depending on which pathological changes are predominantly affected, such symptoms will predominate in the clinical picture, although isolated damage to any one type of fiber practically does not occur, so various variants of the symptom complex are possible.

Motor neuropathy is manifested by muscle weakness, lethargy, trembling even with minor physical exertion, convulsions; over time, muscle mass decreases, and the limb visually becomes thinner. The patient often finds it difficult to raise his arms up, especially from the sides, his coordination of movements is impaired, and it is impossible to hold objects with his fingers.

The first signs of sensory symptoms are tingling in the fingertips, numbness spreading higher and higher; there is a feeling that a thick glove is put on your hand; pain syndrome from mild discomfort to acute and burning pain (causalgia); loss of sensitivity in the direction from the periphery to the center (first the fingers, then the hand and higher).

Vegetative symptoms – pale skin, pigmentation, marbled skin; cold ends of the fingers even in hot weather; hyper- or hypohidrosis; hair loss on the skin, thinning of the skin in places with impaired innervation; thickening and separation of nails; skin ulcerations.

Symptoms increase depending on the stage of the disease. Therefore, if any pain, numbness, loss of sensation or limitation of motor functions occurs, even if there has been no injury, you should consult a doctor.

Damage to one nerve is called mononeuropathy. Types of damage to the nerves of the upper limb are manifested by the following symptoms:

the musculocutaneous nerve controls the functioning of the front part of the arm above the elbow; if it is damaged, the functions of the shoulder and elbow joint are impaired;
damage to the axillary nerve affects the innervation of the dorsal surface of the limb, shoulder abduction and extension of the shoulder joint are impaired;
when the median nerve is damaged, motor skills and sensitivity are impaired along the entire length of the arm, but more often in the hand, thumb, index and middle fingers;
ulnar nerve neuropathy is manifested by impaired movements of the hand, ring and middle fingers;
Radial nerve neuropathy manifests itself as loss of sensitivity on the dorsum of the hand, impairment of finger motor skills, as well as flexion in the elbow and wrist joints.

The first signs of the most common mononeuropathy of the median nerve, carpal tunnel syndrome, are numbness and tingling in the tips of the thumb, index and middle fingers of the working hand in the morning, which goes away after a couple of hours and is no longer noticeable during the day. Already in the presence of such symptoms, you need to seek medical help, since later the hands will begin to go numb at night, and then during the day, it will become problematic to hold objects with the affected hand, and it will increasingly lose function.

Painful sensations initially have the nature of tingling or burning, appearing during a night's rest or in the morning. The patient has to wake up and lower the sore arm down (the pain goes away from this). At first one or two fingers hurt, then gradually the whole palm is involved in the process, and even the arm up to the elbow.

The motor skills of the hand are impaired, the fingers, and over time the hand itself weakens, it becomes difficult to hold objects, especially small and thin ones.

In advanced stages of the disease, sensitivity decreases, the affected limb is constantly numb, and later it ceases to feel touch and even pricks with a sharp object. Atrophic processes occur in muscles and skin.

Symptoms of ulnar nerve neuropathy also begin with numbness and tingling localized in the cubital fossa, along the dorsum of the forearm and hand, including the ring and little fingers. Pain in the same localization and motor disturbances increase, then loss of sensitivity and muscle wasting - in this sequence, cubital canal syndrome develops.

With Guyon's canal syndrome, sensations are localized and increase on the palmar surface.

With mild degrees of neuropathy, there are no serious motor and sensory impairments yet, so the likelihood of recovery depends on timely seeking help.

Complications and consequences

As already mentioned, in the initial stages the sensations associated with neuropathies are quite tolerable and, if you do not pay attention to them, the condition begins to worsen. The muscles hypertrophy, the hand works worse and worse.

Without treatment, the process may end in irreversible atrophy of muscle tissue. Visually, the limb decreases in volume, the hand is deformed and becomes similar to the palm of a primate - flat, with the thumb pressed to it.

Sometimes, with partial damage to the median, or even less often, the ulnar nerve, a causalgic syndrome develops. This is how injuries are complicated when, at the moment of scarring of the wound, irritation of the afferent receptors of nerve cells occurs, which leads to intense, simply unbearable pain. Of course, in such a state it is impossible not to seek help. Causalgia appears approximately on the fifth day after injury, and sometimes a little later, for example, after two weeks.

Axonal neuropathy is characterized by slow development and long duration. Without treatment, the process ends with complete atrophy of muscles deprived of innervation and loss of limb mobility (the arm “shrinks out”).

