Polyneuritis treatment of diabetes mellitus is scientifically proven. Types and treatment of polyneuritis of the lower extremities

Polyneuritis is a disease that is multiple disorders peripheral nerve endings. It manifests itself in the form of paresis, decreased sensitivity, and also in the form of various trophic-type disorders.

Acute or chronic polyneuritis usually develops as a result of exposure to mechanical or toxic factors. Sensitivity disorders lead to changes in the myelin sheath, as well as the interstitium.

Causes of the disease

Polyneuritis occurs due to the influence of such factors:

poisoning of the body with arsenic, lead, mercury, sulfocarbonate or others dangerous poisons, which the kidneys cannot eliminate;
improper treatment of the patient with isoniazid, bismuth or other antibiotics to which the kidneys are sensitive;
viral and bacterial diseases;
oncological diseases;
problems with functioning endocrine gland(eg hypercortisolism);
other diseases internal organs, namely the pancreas, kidneys or liver;
genetic defects.

Polyneuritis is divided into two main groups:

axonopathy. With this type, axons—the cylinders of the nerve axis—are affected. Usually occurs during poisoning toxic substances;
demyelinating type neuropathy. This disease affects the myelin sheath of the nerve endings of the kidneys and other organs. There is a disease that is inherited and an autoimmune type.

A separate type of disease is alcoholic polyneuritis- disease of the nerve trunks. Alcoholic polyneuritis usually affects the distal nerve endings in the kidneys. As a result, the muscles lose strength, paralysis and sensitivity disorders occur. Symptoms of a disease such as alcoholic polyneuritis are usually observed in people who regularly abuse strong alcoholic beverages. Their kidneys cannot cope with the poisons constantly entering the body.

Symptoms

Demyelinating polyneuropathy is characterized by lesions motor fibers. The patient has a disorder of deep reflexes and impaired sensitivity. Also a symptom is loss of vibration sensations and sensitive type ataxia. Clinical symptoms presented peripheral paresis lower or upper limbs. The patient has:

discrepancy between the stage of paresis and the degree of muscle atrophy;
prevailing weakness;
loss of sensation in the limbs;
thinning of the skin on the extremities (usually the hands or feet);
cyanosis on the lower extremities, the presence of swelling and peeling;
fragility of nails.

Chronic polyneuritic syndrome involves the formation of thickenings in the nerves, which leads to rapid sensitivity disorder. To eliminate the factor influencing nerve endings and restore the myelin sheath, it is necessary to carry out competent treatment illness for 6–10 weeks.

Types

The following types of illness are distinguished:

infectious type. Appears due to catarrh of the upper respiratory tract. A variety like infectious polyneuritis involves an increase in temperature, as well as inflammation of cells;
diphtheria type. Appears when treatment is started incorrectly or untimely. The soft palate is paralyzed, the nasal tone in the voice increases. Eating due to illness vagus nerve, usually difficult;
lead type. It often appears due to the consumption of sour berry jam, which was preserved in clay dishes. The disease affects the radial nerves. The patient complains of abdominal pain, as well as lead plaque in the gum area;
arsenic type. There are two types: household and professional. Signs of the disease include stomach pain, vomiting and paralysis. lower limbs;
diabetic type. Suggests nerve damage to the face, arms, or legs;
professional type. Occurs in people whose professional activity associated with tools that produce vibration or work involving strong tension muscles. Symptoms include pain in the hand, pale fingertips and sweating.

Treatment

Treatment of polyneuritis, as a rule, differs depending on the cause of its occurrence and the degree of sensitivity disorder. After a thorough diagnosis, the doctor will find out the causes of the disease and prescribe precise treatment to minimize the consequences of the disease.

The doctor can treat different stages of the pathology in different ways, and here a big role is played by how timely the therapy was started. If this vegetative disease is in initial stage, used drug therapy. The doctor prescribes the following drugs to the patient:

anti-inflammatory;
painkillers;
accelerating metabolism in tissues;
stimulating limb movements.

If the patient experiences an exacerbation of the disease and the symptoms of the disease intensify, he is prescribed treatment using physiotherapy (UHF therapy, electrophoresis).

