Hand neuropathy symptoms. Upper limb polyneuropathy, symptoms, treatment

Polyneuropathy of the upper and lower extremities (peripheral neuropathy) is a disease that affects the human nervous system and impairs the sense of sensation, balance, and the function of the glands or organs of the body, depending on the type of nerves involved.

In polyneuropathy of the upper and lower extremities, the identification of symptoms and their treatment is a complex process that requires a systematic approach.

Peripheral neuropathy has a variety of systemic, metabolic, and toxic causes. The most common treatable causes include diabetes mellitus, hypothyroidism, and nutritional deficiencies in the body.

Common causes of peripheral neuropathy also often include:

systemic diseases (eg, diabetes);
lack of vitamins;
radiation (chemotherapy);
drug therapy (eg, antibiotics);
traumatic injuries;
local decrease in blood supply to organs (ischemia);
excessive use of alcohol or drugs;
diseases of the immune system;
viral infection;
genetic, or idiopathic (uncertain) causes.

The term peripheral neuropathy (polyneuropathy) is generally used to describe multiple, symmetrical and universal damage to adjacent nerves in the distal upper and lower extremities.

Peripheral neuropathy can be chronic, with symptoms developing gradually, or acute, with sudden onset, rapid disease progression, and slow resolution.

It is worth noting that there is, the symptoms of which are associated in a pronounced form of loss of sensitivity of the lower extremities in general and the feet in particular.

For more information on neuropathy of the lower extremities, see.

Read about the symptoms of neuropathy of the lower extremities.

Symptoms

In the early stages of peripheral neuropathy, the disease can cause progressive symptoms of pain, muscle twitching, loss of muscle mass, bone degeneration, and skin changes in the patient.

Upper limb lesions

Neuropathy can cause hand numbness, decreased sensitivity to temperature changes and pain, spontaneous tingling or burning pain and burning, and cutaneous allodynia—severe pain from a common stimulus—such as a light touch.

Illustration of the ulnar nerve of the upper limb

Lower extremity lesions

Motor neuropathies can cause numbness of the lower extremities, impaired balance and coordination of the body, decreased ankle reflexes and distal sensations, and most often, muscle weakness and atrophy of the motor muscles.

Acute neuropathies require an urgent diagnosis, because in this case, the motor, sensory, or autonomic nerves that control the body's automatic functions, including heart rate, body temperature, and respiration, may be affected.

Diagnostics

Diagnosis of polyneuropathy requires a thorough clinical examination, laboratory and electrodiagnostic tests, or nerve biopsy if the diagnosis remains unclear.

A systematic diagnostic approach begins with the localization of the lesion in the peripheral nerves, the identification of underlying causes (the etiology of the disease), and the exclusion of potentially treatable problems.

Initial blood tests for the presence of the disease include:

complete blood count;
complex metabolic profile of blood;
the level of vitamin B 12 and thyroid-stimulating hormone in the blood;
measurement of erythrocyte sedimentation rate and fasting blood glucose.

In the presence of clinical indications, specialized tests are also prescribed.

An electrodiagnostic study, including nerve conduction studies and electromyography, can help distinguish between demyelinating or mixed neuropathy.

For symptoms of distal numbness, tingling, pain, or weakness, the first step is to determine if these symptoms are the result of peripheral neuropathy or CNS involvement.

To test vibration sensations in the limbs, a medical tuning fork of 128 Hz is used.

Loss of sensation (including vibrational) and a violation of the sense of the position of body parts (proprioception) is clarified with an injection in the distal parts of the limbs to detect peripheral neuropathy.

Nerve conduction study (EMG) evaluates the shape, amplitude, delay, and conduction velocity of an electrical signal passing through a nerve.

An electrodiagnostic study can help determine whether neuropathy is the result of damage to the axons (axonal neuropathy) or to the myelin sheath of nerves (demyelinating neuropathy), or damage to both types of nerves (mixed neuropathy).

Nerve conduction and EMG studies with normal results can greatly reduce the chance of peripheral neuropathy, while abnormal nerve conduction results can confirm the diagnosis.

A potential limitation of electrodiagnostic studies is that they can only test for large nerve fibers, and limitedly for small nerve fiber neuropathy, ie. fibers responsible for pain, body temperature and autonomic functions of the body.

In cases of neuropathy of small nerve fibers, specialized tests are performed to analyze the autonomic functions of the body, for example, an epidermal skin biopsy.

An epidermal skin biopsy may be performed in patients with burning, numbness, and pain in which small, unmyelinated nerve fibers are the cause.

Lumbar puncture and cerebrospinal fluid analysis may be helpful in the diagnosis of Guillain-Barré syndrome and chronic inflammatory demyelinating neuropathy.

