Neuritis
Introduction
Introduction to neuritis Neuritis refers to inflammation, decline, or deterioration of a nerve or nerve group. The symptoms vary with the disease, and the general symptoms are pain, tenderness, and tingling. Infected nerves are itchy and unconscious, with some redness and severe spasms. The disease can be urgently slowed due to different causes of internal medicine. The main clinical skills of the cooperation are symmetry sensorimotor and autonomic dysfunction in the distal part of the medicine, and the lower limbs are often heavier. Vitamin B12 supplement, can not exercise vigorously, should be calm, quit smoking, add calcium, have a healthy mentality, taboo strenuous exercise, stand for a long time, prevent muscle atrophy. basic knowledge The proportion of illness: 0.03%-0.05% Susceptible people: no special people Mode of infection: non-infectious Complications:
Cause
Neuritis cause
Poisoning, nutritional and metabolic disorders (45%):
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. Nutritional metabolic disorders: such as B vitamin deficiency, diabetes, uremia, chronic strict gastrointestinal disease accumulation, pregnancy and so on.
Infection, allergic allergic reaction (35%):
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. Allergic allergies: such as serum treatment awareness or neuritis after vaccination.
Other (5%):
In addition to a few causes (such as leprosy), peripheral nerves have inflammatory changes, the main basis of pathological changes is the segmental demyelination and axonal changes of the peripheral nerves, or a combination of both. May be associated with changes in neuromuscular junctions.
cause:
1. Nerve injuries such as nearby fractures and direct blows.
2. The nerve is infected, such as diabetic blood cancer and gout.
3. Poisoning such as mercury, lead and methanol.
4. The lack of vitamin B in the diet (especially arthritis is vitamin B).
Note: Peripheral neuritis is a general term for multiple peripheral nerve damage caused by a variety of pathogenesis, manifested as symmetry of the distal limbs, motor and autonomic dysfunction, so it is also known as polyneuritis or multiple peripheral neuritis.
Prevention
Neuritis prevention
(1) Strengthen physical exercise and enhance anti-infective ability.
(2) Reasonable adjustment of diet, not only to ensure comprehensive nutrition, but also to prevent overnutrition, leading to obesity, avoid alcohol and tobacco.
(3) Avoid long-term exposure to chemical poisons.
Complication
Neuritis complications Complications
There may be complications such as limb paralysis, occasional segmental or conduction beam type sensory disturbance, and some patients may have cardiovascular dysfunction such as blood pressure instability, tachycardia and abnormal electrocardiogram.
Symptom
Neuroinflammation symptoms Common symptoms Pillow nerve pain, hands and feet, numbness, dysfunction, partial numbness, muscle atrophy gloves, or short socks... Little finger, unexplained pain, reflexes disappear
The disease can be urgently slowed due to different causes of internal medicine. The main clinical skills of the cooperation are symmetry sensorimotor and autonomic dysfunction in the distal part of the medicine, and the lower limbs are often heavier.
First, the feeling of obstacles:
In the initial stage, the finger (or toe) end is often stimulated by sensation of sensation or allergies such as pain and numbness, and the symptoms gradually decrease or even disappear. The distribution of sensory disturbances is in the form of gloves or socks, and a small number of patients may have deep sensory sensation.
Second, movement disorders:
It is characterized by tight muscle strength, low muscle tone, low sputum reflex, weakened or disappeared. Individual causes (such as nitrofurazone) can be reflexed after active disease for a long time. Muscle atrophy after severe exercise, numbness in the legs after exercise, dysfunction, unstable standing The feet are barely numb.
Third, autonomic dysfunction:
The skin of the extremities is cold and pale flushed or mildly blemishes, sweating or sweaty skin becomes thinner and tenderer or rougher (toe) nails lose normal luster keratinization and so on.
Because the etiology is different, the symptoms of the above three groups may be different. For example, the pain caused by porphyrin poisoning and arsenic poisoning is often severe. The degree of muscle atrophy is sometimes inconsistent with the severity of various clinical manifestations. The light can only have limbs. The pain in the end is numb without loss of sensation or movement disorder, and in severe cases, there may be limb paralysis. The prognosis is generally better.
Examine
Neuritis check
Laboratory testing is helpful for clinical simultaneous diagnosis
EMG: Through this examination, the functional status of peripheral nerves, neurons, neuromuscular junctions, and muscles themselves can be determined.
B-ultrasound: B-ultrasound can detect whether there is space-occupying lesions, especially the physical properties and quantity and volume of effusions and cysts are quite accurate.
Diagnosis
Neuritis diagnosis
diagnosis
The following checks are possible to confirm the diagnosis:
Laboratory tests are helpful for clinical simultaneous diagnosis. In addition, muscle and B-ultrasound can be performed.
Differential diagnosis
According to the onset form and clinical features, there is no difficulty in diagnosis, but it needs to be differentiated from the following diseases:
First, the central facial paralysis: due to damage to the contralateral cortical brain stem, only the lesions of the contralateral side of the facial muscle facial paralysis.
Second, the identification of peripheral facial paralysis caused by other causes:
(A) acute infectious polyneuritis: may have peripheral facial paralysis, but often bilateral, most with other cranial nerves and limb symmetry and cerebrospinal fluid protein cell separation phenomenon.
(2) Bridge brain damage: the cerebral nucleus and its fibrous damage may have peripheral facial paralysis, but often accompanied by adjacent structures inside the pons, such as abductor nerve, trigeminal nerve, pyramidal tract, spinal cord and other damage, The ipsilateral extraocular rectus tendon, facial dysfunction and contralateral limb spasm (cross sputum) appear in the tumor, inflammation, vascular disease and so on.
(C) cerebellopontine angle damage: more damage to the trigeminal nerve, the auditory nerve, ipsilateral cerebellum and medulla, so in addition to peripheral facial paralysis, there may be pain in the same side of the pain, tinnitus, deafness, dizziness, nystagmus, limbs Ataxia and contralateral limb spasm and other symptoms, called "Cerebellar cerebral horn syndrome", more common in this part of the tumor, inflammation and so on.
(4) Structural lesions adjacent to the facial nerve canal: seen in otitis media, mastoiditis, middle ear mastoid surgery and skull base fracture, etc., may have corresponding medical history and clinical symptoms.
(5) Diseases other than stems and pores: seen in mumps, parotid gland tumors, jaw neck and parotid area surgery, in addition to peripheral facial paralysis, there is a history and clinical manifestations of the corresponding diseases.