Demyelinating neuropathy is characterized by a fairly rapid development of the disease, while sensitivity is impaired and motor functions are lost.

Diagnosis of upper limb neuropathy

At the first symptoms of discomfort - tingling, numbness, burning, soreness, limited motor skills, muscle weakness, you should contact a medical facility.

When interviewing a patient, not only the symptoms that bother him are considered, but also occupational risks, the presence of bad habits, previous injuries and the possibility of intoxication. The presence of chronic diseases, previous infections, and genetic predisposition are taken into account.

Clinical blood and urine tests are prescribed, a blood test for glucose levels, thyroid hormones, protein levels, and B vitamins. A blood and urine test for toxic substances may be prescribed.

The nerve trunks are directly palpated, a biopsy of the nerve fibers is performed, and the depth of their damage is determined. A study of cerebrospinal fluid, testing of nervous reflexes and reactions may be prescribed.

Instrumental diagnostics are carried out: electroneuromyography, radiography, ultrasound examination of the condition of internal organs.

Consultations with doctors of other specialties, additional tests and studies may be prescribed.

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Differential diagnosis

Differential diagnosis is carried out based on the results of examination, results of laboratory and instrumental studies.

Often, with a long course of the disease, neuropathy can be determined even visually by a violation of the symmetry and motor skills of the upper extremities. Laboratory diagnostics help to understand the cause of nerve damage, establish the presence of metabolic disorders, autoimmune process, inflammation and infections. Specific tests make it possible to identify characteristic antibodies and antigens, the content of vitamins and proteins in the blood plasma.

Instrumental studies show a decrease in the speed of the nerve impulse or its absence (atrophy), a decrease in the activity of muscle fibers.

Special diagnostic tests can reveal which nerve has been damaged. For example, with motor neuropathy of the ulnar nerve, the patient cannot clench the affected hand into a fist because the ring and little fingers do not bend. He also cannot spread his fingers like a fan and then bring them together, press his hand to the surface of the table and scratch it with his little finger. Touch reflexes partially or completely disappear on the ring finger and little finger, on the forearm and hand from the elbow.

Neuropathy of the upper extremities is a very common pathology in the practice of a neurologist. Damage may affect one or several nerves, resulting in a different clinical picture of the disease. Regardless of the causes of the disease, the patient begins to experience discomfort, loss of sensitivity, pain and other symptoms.

Causes

Many patients, faced with the problem of neuropathy of the upper extremities, attribute them to fatigue and lack of sleep, believing that appropriate rest will help eliminate them and restore strength.

In fact, so-called mononeuropathies (damage to one nerve fiber) usually develop when a nerve is compressed at the site of its superficial passage under the skin, or in narrow bone canals.

Dozens of reasons can lead to hand polyneuropathy. The most common of them are:

previous operations (in the place where there was surgery, over time, blood stops circulating normally, which contributes to the formation of edema and muscle atrophy, as well as compression of passing nerve bundles);
injuries to the extremities, in which swelling develops, leading to compression of the nerve;
regular hypothermia;
irradiation;
strong and excessive physical stress on the muscles of the limbs;
endocrine diseases, including diabetes;
intoxication of the body;
lack of vitamins of certain groups in the body (most often group B);
tumor diseases;
various previous infections, for example, influenza, HIV, malaria, herpes, diphtheria, tuberculosis, etc.;
long-term use of medications containing phenytoin, chloroquine.

Types of disease

There are three main nerves in the human hand:

ray;
median;

Accordingly, the defeat of each of them will have its own characteristic manifestations, which we will consider below.

Radial nerve neuropathy

The radial nerve is damaged most often as a result of compression (compression). This can occur during deep sleep when the shoulder and radial nerve are compressed by the head or torso (sleep paralysis). Often, compression occurs as a result of a fracture of the humerus, compression by a tourniquet or other hard matter, an incorrect injection, or after squeezing the shoulder with a crutch (“crutch” paralysis).

The clinical picture of radial nerve neuropathy depends on the location of the damage.

When a nerve is damaged in the area of the axillary fossa, a symptom of a drooping hand appears: when the patient tries to raise his arm up, the hand hangs helplessly. With compression in the middle brachial third, the symptoms are mild or absent altogether. If the lower third is damaged, the patient is only concerned about the inability to straighten the fingers and hand as a whole, as well as the lack of sensitivity on the back of the hand.