It is also important to take care of proper nutrition. It is especially important for the patient to include foods containing vitamin B1 in his diet. It is found in yeast rye bread and liver. If the patient has a history of diabetes, they should also limit their carbohydrate intake.

Except proper nutrition doctors recommend exercising physical therapy. Also, massage and mud baths will be an excellent addition to the complex of treatment of sensitivity disorders. Folk remedies can only act as an addition to the main course of treatment, and each of them must be agreed upon and approved by the patient’s attending physician. Folk remedies for polyneuritis cannot be taken independently without the knowledge of a doctor, as this can only aggravate the course of the disease.

As preventative measure It is worth observing the working conditions at the enterprise where work with chemicals is carried out.

There are many diseases of the nervous system, one of which - polyneuritis - is a numerous symmetrical lesion nerve fibers, often of a toxic and traumatic nature.

Polyneuritis is a consequence of a disease, however, it has clear symptoms.

Modern science calls multiple nerve damage “polyneuropathy,” but the outdated term “polyneuritis” has not been eradicated from doctors.

Polyneuritis is divided into external (intoxication with alcohol, arsenic, lead, etc.) and internal (pregnancy, diabetes, nephritis, catarrh of the upper respiratory tract, etc.).

The disease is also classified according to the affected nerve.

Table 1. Sensitivity disorder depending on damage to the cranial nerves

Most susceptible harmful influence nerves entering the limbs, because they are more specialized and at this level, cells quickly sense oxygen starvation.

Reasons

Main provoking factors:

poisons (ethyl alcohol, vaccination, medications, heavy metals, protein breakdown products);
injuries (including electrical);
metabolic products (released during diseases, especially of the endocrine glands);
inflammatory (toxins come from the uncontrolled production of antibodies and other elements of immunity);
infectious agents (bacteria or viruses);
ischemia (consequence of impaired blood supply).

Yeast, liver, and rye bread contain a lot of vitamin B1, so it is important to include them in the diet.

Most common diseases

The cause of polyneuropathy of the extremities can be:

diabetes mellitus;
post-vaccination damage to the central nervous system;
occupational hazard (working in conditions low temperatures, with vibration devices);
vitamin deficiency B 1;
renal failure in chronic form;
infection (flu, diphtheria, typhoid fever, dysentery, tonsillitis);
sclerosis;
arsenic intoxication, heavy metals, phosphorus-containing products.

Polyneuritis caused by diabetes and alcohol is more common. In diabetes mellitus, the disease progresses despite treatment. Therapy only slows down its progress.

Alcoholic polyneuropathy

Ethanol disrupts the integrity of neuron processes and their membranes, which is manifested by sweating of the hands, swelling of the hands and feet.

The disease progresses slowly and - which is typical - when you give up alcohol, the functions of the nerve fibers are resumed.

Alcoholic neuropathy is often associated with brain damage. If it turns into dementia, normalization of the activity of nerve cells when giving up alcohol is impossible.

The disease is treated with vitamin therapy, drugs that improve tissue respiration, and hepatoprotectors.

Reversibility distinguishes alcoholic polyneuropathy from all other types of illness, but not everyone is able to cope with bad habit.

One of the complications of diabetes is diabetes, which can lead to gangrene if treatment is not started in time.

Massage technique for neuritis facial nerve described

Occupational disease drillers and people who work on vibrating equipment - vibration disease. Symptoms, types and diagnosis are described.

Symptoms

The lower extremities are affected first, then the upper; First of all, sensitivity in the area of the feet and hands decreases.

Unsteadiness of gait occurs and the feeling of support disappears. The person feels as if the floor beneath him is soft.

Characteristic is the “rooster gait” - a wide step with legs bent at the knees. This type of movement occurs due to the fact that the muscles have lost tone and the foot sags.

A person is practically unaware of his body in space due to reduced temperature, pain and deep muscle sensitivity.

Symptoms are accompanied by sensations of tingling and goosebumps, numbness, coldness, chills in the heat, shooting and recurring burning sensations severe pain upper and lower extremities. Weakness appears in the hands, it becomes difficult to carry out everyday activities: holding a pen, fastening buttons, tying shoelaces.

