Peripheral nerve damage

Introduction Peripheral nerve refers to the cerebral and spinal nerves other than the olfactory and optic nerve, the autonomic nerve and its ganglia. Peripheral neuropathy refers to a disease that is structural or functionally impaired in the nervous system on Friday.

Cause

The etiology is complex and may be related to nutritional metabolism, drugs and poisoning, vasculitis, tumor, heredity, trauma or mechanical stress.

They selectively damage different parts of the peripheral nerves, resulting in corresponding clinical manifestations. The axonal transport system is of great significance in the pathogenesis of peripheral nerves. The axons have longitudinally bundled neurofilaments and microtubules, which are connected by a transverse bridge to transport a variety of substances required for nerve growth factor and axonal regeneration from the neuronal cell body to the distal end of the axon, and play a role in nutrition and metabolism; It can also affect the transmission of signals by neurons and enhance their metabolic activities. The axon is extremely sensitive to poisons, and the positive transport of the lesion may cause cell membrane components and neurotransmitter metabolism disorders in the distal end of the axon; adverse transport may cause axonal regeneration disorder.

an examination

Related inspection

F-wave accessory nerve examination neurological examination

Clinical manifestation

Peripheral neuropathy has many unique symptoms and signs. Sensory disturbances mainly include sensory loss, paresthesia, pain, and sensory ataxia. Movement disorders include motor nerve stimulation and paralysis. Stimulation symptoms mainly include fascia tremor, muscle fiber twitching, painful phlegm, etc., while muscle strength loss or loss, muscle atrophy is a symptom of motor nerve palsy. In addition, patients with peripheral neuropathy are often accompanied by reduced or disappeared tendon reflexes. Autonomic nerve damage often manifests as no sweat, vertical hair disorder and orthostatic hypotension. In severe cases, there may be no tears, no sputum, impotence and bladder rectal dysfunction. .

Diagnostic medical history description, clinical physical examination and necessary auxiliary examination are the main basis for the diagnosis of peripheral neurological diseases. Nerve conduction velocity and electromyography are valuable for the diagnosis of peripheral neuropathy, and subclinical peripheral neuropathy can be found, which is also an objective indicator for prognosis and efficacy. Peripheral nerve tissue biopsy is generally used in clinical and other laboratory tests for qualitative difficulties, and can determine the location of peripheral nerve injury, such as axonal, neuromembrane cells, interstitial and so on. Some peripheral neuropathy can also be used to determine the nature of the disease such as leprosy, amyloidosis, etc. by pathological examination.

In short, the localization diagnosis of peripheral neuropathy is not difficult based on the above-mentioned changes in symptoms, signs and auxiliary examinations, and the diagnosis of the cause should be combined with the history of the disease, the development of the disease course, the symptoms and signs, and the results of the examination. Any single auxiliary examination is Can not be used as a gold standard for diagnosis.

Differential diagnosis

Nerve Root Injury: A series of conditions caused by nerve damage in the body-related parts caused by factors such as squeezing, pulling, rubbing, and surgery.

Hypoxic-ischemic nerve injury: is a neurological or organic nerve damage caused by neurological ischemic or hypoxic neuroedema caused by respiratory arrest or other causes of neurological dysfunction. Some patients are treated promptly. The recovered nerve function is good, but some nerves are aggravated due to excessive ischemic time and secondary ischemic degeneration.

Pathological nerve injury: It is a disease caused by chronic diseases of a certain disease. The symptoms are unclear at the time of onset. There are only minor neurological symptoms. Due to the diagnosis error, the disease is often diagnosed when the disease is very serious.

Organic nerve damage: refers to the pathological changes in which nerves are lost due to external factors or pathological changes.

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