Below is a video about radial nerve neuropathy - a fragment of the program “Live Healthy”:

Median nerve neuropathy

The cause of neuropathy of the median nerve can be trauma, violation of the technique of administering an injection into the ulnar vein, wounds of the palmar surface of the forearm, as well as overexertion of the hand of a professional nature in musicians, seamstresses, and carpenters.

If the median nerve is damaged, the patient is unable to rotate the hand, bend the wrists, or the first three fingers. Sensitivity on the palmar surface decreases, and over time, atrophy of the hand muscles develops. As a result, the patient is unable to make a fist or move his fingers, which significantly impairs his quality of life and ability to self-care.

Ulnar nerve neuropathy is observed in people who work for a long time with their elbows resting on a machine, a desk, or simply like to lean on the armrests of chairs. The causes of the lesion are also sprains, tears of the ulnar nerve, as well as diseases such as: rheumatoid arthritis, arthrosis deformans, chondromalacia, chondromatosis, deformation of bones or connective tissue, thickening of tendon sheaths

In the case of a complete rupture of the nerve trunk, the patient is concerned about the loss of sensitivity in the skin of the little finger and half of the ring finger, paralysis (impaired function) of the muscles of the thumb. In the case of incomplete (partial) damage, the disease is accompanied by:

weakness of the hand muscles;
decrease in muscle volume in the area of the thumb and index finger;
tingling sensation and paresthesia on the inside of the palm;
numbness and loss of sensitivity of the last two fingers (little finger and ring finger);
pain along the ulnar nerve.

Symptoms common to neuropathies of the upper extremities

Symptoms can be divided into main and accompanying ones. The main ones are characterized by burning pain that haunts the patient throughout the day, and a feeling of numbness in the fingers, hand and arm as a whole. Associated symptoms appear:

swelling;
cramps, spasms, involuntary muscle contractions;
unpleasant sensations of “goosebumps”;
decreased temperature sensitivity;
impaired coordination of movements;
Difficulty moving your arms.

Diagnosis of the disease

To select the correct treatment method, a complete neurological examination of the patient, assessment of reflexes, muscle strength, and special tests are very important.

Instrumental diagnostic methods are:

radiography;

These methods allow you to detect a damaged nerve, find out the cause and degree of conduction disturbance. If necessary, the doctor may refer the patient for additional laboratory tests to rule out other pathologies. Only after the results obtained can a diagnosis be made.

Treatment

The main goal of treatment is to eliminate the cause that led to damage to the nerve fibers, as well as restore the motor and sensory functions of the fingers, hands and arms. During the treatment of neuropathy of the upper extremities, the following are prescribed:

non-steroidal anti-inflammatory drugs,
drugs with analgesic effects;
vitamins;
anticonvulsants that relieve burning neuropathic pain well.

In case of violation of the integrity of the nerve trunk, surgical intervention is performed.

Prevention

Prevention of neuropathy of the upper extremities consists of normalizing metabolic processes and timely treatment of systemic and infectious diseases. It is also important to regularly devote time to physical exercise, not to sit for a long time in an uncomfortable position, and to do minute “warm-ups” at work.

Neuropathy is a non-inflammatory disease of the nervous system that progresses due to damage or depletion of nerve cells. Pathology has no restrictions regarding age or gender. It is worth noting that this painful condition can affect either one nerve fiber or several at once, and they are not always located at the same point in the body.

Etiology

The manifestation of symptoms of the disease can be caused by many reasons. Among the most common are the following:

metabolic disorder;
traumatization of nerve fibers of any severity level;
the presence of benign or malignant tumors;
pathologies of blood vessels;
intoxication of the body;
endocrine diseases;
decreased body reactivity;
blood pathologies;
chronic alcoholism;
infections of viral and bacterial nature;
severe hypothermia of the body;
hereditary factor.

Varieties

In medicine, several classifications of the disease are used, which are based on the causes of occurrence and the nature of damage to nerve fibers.

Classification depending on the reasons for the progression of the pathology:

diabetic neuropathy. This form of pathology progresses against the background of a decrease in blood glucose concentration. Usually develops with;
post-traumatic neuropathy. The main reasons for its progression are mechanical trauma to the nerve fiber and its branches, compression of them, or surgical intervention in the affected area. In most clinical situations, this form of pathology affects the ulnar nerve, sciatic, radial, and also the nerves of the lower extremities. The most common causes of injury are neuropathy of the radial, peroneal, and ulnar nerves;
alcoholic neuropathy. The reason for the progression is the consumption of large quantities of drinks containing high doses of alcohol. This substance, as well as its breakdown products, significantly complicate the metabolic process, in particular, the absorption of vitamins in the intestines. This, in turn, leads to, which becomes the cause of the progression of alcoholic neuropathy;
ischemic form. This type of disease develops due to a disruption in the blood supply to the nerve endings.