When studies cannot determine the exact cause of the disease, and electrodiagnostic studies indicate symmetrical peripheral neuropathy, the presumptive diagnosis in this case is idiopathic peripheral neuropathy.

Minor nerve fiber damage may represent the earliest stages of some peripheral neuropathies.

Treatment

Treatment of neuropathy is usually considered in the context of the underlying disease, correcting nutritional deficiencies in the body, and providing symptomatic therapy for the disease.

Treating the underlying disease often helps manage the symptoms of neuropathy.

Symptomatic drugs

In peripheral neuropathy caused by diabetes mellitus or pre-diabetes, managing blood sugar levels is key to treating nerve symptoms.

With peripheral neuropathy associated with vitamin deficiency, the prognosis of therapy is considered positive.

For neuropathy caused by immune diseases, intravenous injections of immunoglobulin or steroids are used.

CNS-acting drugs are useful in the management of neuropathic pain.

Common treatments for neuropathy include:

Tricyclic antidepressants, in particular, Nortriptyline and Amitriptyline.
Serotonin-norepinephrine reuptake inhibitors, in particular duloxetine.
Antiepileptic therapy, including Gabapentin, Pregabalin, Sodium Valproate.

Research data also support the positive effects of cannabis on neuropathic pain.

Other Therapies

Nerve therapy with transcutaneous electrical nerve stimulation may be effective and safe in the treatment of diabetic peripheral neuropathy.

A significant improvement in pain reduction was found in 38% of patients treated with this method.

Treatment remains effective even after prolonged use, but symptoms return to baseline within about a month after stopping treatment.

Acute inflammatory neuropathies require urgent and aggressive management with immunoglobulin or plasmapheresis (blood purification).

Mechanical ventilation of the lungs is carried out in patients whose forced vital capacity is less than 20 ml per kg of body weight, or whose lung capacity is reduced by more than 30% of the baseline.

Patients with a suspected narcotic cause of neuropathy should be assessed for the risks of substance abuse prior to initiating long-term opioid therapy.

Other supportive measures, such as foot care, weight loss, and proper walking shoes, may be helpful.

Physical therapy can reduce muscle stiffness and prevent limited joint mobility. Physical and occupational therapists may also recommend other helpful assistive devices to relieve symptoms.

Conclusion

If the cause of upper and lower extremity polyneuropathy cannot be corrected, treatment focuses on relieving pain and problems associated with the patient's muscle weakness.

The outlook for treatment depends on the underlying cause of the nerve damage and the degree of associated impairment.

In some cases, treating the underlying cause may lead to an improvement in a person's condition, but in others, the damage remains permanent or the symptoms of the disease may gradually worsen.

Etiology

Such a disorder can develop from the influence of various factors:

genetic predisposition;
immune disorders, when the body begins to attack its own muscles and nerve fibers, while producing immune antibodies;
chemical elements, drugs or alcoholic beverages;
infectious processes of the body, for example, with or;
malignant neoplasms;
systemic ailments, including;
lack of B vitamins in the body;
autoimmune diseases, such as Guillain-Barré syndrome.

Varieties

Depending on the mechanism of damage to the nerves of the muscles of the lower and upper extremities, polyneuropathy is divided into:

demyelinating - development occurs against the background of the breakdown of myelin, a specific substance that envelops the nerves and ensures rapid transmission of impulses. This type is characterized by the most favorable prognosis, subject to timely access to a doctor and effective treatment;
axonal - the disease develops against the background of damage to the axon, which is the core of the nerve that feeds it. The course of this type of ailment is more severe. Treatment - successful, but long;
neuropathic - a disease is formed due to the pathological effect on the bodies of nerve cells.

According to the violation of a particular function of the nerve, polyneuropathy is:

sensory - due to the pathogenic process, the sensitivity of the nerves is disturbed. Outwardly, this is manifested by a burning sensation and numbness of the extremities;
motor - there are signs of damage to motor fibers. The symptom is muscle weakness;
sensory-motor - symptoms of the two above forms appear;
vegetative - in this case, damage to the nerves responsible for ensuring the normal functioning of internal organs and systems is expressed. Signs by which this can be detected are increased sweating, a rapid heart rate, and;
mixed - there are signs of damage to all types of nerves.

According to the etiology, this inflammatory disease is divided into the following types:

idiopathic - the causes of its manifestation are not fully known, but violations of the immune system are not excluded;
hereditary;
diabetic - develops against the background of a complicated course of diabetes mellitus;
dysmetabolic - as a result of metabolic disorders;
toxic - occurs against the background of chemical poisoning;
post-infectious - expressed due to a person suffering from HIV infection or diphtheria;
paraneoplastic - development occurs in parallel with oncological disease;
systemic - occurs during the course of systemic disorders of the connective tissue.

