What are peripheral neuropathies?

Peripheral neuropathies are a pathology of the nervous system that occurs against the background of damage to peripheral nerves due to compression or injury and is not inflammatory. When several nerves located in the same area are affected, the term “polyneuropathy” is used.

Up to 15% of the adult population suffers from various manifestations of neuropathy. Presumably, the number of patients with the disease is higher because some people do not go to the doctor with initial manifestations.

Causes of neuropathy

To date, the exact cause of peripheral neuropathies has not been established. The emergence and development of the disease are influenced by many factors, such as diabetes mellitus, HIV infection, chronic alcoholism, organic diseases, and external factors. In addition, forms of hereditary pathology associated with genetic defects are distinguished.

Internal pathologies that can affect the development of neuropathy:

• endocrine diseases;
• avitaminosis;
• autoimmune diseases;
• multiple sclerosis;
• rheumatoid arthritis.
• External factors include:
• trauma;
• intoxication;
• infections;
• alcoholism.

Depending on the causes of occurrence, peripheral neuropathies are classified:

• post-traumatic – appears as a result of injuries of the nerve fiber and its branches (with bruises, cuts, dislocations, fractures). In most clinical cases, this form of the disease affects the ulnar nerve, facial, sciatic, nerves of the lower extremities;
• diabetic – develops with diabetes mellitus;
• ischemic – develops as a result of compression of nerve bundles in the spine or muscle-bone joints. As a result, the blood supply to the nerve endings is disrupted. It develops against the background of vascular diseases and with large blood loss. In most cases, the optic nerve is affected;
• alcoholic – occurs due to the use of large doses of alcohol, the decay products of which complicate the metabolic process.

Symptoms of neuropathy

The disease manifests itself in different ways. The most characteristic symptoms of neuropathic pain  are:

• violation of the sensitivity of the damaged area;
• pain syndrome of varying severity and intensity;
• muscle weakness;
• spasms and cramps;
• Difficulty moving.

Diagnostics

Neuropathy is considered a rather difficult condition to diagnose. The disease may not make itself felt for a long time and may not show up with specific symptoms. Therefore, the doctor needs to collect a complete history to make the correct diagnosis.

At the reception, the patient needs to tell the neurologist about their lifestyle to inform whether and what medications were taken, if viral diseases were transferred, whether there are chronic and hereditary pathologies, and whether surgical treatment was carried out. After an oral questioning, the doctor examines the patient; palpation of the nerve trunks is mandatory, revealing soreness and thickening along their course. Beating on the nerve endings is carried out, and tingling sensations are detected in the sensitive area. Next, the patient needs to undergo a series of instrumental examinations and laboratory tests:

• clinical and biochemical blood test;
• elastography;
• ultrasound procedure;
• CT scan;
• electromyography;
• MRI and X-ray;
• consultation of related specialists (ophthalmologists).

Numerous and confusing anatomical variants of the peripheral nervous system make it difficult to understand its structure, so only a highly qualified specialist can diagnose the disease. The best neurologist with many years of practice work in our center FNKTs FMBA. Modern equipment and our clinical diagnostic center allow us to quickly and accurately identify the problem, which speeds up the process of starting treatment. Prompt response to the issue helps avoid irreparable processes in the body and exclude the development of pathology.

Prevention

The main task of prevention is the timely treatment of infectious and systemic diseases. Patients with diabetes mellitus and other predisposing pathologies need to visit a doctor regularly and strictly follow their prescriptions and recommendations. The rest of the prevention measures are reduced to simple rules:

• give up addictions;
• lead an active lifestyle with moderate physical activity;
• follow the correct and balanced diet;
• wear comfortable clothing and shoes that do not compress your feet and ankles;
• spend more time outdoors and hiking.

How to treat pain neuropathy?

In the multidisciplinary center of the FNKTs FMBA, therapy is always carried out comprehensively with simultaneous treatment of the concomitant disease that caused the neuropathy. After a thorough diagnosis, the neurologist determines the tactics of treatment depending on the form of the disease, the severity of its course, and the reasons that provoked the lesion of neuromuscular conduction.

Treatment is always consistent. Initially, the damaging factor (compression) is eliminated, then inflammation and pain are relieved, the complete functioning of the affected area is restored, and regenerative processes are stimulated. Prescribed drug treatment includes the use of anti-inflammatory, antiviral, pain relievers, and other drugs, including those that improve nerve patency. A course of vitamins may be indicated for drug therapy.

Physiotherapy shows positive results in treatment:

• physiotherapy;
• electrophoresis;
• magnetotherapy;
• laser therapy;
• hydrotherapy;
• massage;
• acupuncture.

When drug therapy is insufficient, the neurologist refers the patient to a neurosurgeon. FNKTS FMBA offers modern and effective surgical treatment:

• prosthetics or nerve plastics;
• neurolysis;
• negotiation;
• transposition of tendons and muscles.