multiple peripheral neuritis
Introduction
Introduction to multiple peripheral neuritis The general term for multiple peripheral nerve damage caused by multiple causes of multiple peripheral neuritis is mainly characterized by distal symmetry of the limb, motor and autonomic dysfunction. In addition to a few causes (such as leprosy) caused by inflammatory changes in the peripheral nerves, pathological changes are mainly segmental demyelinating changes and axonal changes in the peripheral nerves, or both, a few cases may be associated with neuromuscular The connection point changes. basic knowledge Sickness ratio: 0.0004% Susceptible people: no specific population Mode of infection: non-infectious Complications: peripheral neuritis periodic paralysis progressive bulbar palsy diarrhea
Cause
Causes of multiple peripheral neuritis
There are several common causes:
1. Poisoning: such as lead, arsenic, mercury, phosphorus and other heavy metals, nitrofurazone, isoniazid, streptomycin, phenytoin, carbamazepine, vincristine and other organic compounds such as organophosphorus pesticides.
2. Nutritional metabolic disorders: such as B vitamin deficiency, diabetes, uremia, chronic digestive tract diseases, pregnancy, etc.
3. Infection: often accompanied by or secondary to various acute and chronic infections, such as dysentery, tuberculosis, infectious hepatitis, typhoid, mumps, etc., a small number may be caused by direct invasion of peripheral nerves by pathogens, such as leprosy.
4. Allergies, allergies: such as serum therapy or neuritis after vaccination.
5. Others: such as connective tissue diseases, hereditary diseases such as sacral muscular atrophy, hereditary ataxia-induced peripheral neuritis, hereditary sensory radiculopathy, etc. In addition, various cancers of the body can also cause polyneuritis And can occur several months before the clinical symptoms of the primary lesion, should be alert.
In addition to a few causes (such as leprosy) caused by inflammatory changes in the peripheral nerves, pathological changes are mainly segmental demyelinating changes and axonal changes in the peripheral nerves, or both, a few cases may be associated with neuromuscular The connection point changes.
Prevention
Multiple peripheral neuritis prevention
Strengthen labor protection, prevent metal and pesticide poisoning, and minimize the use of furan drugs (if you need to take it, you can also take vitamin B drugs).
Complication
Multiple peripheral neuropathy complications Complications, peripheral neuritis, periodic paralysis, medullary paralysis, diarrhea
In a small number of cases, the condition develops rapidly, and early cranial nerves, ie affected limbs, have difficulty breathing and tachycardia.
Symptom
Multiple peripheral neuropathy symptoms Common symptoms Muscle tremors limbs wet cold gloves or short socks... Feeling excessive diarrhea cross-threshold gait
1. Symmetrical weakness of the proximal muscles of the extremities, squatting, standing up, difficulty climbing the stairs, difficulty lifting the hands.
2. The neck muscles, throat muscles are weak, difficult to look up, hoarseness, difficulty swallowing. Respiratory muscle weakness causes difficulty in breathing, purpura.
3. Myalgia, neck and shoulder, upper arm, forearm, thigh, calf are more common.
4. Muscle atrophy, more common in the proximal part of the limb.
5. Skin damage, such as edema and purple erythema on the head and face.
6. A small number of fever, joint pain and so on.
Examine
Examination of multiple peripheral neuritis
1. Blood leukocytes can be slightly elevated, dystrophic anemia, diabetes is blood, urine sugar is increased.
2. Electrophysiological examination, MCV (motor nerve conduction velocity), SCV (sensory nerve conduction velocity) can be slowed or disappeared, and EMG (electromyogram) is denervated.
Diagnosis
Diagnosis and diagnosis of multiple peripheral neuritis
1. Limb symmetry weakness with tenderness.
2. Serum enzyme activity is increased, CPK, LDH are high, especially LDH is more sensitive.
3. Spontaneous fibrillation potential and normal phase spikes were seen on the EMG.
4. Muscle biopsy showed muscle fiber degeneration, necrosis, regeneration, inflammatory cell infiltration, vascular endothelial cell proliferation and so on.
