What Is Hand Neuropathy?

Peripheral nerve is a general term for cranial nerve, spinal nerve, plexus, nerve cord, neural stem and peripheral nerve damage. Can be divided into two categories of neuralgia and neuropathy. When neuralgia occurs, severe pain occurs only in the sensory nerve distribution area. The neuron's main mass has not changed significantly, and its conduction function is normal. Peripheral nerve degeneration caused by infection, poisoning, trauma, or metabolic disorders is neuropathy, commonly known as neuritis. According to the location of peripheral neuropathy, they are called cranial neuritis, radiculitis, ganglionitis, plexus inflammation, neural stem inflammation, and peripheral neuritis.

Peripheral nerve disease

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Peripheral nerve is a general term for cranial nerve, spinal nerve, plexus, nerve cord, neural stem and peripheral nerve damage. Can be divided into two categories of neuralgia and neuropathy. When neuralgia occurs, severe pain occurs only in the sensory nerve distribution area. The neuron's main mass has not changed significantly, and its conduction function is normal. Peripheral nerve degeneration caused by infection, poisoning, trauma, or metabolic disorders is neuropathy, commonly known as neuritis. According to the location of peripheral neuropathy, they are called cranial neuritis, radiculitis, ganglioitis, plexus inflammation, neural stem inflammation, and peripheral neuritis.

Chinese name

Peripheral nerve disease

Meaning

General term for nerve damage

Classification

Neuralgia and neuropathy

Results

disfunction

The peripheral nervous system includes all nerves except the central nervous system (brain and spinal cord). The cranial nerve directly connects the head, face and brain, and also connects the eyes and nose to the brain. The remaining peripheral nerves connect the spinal cord with the rest of the body.

The brain-to-trunk connection is done through 31 pairs of spinal nerves. These nerves originate from the spinal cord. Each pair of spinal nerves includes: a nerve located in front of the spinal cord, which transmits information from the brain to the muscles; another nerve behind the spinal cord, which transmits sensory information to the brain. The spinal nerves are connected to each other by nerve plexuses in the neck, shoulders, and pelvis, and then branch off to dominate the area further away from the body.

Peripheral nerves are actually formed by bundles of nerve fibers. Some are very small (less than 0.4mm in diameter), while others are very large (more than 6.5mm in diameter). Larger fibers transmit signals to muscles (motor nerve fibers) and touch and position (sensory nerve fibers). Smaller sensory fibers transmit pain and temperature and control the body's autonomic functions such as heart rate, blood pressure, and temperature. (Autonomic nervous system). Schwann cells surround each nerve fiber and produce several layers of lipid insulation called myelin.

Peripheral nerve dysfunction can be due to damage to the nerve cell body of the nerve fiber itself, Schwann cells or myelin sheath. When the myelin sheath is damaged and myelin is lost (demyelination changes), the nerves cannot transmit impulses normally. However, myelin sheaths can regenerate quickly, allowing nerve functions to fully recover. Nerve cells are different from myelin sheaths. When they are damaged, they repair and regenerate slowly. Sometimes regeneration can lead to abnormal neural connections, such as a nerve. If attached to a muscle incorrectly, this can lead to reflexes or awkward movements. If the sensory nerve grows incorrectly, it can cause a person to receive tactile or pain erroneously.

Muscle-brain pathway

Neural connections and information transmission are accomplished through synapses. A muscle movement involves two complex neural pathways: sensory and motor pathways. It includes the following 12 basic steps:

1. Sensors on the skin relay the information received.

2. The signal travels along the sensory nerve to the spinal cord.

3 The sensory nerve is connected to neurons in the spinal cord via synapses.

4 The sensory nerve crosses to the opposite side of the spinal cord.

5. This signal is passed up the spinal cord.

6. Signals carried in the thalamus spinal cord are transmitted to nerve fibers in the sensory center via synaptic connections.

7. The sensory center receives signals and can trigger the motor cortex center to generate motor signals.

8. Nerve fibers carrying motor signals cross to the opposite side in the brainstem.

9. The signal goes down to the spinal cord.

10. Send signals to motor nerves via synaptic connections in the spinal cord.

11. Signals are transmitted along the motor nerve.

12. The signal reaches the motor end plate, where it stimulates muscle movement.

-Muscle irritating diseases

The neural pathway from the cerebral cortex to the muscle is complex, and dysfunction anywhere on this pathway can lead to muscle and motor disorders. Without the proper stimulation signals from the nerves, the muscles become weak and atrophic, and sometimes, even if the muscles are normal, they will be completely paralyzed. Muscle disorders that occur due to neurological abnormalities include amyotrophic lateral sclerosis (Lou Glick's disease), progressive muscular atrophy, progressive bulbar paralysis, primary lateral sclerosis, and progressive pseudobulbar palsy. In most cases, the cause is unclear. The genetic predisposition for these diseases is approximately 10%.

All these diseases are similar in that the motor nerve fibers involved in stimulating muscles in the spinal cord and brain show progressive deterioration, causing muscle weakness and eventually paralysis. In addition, different diseases cause muscle abnormalities in different parts due to different parts of the nervous system. As a result, each disease occurs in different parts of the body. These diseases are more common in men than women. The symptoms of the disease usually begin to show up at the age of 50.

