Numbness and burning sensation in the ankle and foot
Introduction
Introduction Anesthesia and numbness and burning sensation are a neuropsychiatric symptom of beriberi patients. The beriberi disease is vitamin B1 deficiency, and the vitamin B1, Thiamine, is a precursor of thiamine pyrophosphate (TPP). TPP is an important coenzyme for the decarboxylation of pyruvic acid and -ketoglutaric acid in the Krebs cycle, and is also a coenzyme of erythrocyte ketol transferase. In addition, there is a certain relationship between brain cell activity and nerve impulse conduction. Once lacking, it can cause a series of symptoms of the nervous system and circulatory system, called beriberi.
Cause
Cause
(1) Vitamin B1 is too small. The daily intake of normal adult males is 1.2-1.5 mg, and females 1.0-1.1 mg, which are related to energy demand, generally not less than 0.5 mg/1000 kcal. Vitamin B1 is abundant in yeast, animal tissues, beans, peanuts, wheat, brown rice. After grain refining or improper storage, mildew and deterioration, vitamin B1 can be lost. Thiamine is a water-soluble vitamin that is not resistant to high temperatures under alkaline conditions, so improper cooking can be lost or destroyed with rice soup and soup. In addition, loss of appetite, heavy drinking, long-term intravenous nutrition can cause insufficient intake of vitamin B1.
(B), increased demand in physiological conditions, such as growth and development period, pregnancy and lactation, strong physical labor and exercisers, or high-carbohydrate, low-fat, low-protein diet structure, vitamin B1 demand increase. In pathological conditions, such as thyrotoxicosis, long-term fever, and chronic wasting disease, vitamin B1 demand also increases.
(3) Absorption barrier Vitamin B1 is absorbed in the small intestine in the form of passive diffusion and active transport according to the concentration, and the amount of storage in the body is small. Chronic diarrhea, intestinal tuberculosis, intestinal typhoid and other diseases can cause vitamin B1 malabsorption. Alcohol abuse, chronic malnutrition and folate deficiency may also present with malabsorption. In addition to malabsorption, patients with alcoholic liver disease are also associated with an intermediate metabolic disorder in which thiamine is converted to thiamine pyrophosphate.
(D), decomposition and increase the consumption of certain thiamine-containing foods, such as sashimi, oysters, shrimp, coffee, tea and other plants, can oxidize vitamins, so that the body's thiamine levels are reduced.
(V), excretion increases the excretion of vitamin B1 in the urine is mainly thiamine itself (excreted by renal tubules) and acetylated derivatives, thiazole acetate derivatives. When a diuretic is used, vitamin B1 can be lost too much. In addition, hemodialysis, peritoneal dialysis, or diarrhea can also cause loss of vitamin B1.
Examine
an examination
Related inspection
Vitamin B1 (VitB1, VB1) Vitamin B1
Mainly based on the history of nutritional deficiencies and clinical manifestations. The diagnosis of peripheral neuritis can be determined by the following method:
1 test, when the patient takes a posture, it feels pain in the calf and difficulty in standing up. It is often used to support the knee to help stand up.
2 There is pain when the gastrocnemius muscle is squeezed.
3 foot back, sputum, lower tactile sense of the lower leg and pain.
4, knee reflex abnormalities, mostly decreased or disappeared.
The basis for the diagnosis of fulminant beriberi heart disease is:
1 There are more than 3 months of vitamin B1 nutritional deficiency and signs of peripheral neuritis.
2 High-volume heart failure that occurs suddenly, accompanied by polydipsia.
3 heart enlargement, rhythm rules, no other causes can be investigated.
4 For the suspicious case immediately for the treatment test, the symptoms of the disease quickly improved after treatment.
Diagnosis
Differential diagnosis
Vitamin B1 deficiency in peripheral neuritis manifestations must be differentiated from lead poisoning, arsenic poisoning and infection caused by diphtheria, bacillary dysentery, leprosy and other infections. Patients with edema must be distinguished from nephritis, malnutrition and physiological edema. Urine routine examination, plasma protein determination, and examination of the presence or absence of concomitant peripheral neuropathic symptoms are helpful for diagnosis. Patients with heart failure should be identified with other high-output heart disease with heart failure, such as hyperthyroidism, anemia, and toxic, viral myocarditis.
In alcoholics, vitamin B1 deficiency can be accompanied by liver disease and alcoholism, sometimes difficult to distinguish, and careful diagnosis is needed.
Mainly based on the history of nutritional deficiencies and clinical manifestations. The diagnosis of peripheral neuritis can be determined by the following method: 1 test, when the patient takes a posture, it feels pain in the calf and difficulty in standing up. It is often used to support the knee to help stand up. 2 There is pain when the gastrocnemius muscle is squeezed. 3 foot back, sputum, lower tactile sense of the lower leg and pain. 4, knee reflex abnormalities, mostly decreased or disappeared.
The basis for the diagnosis of fulminant beriberi heart disease is: 1 history of vitamin B1 nutritional deficiency and signs of peripheral neuritis for more than 3 months. 2 High-volume heart failure that occurs suddenly, accompanied by polydipsia. 3 heart enlargement, rhythm rules, no other causes can be investigated. 4 For the suspicious case immediately for the treatment test, the symptoms of the disease quickly improved after treatment.