Symptoms

Various causes that cause polyneuropathy, first of all, lead to irritation of the nerve fibers of the muscles of the limbs, and as they progress, they lead to disorders in the functioning of the nerves. The first symptoms of polyneuropathy include:

pronounced trembling of the hands or feet;
involuntary twitching of muscle structures, noticeable to people around;
the occurrence of painful cramps;
expression of pain of varying intensity;
sensation of "goosebumps" on the skin;
an increase in blood pressure.

Symptoms of nerve dysfunction include:

muscle weakness;
muscle thinning;
decreased muscle tone;
bouts of severe dizziness;
cardiopalmus;
dryness of the skin of the affected limbs;
the occurrence of constipation;
significant hair loss in the pathological area;
decreased or complete loss of sensation in the tips of the fingers and toes.

Complications

If you do not turn to a specialist for qualified help in time, the following consequences may develop from the inflammatory process in the nerves of the upper and lower extremities:

violation of motor functions - observed with severe weakness, especially with diabetic polyneuropathy;
damage to the nerves responsible for the respiratory process, which can lead to oxygen deficiency;
sudden cardiac death - caused by abnormal heartbeats.

Diagnostic measures

An important step in establishing a diagnosis is the discovery of the cause that led to the appearance of polyneuropathy. This can be achieved through the following activities:

collecting detailed information about the course of the disease. This is necessary in order to identify a predisposing factor. For example, in the hereditary or diabetic form of the disorder, symptoms develop rather slowly;
neurological examination, with the help of which it is possible to determine the location of the localization of unpleasant signs in the form of burning or numbness;
a blood test, thanks to which it is possible to detect the presence of chemical elements, as well as to establish the level of sugar, urea and creatinine;
electroneuromyography is a technique that allows you to evaluate the speed of the impulse along the nerves of the lower and upper extremities;
nerve biopsy - performed for microscopic examination of a small part of the nerve;
additional consultations of such specialists as a therapist and an endocrinologist, in cases of the appearance of such a disease in pregnant women - an obstetrician-gynecologist. If the patient is a child, an additional examination by a pediatrician is necessary.

After receiving all the test results, the specialist prescribes the most effective tactics for treating the inflammatory process of the upper and lower extremities.

Treatment

With hereditary polyneuropathy, treatment is aimed only at eliminating unpleasant symptoms, and in cases of diabetic, alcoholic or drug-induced, at reducing the manifestation of symptoms and slowing down the development of the process. Comprehensive treatment of polyneuropathy includes:

prescribing medications. Depending on the cause, these can be - glucocorticosteroids, immunoglobulins, painkillers and blood sugar-lowering drugs;
the implementation of a kidney transplant with a dysmetabolic type of disorder;
limiting contact with toxins;
surgery to remove malignant neoplasms;
taking antibiotics to eliminate inflammatory or infectious processes in the body;
injections of B vitamins;
wearing orthoses to support the lower or upper extremities with severe weakness.

Prevention

In order for a person not to develop such a disease as polyneuropathy, it is necessary to follow simple rules:

lead a healthy lifestyle, stop drinking alcohol;
how best to protect yourself from toxins when working with them;
to control the level of sugar in the blood;
take medicines only as prescribed by a doctor;
undergo preventive examinations at the clinic several times a year.

In most cases, the prognosis after recovery is positive. Exceptions are patients with a hereditary inflammatory process of the lower and upper extremities, for whom it is not possible to achieve a complete recovery. People with diabetic polyneuropathy are more likely to relapse.

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Neuropathy of the upper extremities is a complex of diseases that lead to the development of a characteristic clinical picture in the form of impaired sensitivity and motor activity. Sufficiently well-studied symptoms of neuropathy of the upper extremities allow treatment to be carried out as quickly and efficiently as possible. For this, an integrated approach is used, in which traditional and manual therapy, medicines and massage, therapeutic exercises and kinesiotherapy find their place.

Usually neuropathy of the upper extremities is associated with the development of tunnel syndromes. This may be a carpal valve, carpal tunnel, cubital meatus, or pronator teres syndrome. nerve fibers can be damaged due to traumatic effects, compression by clothing, inflammatory processes, internal hematomas, etc. In principle, the localization of the pathological process can be any. The higher and closer it is to the cervical spine, the larger part of the arm gives symptoms of impaired sensitivity and motor activity.

The classic symptoms of this disease include paresthesias, impaired skin sensitivity, excruciating pulling and twisting pains, etc. Therefore, it is not difficult for an experienced neurologist to make an accurate diagnosis.

If you have symptoms of neuropathy of the upper extremities, we invite you to a free consultation with a neurologist at our manual therapy clinic. An experienced doctor works here, who during the appointment will conduct an examination, make a number of diagnostic tests and make a diagnosis. Then you will be given individual recommendations for complex therapy.