Based on the nature of damage to nerve fibers, the following types of disease are distinguished:

sensory neuropathy. It is characterized by a violation of the sensitivity of a certain organ in the human body. Manifested by the absence of pain, numbness and tingling, as well as phantom pain;
peripheral neuropathy. Its progression is said to occur if the physiological process of transmission of nerve impulses from the central nervous system to the organs innervated by the affected nerve fibers is disrupted. As a result, peripheral neuropathy is manifested by the following symptoms: decreased or complete loss of sensitivity, muscle weakness, cramps, tics and impaired coordination of movements (usually this symptom manifests itself in the case of neuropathy of the lower extremities, neuropathy of the radial nerve, etc.);
motor neuropathy. A characteristic symptom is inadequate motor activity. It is noteworthy that no decrease in sensitivity is observed. Characteristic symptoms: the patient makes movements with his limbs that he cannot control, some muscle reflexes disappear, muscle weakness gradually increases;
Autonomic neuropathy. In this case, the innervation of internal organs is disrupted. This form of pathology is rightfully considered the most dangerous, since if it progresses, there is a disruption in the functioning of certain organs and systems. In particular, the patient may have problems with urination, swallowing, and defecation.

Depending on the affected nerve fiber:

peroneal nerve neuropathy;
ulnar nerve neuropathy;
radial nerve neuropathy;
damage to the trigeminal nerve;
damage to the nerves of the lower extremities.

Symptoms

Symptoms of the disease largely depend on which nerve fiber (or fibers) were compressed or injured. In fact, there are quite a lot of signs of this disease, but most of them are not characteristic, which to a certain extent creates difficulties in making an accurate diagnosis.

Diabetic form

Diabetic neuropathy is the most common complication of diabetes mellitus. The most common manifestation of this disease is peripheral neuropathy. Manifestations of the disease are multiple, since the pathological process involves the spinal nerves, as well as the nerves responsible for the functioning of internal organs.

Symptoms of diabetic neuropathy (in case of progression of peripheral neuropathy):

tingling in the legs;
the muscle structures of the limbs may change their shape as diabetic neuropathy progresses;
the patient may note that at one time he feels a strong coldness in the extremities, and at another moment a feeling of heat arises in them;
feeling of "crawling" in the limbs;
pain in the extremities (manifests mainly at night);
increased sensitivity to tactile touch. Sometimes even a light touch can cause pain;
a characteristic sign of peripheral neuropathy is the feeling of gloves or socks on the limbs, but they are bare;
burning in the limbs;
wounds caused by existing peripheral neuropathy take a very long time to heal.

Autonomic diabetic neuropathy manifests itself with the following symptoms:

nausea and vomiting;
dizziness when trying to change body position;
heartburn;
problems with urine output;
, which can manifest itself even in a state of complete rest;
erectile dysfunction;
irregular bowel movements;
even in the case of severe overcrowding of the bladder, there is no urge to urinate;
loss of consciousness, despite there being no apparent reason for this;
increased sweating;
excessive dryness of the skin.

Facial nerve damage

Facial nerve neuropathy is very common. It is also called trigeminal neuropathy in medical literature. Usually it is provoked by hypothermia of the nerve fiber, so the disease has its own seasonality. More often it occurs in the autumn-winter period. Neuropathy of the facial nerve begins acutely - the symptoms and the degree of their severity directly depend on the location of the lesion.

Symptoms of facial nerve neuropathy:

salivation;
half of the face, where the affected nerve is localized, seems to freeze;
violation of taste perception;
with neuropathy of the facial nerve, there is severe pain from the affected nerve;
the eye does not close fully and the person cannot blink;
a characteristic symptom of neuropathy of the facial nerve is the front part of the tongue becomes numb;
lacrimation;
Sometimes severe dryness of the eye may occur.

Peroneal nerve damage

Peroneal nerve neuropathy usually affects girls between the ages of 10 and 19 years. It is worth noting that this disease has a poor prognosis. Peroneal nerve neuropathy can be triggered by injury to the knee joint or ligamentous apparatus, bone fractures, surgical intervention along the path of the nerve fiber, etc.

Symptoms of peroneal nerve neuropathy:

the ability to rotate the foot is gradually lost;
patients may suddenly twist their ankle while walking or running;
inability to bend and straighten your toes normally;
foot drop;
a person cannot walk on his heels.

