Peripheral neuritis

Introduction Peripheral neuritis is a general term for multiple peripheral nerve damage caused by a variety of causes, manifested as distal symmetry of the limbs, motor and autonomic dysfunction, so it is also known as polyneuritis or multiple peripheral neuritis. Due to the different causes of the disease, the onset can be acute and slow. The main clinical manifestations are the symmetry of the distal part of the limb, the movement and autonomic dysfunction, and the lower limbs are heavier. First, the sensory disorder: the initial often refers to the (or toe) end of the burning, pain, numbness and other sensational symptoms such as paresthesia or hypersensitivity, gradually appearing feelings of decline or even disappear, the distribution of sensory disturbances are gloves or socks, a few The patient may have deep sensory disturbances, and the gastrocnemius muscles often have tenderness. Second, movement disorders: manifested as muscle weakness, muscle tension is low, tendon reflexes weakened or disappeared, individual causes (such as nitrofurazone) caused by reflexes can be active, long-term disease may have muscle atrophy. Third, autonomic dysfunction: the skin of the extremities is cold, pale, flushed or mildly bun, less sweat or sweaty, the skin is thinner and tenderer or rougher, and the nails lose normal luster and enhance keratinization.

Cause

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.

Second, nutritional metabolic disorders: such as B vitamin deficiency, diabetes, uremia, chronic digestive tract diseases, pregnancy and so on.

Third, infection: often accompanied or secondary to various acute and chronic infections, such as dysentery, tuberculosis, infectious hepatitis, typhoid, mumps, etc., a small number of pathogens directly invade the peripheral nerves, such as leprosy.

Fourth, allergies, allergies: such as serum treatment or vaccination after neuritis.

5. Others: such as connective tissue diseases, hereditary diseases such as sacral muscular atrophy, hereditary ataxia-induced peripheral neuritis, hereditary sensory radiculopathy. In addition, a variety of 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 the inflammatory changes in the peripheral nerves caused by a few causes (such as leprosy), the pathological changes are mainly segmental demyelination and axonal degeneration of the peripheral nerves, or both. A small number of cases may be associated with changes in neuromuscular junctions.

an examination

1. Laboratory examination has auxiliary significance for clinical diagnosis.

2, myoelectric.

3, B-ultrasound.

Differential diagnosis

According to the characteristics of motion, sensory and autonomic dysfunction of the distal end of the symmetrical limb, the diagnosis of the disease is not difficult. Sometimes EMG and nerve conduction velocity measurements or nerve and muscle biopsy are needed to help diagnose. The cause of the disease needs to be determined based on the history of the disease, the characteristics of the clinical symptoms, and the results of the relevant laboratory tests. Some patients may not find a clear cause.

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