Causes of upper limb neuropathy

There are various everyday, traumatic, inflammatory and degenerative causes of neuropathy of the upper extremities, we will try to consider them in more detail. First of all, it is worth understanding that any neuropathy is a lack of innervation of one or another part of the arm, for which one or another branch is responsible. By typical signs, it is easy to determine which nerve is affected and in what approximate place. And due to the knowledge of the anatomy of the upper limb (location of muscles, tendons and ligaments), the doctor will be able to accurately diagnose and prescribe treatment. But in order to achieve a positive result, it is important to first eliminate the cause of the pathology.

Among the potential risk factors for damage to the nerve fiber, there are the following diseases:

osteochondrosis of the cervical spine and associated protrusions, intervertebral hernias, instability of the vertebrae;
inflammation of the lymph nodes of the axillary group;
degenerative processes in the cavity of the shoulder and shoulder-blade joints of the bones;
shoulder, forearm, hand injuries;
habitual dislocation of the shoulder with deformation of the internal articular lip;
bone fractures and cracks;
synovitis, tendovaginitis, bursitis and other inflammatory processes leading to soft tissue swelling and nerve compression;
cicatricial changes in the tendon, ligament, muscle and connective tissue;
tunnel syndromes (narrowing of those places where large branches of the brachial nerve pass);
arthrosis, arthritis and other joint diseases;
tumors in the shoulder, elbow, carpal joints;
tuberculosis and other dangerous infections that affect the cartilaginous tissues of the musculoskeletal system of the human body.

In addition, neuropathy of the upper extremities may be associated with trophic and endocrine disorders. Often diagnosed toxic, alcoholic and diabetic neuropathy. In this case, the atrophy of the nerve fiber is influenced by the action of poisons and toxins, regularly taken alcohol, and elevated blood sugar levels.

In elderly patients, the predominant cause of neuropathy of the upper extremities is atherosclerosis of blood vessels and their narrowing with partial obstruction. Such conditions often cause a violation of tissue trophism. Partial dystrophy of the muscle fiber occurs, the axon tissues cease to receive sufficient blood supply and lose their usual functions.

Constant intoxication always provokes a violation of innervation and secondary muscle dystrophy. An increase in blood sugar levels works in a similar way. This stimulates the production of cortisol, which constricts small blood vessels.

In young active people, the main cause of upper limb neuropathy is carpal tunnel syndrome. In second place in terms of prevalence is vitamin and mineral deficiency. A similar syndrome is typical for young girls who regularly “diet”. Their diet lacks foods that contain all the B vitamins. Combined with insufficient intake of potassium and magnesium, this condition leads to nerve fiber atrophy. It is very difficult to identify such a disease, since it often masquerades as a carpal tunnel syndrome, carpal tunnel or cubital space. Helps in the diagnosis of a biochemical detailed blood test and a series of radiographic images.

Sensory neuropathy of the median and other nerves of the upper extremities

Sensory neuropathy of the upper extremities is the most common form of the disease. Disturbance of motor activity develops at later stages and is accompanied by persistent contractures of the joints of the arms and hands.

Neuropathy of the upper extremities is also subdivided according to the type of damage to the branches of the nerve fiber. Most often diagnosed:

neuropathy of the median nerve of the upper extremities;
damage to the radial nerve in the carpal tunnel;
pinching of the ulnar nerve in the main canal.

Less common are nephropathy of the brachial and carpal nerves. But the possibility of their occurrence should not be discounted.

With neuropathy of the median nerve, various parts of the hand can be affected. N. medianus originates from the radicular nerves extending between the C5-Th1 vertebrae. then the axons are sent to the axillary region, where, with severe lymphadenopathy (an increase in the lymph nodes of the axillary group), primary compression may occur. When leaving the axillary zone, the nerve passes along the inner surface of the shoulder under the round pronator and exits into the projection of the forearm. Accordingly, with the syndrome of the round pronator, it is pinched and neuropathy develops.

Also in the area of the elbow joint, the median nerve gives medial branches responsible for the innervation of the muscles of the forearm. Accordingly, with pronator teres syndrome, first of all, patients notice muscle weakness of the forearm, numbness and tingling in this area.

After passing through the carpal tunnel, the median nerve splits into bundles. They are responsible for the innervation of the thumb, index and middle fingers. With compression of the median nerve in the carpal tunnel, there is a violation of the innervation of part of the palm and these three fingers.

With neuropathy of the radial and ulnar nerve, there are also characteristic signs. The ulnar nerve is responsible for the innervation of the little finger and ring finger. With his neuropathy in the initial stages of the disease, there is a violation of innervation, soreness, convulsions, lack of ability to perform fine motor movements.

