somatic neuropathy
Introduction
Introduction to somatic neuropathy Reflective somatic neuropathy (also known as somatic neuropathy, reflex sympathetic dystrophy). It refers to a disease in which the lateral limbs are caused by a slight traumatic injury or contracture caused by slight trauma of the hand and foot, accompanied by obvious autonomic dysfunction as the main clinical manifestation. The disease is mainly caused by minor trauma to the extremities, such as stab wounds, bruises, cuts, earthquakes, acupuncture or acupoint injections, etc., which damage the median nerves, phrenic nerves, sacral nerves and other peripheral nerves rich in sympathetic nerve fibers. Forming a permanent stimulation spot at the wound, stimulating the proprioception and deep pain fibers, and sending out pathological impulses, continuously transmitted to the spinal cord, forming pathological dominant lesions in the corresponding and adjacent segments of the spinal cord, when the pathological dominant lesions The anterior horn of the spinal cord is characterized by reflex palsy when inhibited, and reflex sputum when excitatory is dominant. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications:
Cause
Cause of somatic neuropathy
Cause:
The disease is mainly caused by minor trauma to the extremities, such as stab wounds, bruises, cuts, earthquakes, acupuncture or acupoint injections, etc., which damage the median nerves, phrenic nerves, sacral nerves and other peripheral nerves rich in sympathetic nerve fibers. Forming a permanent stimulation spot at the wound, stimulating the proprioception and deep pain fibers, and sending out pathological impulses, continuously transmitted to the spinal cord, forming pathological dominant lesions in the corresponding and adjacent segments of the spinal cord, when the pathological dominant lesions The anterior horn of the spinal cord is characterized by reflex palsy when inhibited, and reflex sputum when excitatory is dominant.
pathology:
When the pathological dominant lesions affect the lateral autonomic nerve center, there may be autonomic dysfunction. This pathological dominant lesion is limited to one side of the spinal cord and exhibits ipsilateral symptoms. If the contralateral spinal cord segment is simultaneously affected (generalization) , can be expressed as bilateral symptoms, but often manifested as the primary side is heavier, in addition, mental factors, excessive tension also play a role in the occurrence of the disease.
Prevention
Somatic neuropathy prevention
(1) Develop sports, enhance the physical fitness of the people, enhance the body's resistance and immunity, and reduce the occurrence of mental disorders caused by acute and chronic central nervous system infections and mental disorders caused by physical diseases.
(2) Pay attention to labor protection. With the rapid development of industry and agriculture, special attention should be paid to labor protection to reduce mental disorders caused by acute and chronic poisoning caused by mercury, lead, benzene, manganese, carbon monoxide (gas) and certain pesticides. Prevent alcohol abuse, popularize medication knowledge, and avoid mental disorders caused by some mental activity substances.
Complication
Somatic neuropathy complications Complications
Often irritability, emotional instability, insomnia; pigmentation in the injury site, severe cases may also have bone decalcification and joint space widening; muscle atrophy appears earlier, and can affect the entire limb.
Symptom
Symptoms of somatic neuropathy Common symptoms Sensory disorder Skin temperature reduces muscle atrophy
1. Good hair
Occurs in the sympathetic median nerve and the sacral nerve innervation area after minor trauma to the extremities.
2. The nerve damage is mild, and the symptoms are severe and extensive, such as a slight stab wound on one side (toe), can cause the lateral and forearm (foot and calf), and even the axillary and muscular atrophy of the entire limb and contralateral limb. The dysfunction is extensive and far beyond the dominating area of the nerve.
3. Neurological symptoms
(1) autonomic dysfunction: often within half an hour to several hours after injury (generally 2 to 3 hours), there may be obvious autonomic dysfunction mainly characterized by vasomotor dysfunction. Often manifested by limb swelling (severe and can appear blisters), skin color red, purple or marble pattern, skin temperature is reduced and cold; late stage may have pigmentation of the injury site and long-term does not fade, and finger (toe ) A nutritional change in A. In severe cases, there may be bone decalcification and widening of the joint space.
(2) dyskinesia: more manifestations of severe limb paralysis or contracture. The former appears mostly in the early post-injury, and often manifests as incomplete (a few are complete) ; reflexes are more hyperactive, but also reduce or disappear; the latter appears later, or from . The cause of dyskinesia is due to the reflexive dominant spinal cord lesions and the motor pain caused by limbs and joints. Muscular atrophy occurs earlier and can affect the entire limb. The atrophied muscle has increased excitability for both mechanical stimulation and DC-induced electrical stimulation, but there is no electrical denaturation reaction.
(3) Sensory disorder: mainly pain. Generally, after the injury, the injured limb can have unbearable pain or indescribable discomfort, and the wound or its surroundings can be extended, and even the distant joint can be enlarged. When the joint is active, the pain is obviously aggravated, so the patient I dare not act or even refuse the inspection of medical personnel. Pain can be significantly reduced or only mildly painful or numb when quiet and not moving. Objective examinations are mostly short-sleeved sensations, and a few may have allergies. In severe cases, the long sleeve sensation may be reduced and may reach the torso portion near the proximal end of the limb.
Examine
Examination of somatic neuropathy
Laboratory inspection:
Blood routine, biochemical examination and routine examination of cerebrospinal fluid are mostly non-specific.
Other auxiliary inspections:
Most of the head and limb imaging examinations are normal, but they have differential diagnosis.
Diagnosis
Diagnosis and differentiation of somatic neuropathy
1. Patients with obvious autonomic symptoms should pay attention to the identification of diseases such as erythema limb pain, cellulitis, and contact allergic dermatitis.
2. Apparent movement disorders: should pay attention to the identification of peripheral nerve trauma, snoring and other diseases.
3. Pain symptoms are obvious: should pay attention to the identification of diseases such as burning neuralgia, shoulder hand syndrome.