Therapeutic measures

Treatment of neuropathy should be carried out as soon as the first alarming signs of pathology progression appear. To prescribe the correct course of treatment, you must visit your doctor. Self-medication is not acceptable.

Treatment of neuropathy is performed sequentially. Necessary activities:

elimination of the damaging factor (compression);
elimination of inflammation;
pain relief;
restoration of the full functioning of the affected nerve fiber;
stimulation of regenerative processes;
treatment of ailments that provoked pathology (if any);
relapse prevention.

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Diseases with similar symptoms:

Migraine is a fairly common neurological disease accompanied by severe paroxysmal headaches. Migraine, the symptoms of which are pain, concentrated on one side of the head mainly in the area of the eyes, temples and forehead, nausea, and in some cases vomiting, occurs without reference to brain tumors, stroke and serious head injuries, although and may indicate the relevance of the development of certain pathologies.

The pathological effect on the entire body, caused by extremely large damage to the extensive network of peripheral nerve roots, intervertebral spinal ganglia and nerve plexuses, causes a number of heterogeneous (different in genesis) diseases under the general name - polyneuropathy (PNP).

It is characterized by symmetrical damage to motor-sensory functions with distal localization with gradual spread proximally.

Polyneuropathy - what is it?

It manifests itself as nutritional, vascular disorders and peripheral paralysis in the form of loss of sensitivity - PSP of the lower and upper extremities (like “gloves, socks, golf, etc. in ascending order”).

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Depending on the specific functions of the nerve lesions, the disease manifests itself in several varieties:

If, for example, the neurons responsible for motor functions are affected pathologically, this manifests itself in the patient as a difficult or lost ability to move. This type of polyneuropathy is called motor polyneuropathy.
The sensory form is caused by damage to the nerve fibers that control sensitivity.
Pathological effects on autonomic neurons (due to hypothermia, atony) cause insufficiency of nervous regulation of the functions of internal organs.

About the causes

The disorders are caused by two types of nerve damage - demyelinating (the nerve sheath is affected) and axonal (impairments in the axial cylinder of the nerve).

The axonal appearance is observed in all forms of the disease with a difference in the prevalence of motor or sensory disorders. With this type of disease, it is often diagnosed alcoholic polyneuropathy.

It is provoked not only by the duration of alcohol intake, but also by its quality, since low-quality drinks contain many toxic substances harmful to the body.

The genesis of pathological influences that can cause extensive lesions in peripheral nerves is due to many factors.

These may be certain hereditary genetic disorders that provoke the development of PSP;
Failures in metabolic processes. This includes uremia and diabetes, characterized by high levels of protein metabolic products in the blood.
Immune function disorders, manifested by increased production of antibodies that attack one’s own nervous system.
Systemic pathologies that provoke the development of autonomic polyneuropathy.
Dangerous bacterial or viral infections.
Intoxication due to poisoning (medicines, alcohol, industrial solvents, etc.).

Depending on the provoking factor, polyneuropathy manifests itself in many forms:

toxic, fungal and diabetic;
inflammatory, traumatic or allergic;
diphtheria, vegetative, or serum.

It should be noted that diabetic polyneuropathy, as a complication of diabetes, occurs much more often than other forms of the disease.

The most characteristic symptoms of the disease are caused by peripheral disorders in the extremities (upper and lower). In this case, neural damage can be localized only in the arms, or only in the legs, or manifest itself as extensive damage to all nervous tissues of the extremities at the same time.

The symptoms of polyneuropathy of the upper extremities are quite characteristic - according to the genesis of development, this type of pathology can be a consequence of axonal and demyelinating lesions. According to the clinical course, it manifests itself with signs of impairment of autonomic, sensory and motor functions. It rarely manifests itself in any one type of disorder; variations in several types of symptoms are more often observed, manifesting itself:

Pain syndrome of the branches of the median, ulnar or radial nerve, according to the length of its localization. Often the pain ascends from distant distal parts - starting with a pain syndrome from the hands and palms of the hands, gradually ascending to the wrist to the area of the forearm and shoulder. Damage to neurons provokes muscle pathologies that are innervated by them.
The development of muscle weakness, their convulsive contractions, or the degeneration of muscle fibers, with a decrease in the mass of muscle tissue or their necrosis.
Muscle weakness that contributes to impaired fine motor skills of the fingers, leading to problems associated with performing habitual physical activities.
Muscle dystrophy, which can manifest itself as shortening and decreased extensibility, which is manifested by a violation of extensor functions in certain parts of the limb.
Numbness of the skin on the hands, a feeling of “crawling goosebumps”, or a complete loss of any sensitivity.
Baldness of the hands and dysfunction of hydrosis (sweating).