Symptoms of upper limb neuropathy

With its development, neuropathy of the upper extremities gives various symptoms, which can manifest themselves in the form of pain, paresthesia, impaired sensitivity and motor activity. the first signs are very difficult to notice, since they lie behind the sensations of rapid muscle fatigue, weakness, inaccuracy in performing finger movements. Most patients attribute these manifestations to fatigue, increased physical activity, an incorrectly chosen position for a night's rest, etc.

After some time, the symptoms of neuropathy of the upper extremities become more typical for this disease:

pain appears first after performing certain operations (for example, after prolonged work at the computer), then discomfort is present almost constantly;
pain and tension in the muscles of the upper limbs increase in the evening, reach their peak during bedtime, in the morning they may be completely absent;
numbness of individual areas is combined with paresthesia (a feeling of crawling);
decreased muscle strength;
increased fatigue of the muscles of the hand when performing the usual physical work;
violation of motor activity;
development of contractures in the joints of the fingers at a late stage.

With prolonged development of neuropathy of the upper extremities, paresis, plegia, muscle paralysis may occur. It will be very difficult to restore their performance later. Therefore, it is necessary to start treatment in the early stages of the disease.

Before treating upper limb neuropathy

It is important to understand that before treating neuropathy of the upper extremities, it is necessary to identify and eliminate the cause of the development of this disease. If this is not done, then all the efforts of the doctor and the patient will be completely in vain.

In this regard, in our clinic of manual therapy, during the initial examination, the doctor takes an anamnesis. Based on the information received from the patient, the doctor makes initial conclusions about the potential causes of the development of neuropathy. Then a number of diagnostic examinations are assigned, which allow confirming or refuting the preliminary conclusions.

If the cause is osteochondrosis of the cervical spine, then it is necessary to carry out concomitant treatment of this degenerative disease. If neuropathy is associated with diabetes mellitus, overweight, then it is necessary to correct the diet. When identifying a factor of occupational hazard, it is important to take measures to improve the ergonomics of your workplace. If this is not possible, then a change of place of work and type of professional activity is shown.

Treatment of neuropathy of the upper extremities

Comprehensive treatment of neuropathy of the upper extremities includes the obligatory elimination of the etiological factor (cause of the disease), restoration of the structure of the nerve fiber, improvement of blood microcirculation and lymphatic fluid in the affected area.

Official medicine in such cases uses complex vitamin preparations, reparative agents, non-steroidal anti-inflammatory substances. To improve the conduction of the nerve impulse, injections of prozerin may be prescribed.

Manual therapy uses the following techniques:

massage and osteopathy to improve blood supply and tissue innervation;
reflexology to accelerate tissue repair processes;
therapeutic exercises and kinesiotherapy;
laser and electromagnetic influence.

In our clinic of manual therapy, the course of treatment is always developed strictly individually. The doctor, after examining and examining the patient, offers him a special course of therapy, gives individual recommendations. All procedures are carried out under the supervision of the attending physician.

We invite you to an initial free consultation with a neurologist at our manual therapy clinic. Make an appointment at a convenient time for you.

Polyneuropathy is a dangerous and serious disease that primarily affects the peripheral nervous system. This ailment can lead to limb weakness, loss of sensation, flaccid paralysis, and other unpleasant consequences.

In older people, this disease occurs several times more often. Polyneuropathy does not go away on its own and can progress, so timely diagnosis and properly selected treatment are necessary.

What is polyneuropathy and why does it occur?

Polyneuropathy of the hands occurs due to damage to the nervous system and leads to paralysis

Nerves are the conductor that transmits signals from the brain to other parts of the body. If the conductivity is disturbed, sensitivity problems arise. Polyneuropathy is translated as a disease of many nerves. With this disease, several branches of the peripheral nervous system are affected at once. The disease leads to impaired motor function of the limbs.

To find out how polyneuropathy of the upper extremities manifests itself, the symptoms, treatment and prognosis of this disease, you need to contact a neurologist. The course of the disease can be varied: slow and inconspicuous or rapid, lightning-fast.

Often, polyneuropathy develops against the background of another disease. The causes of the development of the disease can be:

It is known that polyneuropathy can be hereditary. It is not the disease itself that can be genetically transmitted, but the predisposition to it.

Polyneuropathy of the upper extremities cannot be called a common disease. It is diagnosed in about 2.5% of people. In the elderly, the disease occurs more often (approximately 8%).

The main symptoms of the disease

The disease has a rather characteristic clinical picture, but the intensity of its manifestation depends on the stage of the disease, its characteristics, and the state of the body. At first, the signs may be mild. First, irritation of the nerve fibers occurs, and then a violation of their conduction.

At first, the only symptoms may be weakness in the limbs, pallor of the skin. As a rule, with such manifestations, no one goes to the doctor. Then the disease begins to progress, leading to various complications. The sooner the diagnosis is made and treatment is started, the lower the likelihood of developing unpleasant consequences.