Characterized by darkening or bluishness of the skin, thinning and striation of the nails, ulcers due to tissue malnutrition, loss of the ability to feel sharp and hot objects.

Table 2. Comparative characteristics various types polyneuritis

Name	Terms of purchase	Signs of illness				Therapy
Diphtheria	After a late or small injection of serum, in the 2-3rd week from infection; at toxic form- on the 5-6th day	Immobility soft palate, nasal voice, sore throat when eating due to dysfunction of the vagus nerve. Possible damage to the nerves of the limbs, with hypoxia - paralysis respiratory muscles and the vagus nerve of the heart				Stimulation of respiratory and cardiovascular systems, drugs that improve tissue respiration
Infectious	Complication of sore throat, flu	Temperature rise, feeling unwell, increase in lymphocytes, leukocytes, ESR in the blood			“Bringing down” the temperature: rubbing with alcohol, cold compresses on the bends of the limbs
Lead	Eating sour jam (from lingonberries, cranberries) from glazed clay containers	Drooping hand (radial nerve is affected), pain in the trunk, anemia, gray-violet border on the gums		Drink plenty of fluids, B vitamins, take diaphoretics, saline injections
Arsenic	Improper seed treatment, chemical poisoning, occupational factors	Stomach pain, vomiting, diarrhea, hand and leg paralysis		Drink plenty of fluids, B vitamins, take diaphoretics, salt injections
Diabetic	Diabetes mellitus type 2	Burning and pain in the calves, chills, coldness, swelling of the feet due to damage to the nerves of the legs, less often the face and hands; peeling, itching, dark purple skin color		Limiting carbohydrates in the diet, complete rest, lack of stress, drugs to improve blood circulation
Professional	Work with vibrating implements, in the cold, requiring muscle strength (milkmaids, laundresses, seamstresses)	Pain in the hands, burning, tingling, cold, sweating, whitening of the terminal phalanges. At rest (at night) the symptoms are more disturbing than when moving		Elimination harmful factor
Allergic	After vaccination, for some infections, anemia, leukemia and other blood diseases, the use of sulfonamides, penicillin	Rash, itching, burning, red eyes, watery eyes	Eliminating the allergen

As the disease progresses, symptoms increase (except acute poisoning). The patient is unable to care for himself and becomes bedridden. This scenario is especially likely for alcoholics.

Previously, neuritis in pregnant women was associated with toxicosis, but later it was established that the cause lies in foreign proteins from the fetus and placenta.

Treatment

Because polyneuropathy is a consequence of an underlying disease; it is necessary to eliminate the cause or reduce its impact. It is easier to cure external polyneuropathy, in particular, alcoholism and toxic substance poisoning. Some time after blocking the harmful factor, the functions of the nerve cells return. The same applies to infectious neuritis. However, it often causes complications.

Treatment comes down, in addition to eliminating the underlying disease, to nourishing the nerve fibers.

Nootropic drug Piracetam

Neuroprotectors are used for this:

Piracetam and its derivatives;
medications based on lipoic acid (Berlition, Thiogamma);
B vitamins (Neurorubin, Neurovitan, Milgamma);
Actovegin.

Vitamin injections are prescribed:

In 1 5% - 1 ml, intravenously with a 40% glucose solution;
12,200 mcg intramuscularly - once, for 20 days;
In 15 tablets - orally, 0.05 g three times a day.

In case of diphtheria origin of the disease, 1 ml of 0.1% strychnine solution is injected subcutaneously daily, in case of allergies - 2-5 ml of 1% diphenhydramine, 1-2 ml of 2.5% aminazine, calcium chloride.

For recovery motor activity baths, iontophoresis, massage are used, splints and sandbags are applied to the limbs.

If polyneuropathy is caused by injury, only surgical measures are carried out. When a nerve ruptures, a neurosurgeon stitches it together (nerve fibers grow by 1 cm per year).

To speed up healing, anti-inflammatory and physical therapy is prescribed. The latter takes up to 50% of the complex treatment.