The symptoms of polyneuropathy of the lower extremities are caused by the influence of diabetes, alcohol intoxication, vitamin deficiency (“B1” and “B12”), blood diseases, infections and other pathological origins.

Basically, this PSP refers to manifestations of axonal forms of the disease. Depending on the trend of the clinical course, the symptoms of various forms of this pathology can be acute, subacute, chronic and recurrent forms of manifestation.

Acute symptoms develop within 2-4 days. After a couple of weeks, symptoms increase, moving to the subacute stage.

The long-term, progressive nature of the disease is due to the development of chronic pathology. The recurrent nature of the disease is manifested by serious dysfunctions in the lower extremities.

Initial signs include loss of skin sensitivity on the soles of the feet. Patients may not feel pain from minor abrasions and wounds caused by ill-fitting shoes.
“Goosebumps” and numbness are felt along the nerve tract.
As the process progresses, loss of sensitivity of the skin is noted over the entire surface of the legs.
There are symptoms of muscle disorders, manifested by the development of signs of contracture of small plantar muscles and a decrease in muscle strength in large muscles.
Functional pathologies in large muscles provoke a dramatic decrease in the patient’s physical strength, due to the inability of the legs to support the patient’s weight.
“Vegetation” disappears on the skin of the legs, hydrosis is disrupted, and pain occurs in various areas of the limbs.

In addition to these symptoms, the skin color on the legs may change, swelling in the distal areas may appear, and the temperature of the legs may change. With alcoholic polyneuropathy, the above-described symptoms can increase over weeks and months and continue for many years. Until you stop drinking alcohol, you cannot cope with the disease.

Although the symptoms of PSP of the upper extremities are slightly different from the symptoms of polyneuropathy of the lower extremities, the treatment of the pathology is identical. And the sooner it is started, the more effective it will be.

Treatment of polyneuropathy - drugs and techniques

Treatment of polyneuropathy of the upper and lower extremities is complex, complex and lengthy. The main factor is the restoration of the impaired functions of the affected neurons and the elimination of the causative factor.

For example, when treating diabetic polyneuropathy, it is necessary to normalize blood sugar levels, for alcoholic and toxic PNP, to eliminate the damaging effects, and for infectious pathology, to cure the underlying infection.

Drugs used to treat PSP are caused by different mechanisms of influence on the elimination of pathology.

To stimulate restoration processes in neurons and reduce pain, drugs based on alpha-lipolyic acid - "Tiogamma" or "Berlition" - and vitamin group drugs - "Kombilipena", "Milgamma", "Compligamma" and "Neurobiona" are prescribed.
Correction of pain in the extremities in this disease with conventional analgesics, anti-inflammatory and non-steroidal drugs does not give positive results. To relieve it, anticonvulsants are used that inhibit the spread of pain impulses from damaged neurons - Pregabalin, Finlepsin or Gabapentin.
Antidepressants that inhibit pain impulses - Amitriptyline, Duloxetine or Venlafaxine.
Local anesthetics, in the form of ointment, sheets or gel with lidocaine base, cream and pepper patches containing capsaicin. To avoid burns, half an hour before attaching the pepper patch, the attachment site is pre-lubricated with a cream containing lidocaine base.
For severe, prolonged pain symptoms, the action of the opioid analgesic Tramadol helps well. The combination product “Zoldiar” is a very effective combination of “Tramadol” and “Paracetamol”.
To reduce increased muscle tone, a drug of narcotic properties is used - “Baclofen” and its analogues in strictly prescribed dosages and a certain course of treatment.

In addition to drug therapy, physiotherapeutic treatment is prescribed - magnetotherapy, which has a therapeutic effect on nerve tissue, electrical stimulation, reflexology and therapeutic massage techniques. To maintain muscle tone, a course of physical therapy is prescribed.

The patient is given a special diet that excludes carbohydrates and foods rich in fat. For the entire treatment and recovery period, you should avoid using stimulants and stimulants and stop smoking.

Prognosis for PSP

Depending on the origin and clinical manifestations, polyneuropathy can put the patient in bed for a long time. A favorable prognosis is possible with complete and timely treatment.

An exception may be polyneuropathy of hereditary origin. It cannot be completely cured; it is only possible to alleviate the severity and severity of the symptoms.