Symptoms characteristic of polyneuropathy of the upper extremities include:

Muscle weakness. Polyneuropathy is often accompanied by muscle weakness and atrophy of muscle fibers. First there is weakness of the hand, and then of the whole arm. Habitual loads become impossible.
Tremor. With the development of the disease and the onset of muscle weakness, a tremor also appears, which is expressed in involuntary and constant trembling of the hands.
Hypesthesia. Hypesthesia is the reduction or complete disappearance of the sensitivity of the skin in the extremities. As a rule, this applies only to the hands, in the rest of the hand, sensitivity is preserved.
Hypohidrosis. Due to disruption of the nerves, increased dryness of the skin of the hands is observed.
Strong pains. Soreness of the hands may not be observed immediately. As a rule, the pains are quite intense, spontaneous, appear and disappear for no apparent reason.
Slow tissue regeneration. Damage to the skin, wounds, scratches on the hands heal much longer than usual.
. Edema may appear in the limbs due to excess fluid accumulation and disruption of the cardiovascular system. Edema appears symmetrically on both hands.
Sweating. As a rule, the sweating function is impaired, so the skin on the limbs sweats constantly, regardless of the ambient temperature.

Polyneuropathy may be accompanied by symptoms unrelated to movement or function of the limbs. So, for example, quite often the patient has shortness of breath, problems with blood vessels, as well as disorders of the gastrointestinal tract, constipation, etc.

Types of neuritis of the upper limbs and their features

To choose the right treatment, it is necessary to determine the stage and form of the disease. Polyneuropathy has several varieties:

Touch. With sensory polyneuropathy, sensitivity is primarily impaired. The patient has goosebumps, tingling and other unusual sensations in the area of the affected limb. The palm may become numb or, on the contrary, burn.
Motor. The main symptoms of motor polyneuropathy are impaired motor functions. The patient hardly raises his hand or cannot rotate his hand, bend his fingers. This is due to progressive muscle atrophy.
Sensorimotor. This type of polyneuropathy combines sensory and motor disorders and is the most common.
Vegetative. With autonomic polyneuropathy, all symptoms are associated with damage to the autonomic nervous system, that is, sweating, pallor, as well as signs not associated with the limbs. In this case, those nerves that control the work of various internal organs are affected.
Mixed. With mixed polyneuropathy, the lesion is extensive, so all of the above signs appear, gradually or simultaneously.

If we talk about polyneuropathy of the upper extremities, then there is also a classification depending on the affected nerve. So, for example, there is neuropathy of the radial nerve, which runs through the entire arm. In this case, the symptoms will depend on the specific affected area. Often there is a dangling hand syndrome, that is, the hand simply hangs when the arm is raised up.

Median nerve neuropathy can result from trauma or from a failed injection into a vein in the elbow crease.

Symptoms relate primarily to the ability to move the brush: it does not rotate, does not bend, it is difficult for the patient to move his fingers. As the disease progresses, the symptoms worsen, the muscles become weaker, the patient cannot clench his hand into a fist.

Ulnar neuropathy can be occupational and occurs more often in those whose work involves relying on the elbows. With severe lesions, the patient loses sensitivity in the area of the little finger and ring finger.

Diagnostics and drug therapy

Diagnosing the disease is often difficult because the symptoms can be blurry, similar to signs of other diseases. First, a neuropathologist collects an anamnesis, but it is impossible to make a diagnosis based on an anamnesis, so a further examination is prescribed. The doctor will check reflexes, prescribe a blood test, as well as electroneuromyography, which is fundamental in the diagnosis of polyneuropathies.

The essence of the method is to assess the electrical activity of muscles and nerve fibers. The procedure does not require special preparation. It is enough to come to the office on an empty stomach and do not take drugs on the day of the examination. During the procedure, electrodes are attached to the body (namely, to the injured limb). Electrical impulses cause contractions of a particular muscle. The doctor may ask you to tighten your arm or make several movements with it. The procedure is quite fast and non-invasive. The result is obtained in the form of a graph, as with .

If a patient has been diagnosed with polyneuropathy of the upper extremities, it is necessary to start treatment as soon as possible. Medical therapy includes:

Painkillers. Polyneuropathy can be accompanied by severe pain. But since this pain is neurological in nature, it is very rare to completely remove it. Recommended analgesic anticonvulsants, such as Gabapentin, Neurontin. Conventional painkillers such as Analgin will not give an effect.
Vitamins. Multivitamin complexes or injections with B vitamins are prescribed to strengthen the nerve fibers and improve their conductivity. There are special complex preparations that contain vitamins and lidocaine. When injected, they relieve pain. The course of vitamin therapy lasts about a month.
metabolic agents. As a rule, these are complex drugs that improve metabolism, normalize blood flow and conduction of nerve impulses. These drugs include Actovegin, Instenon, Cytochrome C. However, not all of them are effective in treating certain types of polyneuropathies.

