peripheral neuritis
Introduction
Introduction to peripheral neuritis Peripheral neuritis is complicated by infection or inflammation in most cases, and is also called peripheral neuropathy. The disease is caused by a variety of causes of peripheral neuropathy (including cranial nerves and spinal nerves), manifested as sensory, motor and autonomic dysfunction within the range of damaged innervation, multiple or singular, symmetrical or asymmetrical Is a more common disease of the nervous system. It can occur at any age. In the acute phase, bed rest should be performed. For multiple causes of polyneuritis, high-dose B vitamins, vitB1, B6, and B12, and severe cases of ATP and coenzyme A can be used. Apparent pain relievers, sedatives such as carbamazepine. Adrenal corticosteroids such as prednisone, dexamethasone or hydrocortisone can be used in inflammatory demyelinating lesions. The vasodilator niacin (50~100mg/time) and the diazepam 5~10mg/time can also be used. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific population Mode of infection: non-infectious Complications: Somatosensory Disorders Movement Disorders
Cause
Causes of peripheral neuritis
Some collagen diseases (20%):
Such as disseminated lupus erythematosus, rheumatoid arthritis, etc.; allergic reactions, such as various immune serum injections, after vaccination (such as tetanus antitoxin and rabies vaccine) can also cause neuritis.
Infection (20%):
Often accompanied or secondary to various acute and chronic infections, such as dysentery, tuberculosis, infectious hepatitis, typhoid, mumps and other minor causes of direct invasion of peripheral nerves caused by pathogens, such as leprosy and other nutritional disorders: diabetes, athlete's foot Disease (deficiency of vitB1), pellagra and chronic alcoholism can be complicated by peripheral neuritis.
Poisoning (15%):
Such as lead, arsenic, mercury, phosphorus and other heavy metals; nitrofurazone isoniazid streptomycin phenytoin carbamazepine, vincristine and other drugs and organic phosphorus pesticides and other organic compounds.
Family genetic factors (10%):
Such as progressive hypertrophic polyneuropathy, hereditary sensory neuropathy.
Nutritional metabolic disorders (15%):
Such as B vitamin deficiency, diabetes, uremia, chronic strict gastrointestinal disease accumulation, pregnancy and so on.
Other (15%):
Unexplained multiple neuropathy, recurrent polyneuropathy, chronic progressive polyneuropathy. The lesions caused by any cause often cause axonal degeneration and segmental demyelination, that is, the segmental myelin destructive degeneration of nerve fibers varies in length, and Schwann cell proliferation and phagocytosis can also cause neuronal degeneration. Necrosis.
Prevention
Peripheral neuritis prevention
1, usually exercise properly.
2, maintain a good attitude, avoid anger or excessive depression, eliminate the psychological state of tension, agitation, etc., to maintain a comfortable and open-minded mood, emotional stability.
3, the diet should be rich in nutrients, light, avoid the thick taste of the cream, especially avoid alcohol and tobacco.
4, the regularity of daily life, the house has a section, so as not to further deplete the righteousness.
Complication
Peripheral neuritis complications Complications somatosensory disorders dyskinesia
First, the sensory disorder : In the initial stage, the finger (or toe) end of the burning, pain, numbness and other irritating symptoms such as paresthesia or hyperesthesia, gradually appear to feel reduced or even disappear. The distribution of sensory disturbances is in the form of a glove or a sock. A small number of patients may have deep sensory disturbances. There is often tenderness in the gastrocnemius and other places.
Second, dyskinesia: manifested as muscle weakness, low muscle tone, sputum reflexes weakened or disappeared, and the reflexes caused by individual causes (such as nitrofurazone) can be active. There may be muscle atrophy after a long illness.
Third, autonomic dysfunction : the skin of the extremities is cold, pale, flushed or mildly bun, less sweat or sweaty, the skin becomes thinner and tenderer or rougher, and the nails lose normal luster and keratinization.
Symptom
Symptoms of peripheral neuropathy Common symptoms Autonomic dysfunction Nasal labial sulcus Shallow muscle atrophy Sensory disorder Muscle tone Reduced ptosis Sensation Fingertip pain or tenderness Nervous nerve fiber nerve damage Neurological fracture
Mainly symmetrical limb movements, sensations and autonomic dysfunction.
1, feeling symptoms : the beginning of the disease is mostly numbness or pain in the extremities, but also may have allergies or abnormalities, such as ants walking feeling, after the feeling of decline or even disappear, the typical is glove, sock-type sensory disturbance.
2, motor symptoms : the distal part of the extremities are mainly flaccid type incomplete paralysis, muscle tension is reduced, against reduction or disappear, and later muscle atrophy.
3, autonomic dysfunction : such as hand and foot vasomotor, sweating, pale skin, cold or red fever, tender or hyperkeratosis, dry and easy to crack; in addition, due to different causes, clinical manifestations have their own characteristics, If the furan drug is poisoned, the movement disorder is not obvious, and the pain and autonomic symptoms are prominent. If it is a single cranial neuropathy, it is common for peripheral facial neuritis (Bell facial paralysis): half face facial muscle spasm, frontal line disappears, eye closure is incomplete, diseased nasolabial fold becomes shallow, mouth angle droops, mouth when mouth Healthy side.
Examine
Peripheral neuritis check
According to the history, physical signs, and distribution of damaged nerves, it is determined whether the lesion is mononeuropathy, majority (monofocal) mononeuropathy or polyneuropathy can be examined by visual inspection, such as vasomotor contraction of the hands and feet, sweating, pale skin, change Cold or red fever, tenderness or excessive keratinization, dry and cracking, etc., can be initially determined. Note that palpation is combined with clinical symptoms to make a diagnosis.
Diagnosis
Diagnosis and diagnosis of peripheral neuritis
Single neuropathy refers to a local lesion of a peripheral nerve trunk or plexus, such as inflammation, vascular disease, etc. Most single neuropathy refers to the simultaneous or sequential damage of two or more non-adjacent nerve trunks, and the lesion is multifocal. The cause is inflammatory demyelination and vasculitis of connective tissue disease. Polyneuropathy refers to peripheral symmetry of peripheral nerves with severe distal extremities, such as poisoning, nutritional deficiencies, and systemic metabolic diseases.