Manipulations in beauty salons are dangerous, because... injections can damage the trigeminal and facial nerves. Problems that appear when their integrity is violated (surgeries or “beauty injections”) cannot be eliminated!

Damage to the body by poisons can lead to such pathologies as. About symptoms and possible complications will be discussed in the article.

You will learn about the causes of facial nerve paresis in newborns and treatment methods.

Courses of neuroprotective therapy should be long and regular.

The success of treatment depends on age, presence bad habits, timeliness. The main thing is not to give up and turn to competent specialists. A consultation with a neurologist is required.

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Diabetic polyneuritis can be called the most common complication of diabetes mellitus. The severity and development of the disease directly depend on its duration and course. With this disease, cranial (III, IV and VI pairs) or large peripheral (femoral, sciatic, median or radial) nerves can be affected. The autonomic nervous system also suffers in diabetes mellitus, and often first of all.

Symptoms

It is customary to distinguish subclinical and clinical stages of polyneuropathy.

The subclinical stage is characterized by changes in the structure nerve tissue, although clinical symptoms it is not noted, whereas in clinical stage this symptomatology is pronounced.

For diabetic polyneuritis characterized by sensory disturbances (most common form). The patient is bothered by pain of varying severity, a burning sensation (usually in symmetrical areas of the lower extremities), as well as muscle cramps (usually the calf muscles). Pain syndrome manifests itself to a greater extent in the lower extremities at night. Changes in all types of sensitivity are also observed, most often temperature, pain, and vibration. It should be noted that sensory disturbances first appear on the feet.

The next group of lesions is dysfunction motor nerves, which is manifested by weakness and a decrease in the volume of peripheral muscles - the forearm, hand, foot, a decrease, and in some cases, the disappearance of the knee and Achilles reflexes.

At combined lesion peripheral nerves, symptoms of impaired sensory and motor functions are observed.

Asymmetric polyneuropathy occurs when the functions of individual cranial nerves are impaired. At the same time, they are more often affected oculomotor nerves. Less commonly, the pathology affects trigeminal nerve, but disruption of its function can be combined with defeat III and VI pairs cranial nerves.

In case of defeat vegetative fibers against the background of diabetes mellitus, disorders of various internal organs - heart, kidneys, bladder, etc. can be observed.

Treatment

Treatment involves the use of adequate diabetes therapy. The milder the diabetes mellitus, the later and less significant the development of neurological complications.

Alcoholic polyneuritis is observed mainly in people who chronically drink alcohol in all its forms. All kinds of alcohol substitutes are especially harmful: hypocrite, denatured alcohol, etc. The disease most often occurs in middle age and in men more often than in women. IN childhood it is extremely rare.

Pathological anatomy and pathogenesis

Alcoholic polyneuritis can affect almost all nerves; the lesions are mostly parenchymal in nature. Various stages of degeneration are observed, from mild periaxillary neuritis to severe changes with the disappearance of the shell. Primary degenerations are often accompanied by secondary ones - degenerations of distal segments. It is also common degenerative changes muscles, which depend not only on damage to motor nerve fibers, but also on myositis, which appears from the direct effect of alcohol.

Course and prognosis

Alcoholic polyneuritis always occurs acutely or subacutely. Stormy, with high temperature ongoing cases give an unfavorable prognosis. Death sometimes occurs after 10-14 days. If the current is less fast, then the forecast is based on general condition and the intensity of the spread of paralysis as well as on the participation of cranial nerves.

With damage to the legs alone, the prognosis is more favorable than if the arms or torso are also affected.

Chronic forms are very rare. There are recurrent forms, for example, annually at the same time. In most cases, the course is favorable, it occurs or full recovery, or partial with defects. Until all the symptoms of paralysis disappear, a year may pass, and, as an exception, several years.

Symptoms

Most common symptoms:

numbness of the limbs;
soreness in the calves and nerve endings;
decreased sensitivity of the feet;
tiresome hiccups;
insomnia;
weakness and fatigue.