Drugs are prescribed depending on the underlying causes of the disease. First of all, it is necessary to eliminate these causes and cure the disease that led to polyneuropathy.

Operative and folk treatment

Surgery for polyneuropathy is not always effective. If the damage to the peripheral nerves is caused by an infection, diabetes mellitus or another disease, conservative treatment, physiotherapy, massage, etc. are prescribed.

Surgery is recommended if the polyneuropathy is caused by a pinched nerve and symptoms become more severe. For example, surgery is prescribed for tunnel neuropathy. The muscles compressing the nerve are cut, the ligaments are dissected to stop the pinching of the nerve. In most cases, the operation leads to the elimination of all unpleasant symptoms. However, the effectiveness of surgical intervention largely depends on proper rehabilitation.

As a rule, polyneuropathy is not treated exclusively by alternative methods, but they often complement drug therapy and allow you to quickly cope with the disease.

The most common folk treatments for polyneuropathy are:

Clay. Natural clay has many healing properties. It is applied topically. Blue or green clay powder is diluted with water to a thick slurry. This gruel should be applied in a thick layer on the injured hand and wait for it to dry. You can also make warm compresses with clay.
Massage. The correct massage technique will help not only relieve pain, but also improve blood circulation. For massage use warming ointments or castor oil. The hand should be rubbed with soft movements until redness of the skin appears. Then you can rub vodka, wrap your hand with a warm cloth and leave it overnight.
Phytotherapy. With polyneuropathy, decoctions of herbs are recommended to be taken orally. To restore the functioning of the nervous system, you can take decoctions and infusions of burdock, dill, rosemary, cloves. Burdock root can be chewed raw. It is believed that this way it is more effective.
Kefir. Fresh kefir must be mixed with parsley and sunflower seeds. It will turn out a medicine that will not only strengthen the nervous system, but also remove toxins from the body.

Alternative methods of treatment of polyneuropathy have their own contraindications. They can cause an allergic reaction. Before using the remedy, it is necessary to consult a neurologist.

Prognosis and possible complications

With timely treatment of acute polyneuropathy, the prognosis is favorable. However, the treatment of the chronic form of the disease lasts a lifetime. Full recovery does not occur, but the patient's quality of life can be improved.

If the treatment does not work, the person becomes disabled. Polyneuropathy can lead to various unpleasant consequences. Constant pain and muscle weakness lead to the fact that a person cannot fully work. The rapidly progressing disease can be fatal.

Severe complications of polyneuropathy of the upper extremities include:

Sudden cardiac arrest. Violation of the peripheral nervous system is often accompanied by serious cardiac failures, etc. A severe attack of arrhythmia can lead to sudden cardiac death.
Respiratory disorders. The nervous system performs many functions, one of which is the supply of impulses to the muscles. If the connection with the respiratory muscles is broken, shortness of breath, asthma and other respiratory disorders develop, which can also lead to death.
Irreversible movement disorders. Serious damage to the peripheral nerves leads to the inability to move the arm normally, up to paralysis. These effects may be reversible or irreversible in the chronic progressive form of the disease.

More information about polyneuropathy can be found in the video:

To avoid complications, it is necessary to consult a doctor in time and follow his recommendations. Moderate physical activity and proper nutrition are recommended as preventive measures.

The cause of polyneuropathy is often infection, so it is necessary to strengthen the immune system, harden, monitor nutrition, and take multivitamin complexes. It is also very important to get rid of bad habits, especially alcohol intake. There is such a thing as alcoholic polyneuropathy. Alcohol destroys the immune system and the human nervous system.

Neuropathy is a disease that is accompanied by degenerative or dystrophic damage to the nerves. Refers to fairly common diseases of the nervous system and has many factors that can cause it.

The onset of the disease can be indicated by the appearance of pain, numbness, a burning sensation in certain areas of the skin. Then muscle paresis develops with loss of reflexes.

In peripheral neuropathy, the symptoms depend on which nerve is affected. When the motor nerves are damaged, the work of muscle fibers is disrupted. There is muscle weakness followed by muscle atrophy. A change in sensory fibers leads to numbness of the extremities, paresthesia, and the appearance of pain. If the nerve of the autonomic nervous system is affected, then patients complain of the appearance of dry skin, the frequent development of inflammatory processes, hair loss, and discoloration of the skin.