Alcoholic polyneuritis is often accompanied by fever, less often delirium tremens. Paresthesia and pain appear - a feeling of itching, loss of sensation in the ends of the legs and arms, lancinating pain in the extremities. Often the pain is insignificant in severity, but sometimes it is very intense, and can also intensify with movement, with pressure on nerves and muscles, and sometimes just from touching the skin.

Soon weakness appears, mainly in the legs, worsening over days or weeks, rarely months, so that the patient cannot walk at all. The patient’s psyche at this time is either normal or disturbed; there are gastrointestinal disorders, tremor. Further on the side of the legs there is weight loss, which in early periods doesn't happen.

Pressure on muscles and nerves is painful, passive movements are free, but also painful.

Tendon reflexes are either very weak or completely extinguished, but at the beginning of the disease they can be strengthened. Paralysis is usually not complete, not of the entire limb, but only of a certain group of muscles supplied by the diseased nerve; but not all the muscles of this group become sick, but only one or several of them. To others hallmark is the presence of either a complete or partial reaction of degeneration, or a decrease in electrical excitability. Upper limbs often not affected at all.

In general, the disease can affect either one limb, or both, or all, and affects either the nerves of the same name or opposite ones. Motor weakness is often associated with ataxia, which in some cases occurs at the onset of the disease, but sometimes ataxia occurs independently without movement disorders. Coordination disorder also occurs in the upper limbs.

Sensitivity

As for the sensitive sphere, it is less upset than the motor one. This disorder is localized mainly along the periphery of the limb. Often all types of sensitivity are dulled. Sometimes there are combinations of anesthesia for tactile and hyperesthesia for pain sensitivity. Hyperesthesia is especially common on the sole and can cause difficulty in gait. Like motor disorders, sensitivity disorders are more pronounced on the legs.

Skin reflexes

Skin reflexes are for the most part either reduced or absent, but with symptoms of hyperesthesia in this area they can be increased. Vasomotor, secretory and trophic disorders are common with this disease: swelling, thickening of the joints, the skin turns red and becomes glossy. Bladder and the rectum are usually not affected, which may serve as a distinguishing feature from diseases of the spinal cord.

Mental disorders

Mental disorders accompanying alcoholic polyneuritis relate mainly to confusion and weakening of memory for recent events and the appearance of false memories - “Korsakov’s polyneuritic psychosis.” Of the cranial nerves, nerves are most often involved eye muscles. It should be noted that there is never reflex immobility of the pupils, unlike chronic alcoholism. Diseases optic nerve rare. Central scotoma sometimes occurs.

Treatment methods

The main treatment is:

medicinal;
physical therapy (physical therapy);
phytotherapy;
special massage of the limbs.

Thanks to these methods, some nerve endings are restored, as well as muscle strength.

The following procedures are also used for treatment:

acupuncture;
taking B vitamins;
muscle and nerve stimulation;
taking antiviral drugs;
neurolysis of nerve endings, etc.

Almost every patient has a chance of recovery.

The patient's recovery mainly depends on complete refusal alcohol consumption, in any form. If this condition is met, as well as complex and long-term (3-4 months) therapy, the clinical prognosis is favorable.

Polyneuritis is multiple damage to nerve endings. What about kidney polyneuritis? Disruption of the conduction of nerves that are responsible for connecting the organ with the brain. Sometimes inflammation of the nerve endings of the kidney is called demyelinating-type renal neuropathy. How does this condition arise and can the situation be corrected using traditional medicine?

Damage to neurons is fraught with complications in the functioning of the kidneys.

Features of the pathological process

The process of innervation (the connection of organs with the nervous system, which ensures their functionality and response to stimuli) is based on two ways:

afferent (from the organ to the brain), in the kidney it is provided by the lower thoracic and spinal nodes;
efferent (from the central nervous system to the organ), lumbar and thoracic sympathetic nodes.