Causes of neuropathy

There are many causes of the disease, the most common include:

Intoxication - poisoning of the body with salts of heavy metals, arsenic, mercury, side effects of certain drugs, with chronic alcoholism.
Neuropathy in diabetes mellitus - with this disease, this pathology occurs most often. In advanced cases, diabetic foot develops.
Due to trauma, hypothermia.
Lack of minerals and vitamins, metabolic disorders.
Infectious diseases, including HIV.
Multiple sclerosis is a disease in which the nerve sheath is destroyed.

Types of neuropathies

In his medical practice, the doctor often encounters peripheral neuropathy. In this form, the nerves of the arms and legs are affected. Usually the diagnosis is not difficult. With autonomic neuropathy, internal organs suffer, its symptoms are not so specific. The patient seeks medical help from a therapist and not always the disease can be associated with nerve damage.

Post-traumatic neuropathy can also be distinguished. The main cause is trauma to the nerve trunk, damage to the spinal cord. This also includes tunnel neuropathy, which occurs as a result of compression of the nerve by muscle fibers and ligaments.

Diagnosis of the disease

Diagnosis of neuropathy based on complaints, questioning and examination of the patient. The level and extent of nerve damage can be determined using electroneuromyography. This method allows you to find out the presence of an inflammatory process, the degree of disturbance in the conduction of a nerve impulse, what exactly is affected - a muscle or a nerve, is there a tunnel syndrome.

The radial and ulnar nerves are most commonly affected. If the radial nerve suffers, then the patient complains of a change in the sensitivity of the skin and movement disorders. Complaints and signs depend on the degree and level of the lesion.

If the nerve is damaged in the upper parts of the patient, the extensor muscles of the hand, phalanges of the fingers, and forearm do not work. When you try to raise your hand, the hand hangs, the sensitivity of the first, second and some part of the third fingers is impaired. With neuropathy of the radial nerve in the lower sections, the ability to straighten the forearm and hand remains, skin sensitivity is preserved on the shoulder while maintaining the above signs of neuropathy. To determine the level of damage to the radial nerve, there are special diagnostic tests, they are used by neuropathologists.

When the doctor, when contacting the patient, will pay attention to paresthesia and numbness of 4-5 fingers and along the nerve. As the disease progresses without treatment, the brush begins to resemble a "clawed paw" in appearance. Diagnosis is usually straightforward and diagnostic tests are used. Of the neuropathies of the upper extremities, these two nerve trunks are affected more often.

Symptoms of neuropathy of the lower extremities

Tibial nerve neuropathy has the following symptoms:

Sensitivity disorder - paresthesia and numbness of the skin on the sole, back of the leg. Intense pain may also occur.
Damage to the motor roots - paresis of the muscles that turn the foot inward, the flexors of the fingers and foot. The Achilles reflex is lost. In the future, atrophy of the posterior muscles of the lower leg develops. The foot is constantly in an extended state, which makes it difficult to walk.

Diagnosis can be made based on simple tests:

Walking with an emphasis on socks is impossible.
The patient is unable to turn the foot inward and flex the toes and foot towards the sole.

Neuropathy of the peroneal nerve is quite common. He is one of the branches. With its defeat, motor and sensory disturbances are observed. But here you can see that the opposite muscle group suffers than with damage to the tibial nerve.

What will a specialist see with neuropathy of the peroneal nerve?

There is no way to walk and stand on your heels.
The foot hangs down, turned slightly inward, the toes are half bent.
A characteristic gait - peroneal, cock-like, stepage - a person, in order not to touch the floor with his fingers, tries to raise his leg high. Then he puts the sock on the floor, then the edge of the foot and the sole.
Atrophy of the muscles that are on the anterior surface of the lower leg.
The patient cannot straighten and turn the foot outward.
Decreased range of motion in the ankle joint.

With neuropathy of both the tibial and peroneal nerve, the treatment will differ little from the generally accepted one.

The basis of therapy is the elimination of the causes that caused the disease. In addition, painkillers and agents are prescribed to restore the activity of the affected nerve fiber. In the initial stages of neuropathy, detoxification therapy, vitamins, non-steroidal anti-inflammatory drugs, vascular drugs, hormones, and antioxidants are used for treatment. If the cause is an infectious or viral disease, then antibacterial, antiviral agents are prescribed.

With a decrease in acute manifestations, physiotherapy, massage, physiotherapy exercises, reflexology can be added to the prescribed medications.

It is important to pay attention to the lower extremities, because late therapy will lead to complications and, possibly, disability. The same can be said about neuropathy of the upper extremities. Depending on the severity of the disease, treatment is carried out on an outpatient basis in a polyclinic or in a hospital. The recovery period usually takes place in a sanatorium.

Hand neuropathy symptoms. Upper limb polyneuropathy, symptoms, treatment

Symptoms

Upper limb lesions

Lower extremity lesions

Diagnostics

Treatment

Symptomatic drugs

Other Therapies

Conclusion

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Symptoms of neuropathy of the lower extremities