Herself kidney tissue(parenchyma) does not have nerve endings, but the shell of the organ (capsule) is penetrated by them. Therefore, during inflammatory processes that lead to an increase in the size of the kidney, the capsule stretches, which is picked up by the nerve endings and begins painful sensations. The brain receives a signal about dysfunction. If irritant not eliminated, this may lead to serious violations structures of the myelin sheath (covers nerve cells, a kind of electrical tape), which over time will make it impossible to conduct an electrical impulse along the nerve and will affect the functioning of the organ. What kind of inflammatory processes can provoke such a pathology?

Causes and symptoms

Provoke kidney damage nervous soil» may have physical, chemical or other effects on the nervous system.

Pathologies easily arise in the kidneys if the body is often overcooled. Nervous system also suffers from hypothermia, from a lack of B vitamins. The causes of functional disorders can be of chemical, physiological, mechanical origin, namely:

internal diseases of an endocrine, oncological and genetic nature;
introduction of viral or bacterial agents, which leads to intoxication;
taking increased doses of nephrotoxic drugs (antibiotics, bismuth preparations);
toxic effects of poisons, for example, lead, mercury, arsenic, sulfocarbonate, alcohol;
injuries or their consequences.

Feature alcoholic neuropathy is damage to the distal portions of the nerves in the kidneys. Constant supply ethyl alcohol gradually poisons the kidneys, they cannot cope because they lose contact with the control center, which nerve pathways gives orders. We can say that alcohol partially blocks the renal nerves and the kidney loses sensitivity to toxins that poison it.

Polyneuritis of the kidneys makes itself felt by swelling, marble “patterns” on the integument, and pain in the lower back.

Often polyneuritis occurs against the background advanced disease kidney Treatment not prescribed on time or the patient ignoring the doctor’s instructions leads to various kinds complications. Chronic pyelonephritis, for example, tends to flare frequently and this depletes the renal parenchyma, blood supply, filtration and transmission nerve impulses from and to the organ. Symptoms accompanying renal polyneuropathy are as follows:

nagging pain in the lumbar region;
swelling of the limbs;
muscle weakness, especially during activities requiring fine motor skills and physical effort;
numbness of the limbs, impaired sensitivity to temperature;
hyperhidrosis (increased sweating);
nausea, vomiting;
marbled skin pattern.

Since polyneuritis is a consequence of long-term inflammatory process in the kidneys, then the therapy will be complex. For example, if the cause of polyneuritis was chronic pyelonephritis, then can be applied antimicrobials:

Treatment of kidney polyneuritis includes taking medications, depending on the nature of the damaging factor that provoked the disease.

antibiotics of the fluoroquinolone group (“Ciprofloxacin”, “Norfloxacin”);
sulfonamides (“Urosulfan”, “Biseptol”);
nitrofurans (“Furazolidone”, “Furazidin”, trade name"Furagin", "Furamag");
nitroxoline (“5-NOK”).

Considering that polyneuritis is a lesion of nerve endings, efforts will be aimed at restoring nerve patency. This takes time as symptoms may persist for a long time. B vitamins, drugs that restore the structure of the myelin sheath (Keltikan, Nucleo CMF), nootropic drugs, metabolic therapy - all this will improve microcirculation and trophism of the nerves.

Sulfanilamide uroantiseptics are rarely prescribed, as they cause crystalluria, hematuria, and intercestial nephritis.

Anti-inflammatory and diuretic drugs are also prescribed. You can’t do without a diet, table No. 7: reduced protein, salt, increased amount B vitamins. Drink up to 3 liters of liquid per day. The diet should contain vegetables and fruits that will provide a diuretic effect (pumpkin, watermelon, zucchini), berry fruit drinks, juices, compotes, jelly, weak tea, dairy products, white bread, sugar consumption is allowed (50−70 g per day). Preference is given to stewed and boiled dishes; it is better to exclude fried foods. Diet food provides for waiver alcoholic drinks, cream cakes and pastries, concentrated broths, sweet carbonated drinks, spicy, smoked and canned foods, coffee are prohibited.

A beneficial effect will also be provided bakery products made from flour coarse, buckwheat, beef, liver, seafood, eggs, poultry, dried fruits (figs, dates, raisins). Meals - 4-6 times a day. Mineral waters with low mineralization will give positive effect, and drug treatment will give positive result much faster.