Symptoms

Amyotrophic lateral sclerosis is a progressive developmental disease that begins with weak hands and rarely occurs in the feet. Myasthenia can progress faster, the ipsilateral side of the body is more pronounced than the contralateral side, and it generally develops into the upper arms and legs. Spasms are also common and can occur before muscle weakness, but feel left intact. In addition to progressive muscle weakness, stiffness also appears, muscles become tense, spasms follow, and tremors can occur. Weakness in speaking and swallowing muscles can cause difficulty speaking (dysphonia) and difficulty swallowing. Finally, the disease can weaken the diaphragm and cause breathing problems; some people need a ventilator to help them breathe.

Amyotrophic lateral sclerosis is always progressive, although the rate of progression can vary. About 50% of people with the disease will die within 3 years of the first symptoms. 10% of patients can live for 10 years or more, and occasionally 30 years.

Progressive muscular atrophy is similar to amyotrophic lateral sclerosis, but it progresses more slowly, without spasms, and without muscle weakness. Involuntary muscle contraction or muscle fiber tremor can be the earliest symptoms. Many people with this disease can live for 25 years or more.

In progressive bulbar palsy, the nerves that govern the chewing muscles, the swallowing muscles, and the speaking muscles are affected, making these functions difficult. People with progressive bulbar palsy can also experience strange emotional reactions, often quickly changing from a happy expression to a sad expression for no reason; often there are abnormal emotional vents. Difficulty swallowing often causes food or saliva to be inhaled into the lungs, usually dying within 1 to 3 years after onset, and often the cause of death is pneumonia.

Primary lateral sclerosis and progressive pseudobulbar palsy are rare; they are amyotrophic lateral sclerosis that slowly progress and change. Primary lateral sclerosis first affects both the upper arms and thighs, while progressive pseudobulbar paralysis first affects the muscles of the face, cheeks, and throat. In both diseases, severe myotonia is accompanied by muscle weakness. Muscle tremor and atrophy do not appear, labor is gradually lost, and development can take more than a few years.

. Diagnosis

When an adult develops progressive muscle weakness without sensory loss, the doctor should suspect it. Physical examination and auxiliary examinations can help rule out other causes of muscle weakness. EMG measurements can tell if it's a nerve or muscle problem, but laboratory tests can't determine which neurological disease is causing the problem. A doctor can make a diagnosis by observing and analyzing the involvement of the muscles of the body, when the symptoms begin, the symptoms that first appear, and how the symptoms evolve.

Treatment

There is no special treatment for these diseases. Physical therapy helps patients maintain muscle strength and prevent muscle stiffness (contracture). People with difficulty swallowing must give greater care to help eating and avoid suffocation; some people must eat through stomach tubes. The gastric tube is inserted into the stomach through the abdominal wall. Some drugs can reduce muscle rigidity and sometimes relieve muscle spasms and salivation.

Researchers are experimenting with a substance that promotes nerve growth (neurotrophic factor). To date, clinical studies have not confirmed its efficacy.

-Neuromuscular transmission disorders

Nerves connect with muscles at the neuromuscular junction. When the nerve stimulates the muscle at the neuromuscular junction, muscle contraction occurs, and neuromuscular transmission disorders include: myasthenia gravis, myasthenic syndrome (Eylan's syndrome), and botulism.

Myasthenia gravis

Myasthenia gravis is a type of muscle weakness caused by abnormal neuromuscular junction function. It is an autoimmune disease.

In myasthenia gravis, the immune system produces many antibodies that act on receptors located on the muscle side of the neuromuscular junction. These particular damaged receptors are those that accept neural signals via acetylcholine. Acetylcholine is a chemical (neurotransmitter) that transmits nerve impulses.

It is not clear what causes the body to attack its own acetylcholine receptors, but genetic abnormalities play an important role in immune abnormalities. Antibodies circulate in the blood. Mothers with myasthenia gravis can pass these antibodies to the unborn through the placenta. The fetus, which produces neonatal muscle weakness, will appear in the infant within days to weeks after birth.

Symptoms

The disease is more common in women than in men and usually begins between the ages of 20 and 40 and can occur at any age. The most common symptoms are weakness of the eyelid (ptosis of the upper eyelid); weakness of the eye muscles, which will cause diplopia; and muscles are particularly prone to fatigue after exercise. In patients with myasthenia gravis, 40% of the ocular muscles are affected first, and finally 85% of the patients are affected. Difficulties in speaking and swallowing, and weakness in bilateral upper arms and lower limbs are also common symptoms.

Muscle progressive weakness is a characteristic manifestation of it. For example, a person was able to use a hammer well, and because of muscle weakness, he can no longer use it. The degree of muscle weakness can fluctuate from hours to days. This disease does not have the same development process, and often iterates repeatedly. In severe cases, patients with myasthenia gravis may experience significant paralysis but no sensory disturbance. About 10% of patients develop life-threatening respiratory muscle weakness (known as myasthenic crisis).

. Diagnosis

Doctors should suspect myasthenia gravis when a person develops general weakness, especially when muscle weakness affects the muscles of the eye muscles or facial muscles, or when the muscle weakness increases with the use of the affected muscles and recovers after rest. Because acetylcholine receptors are blocked, various drugs that increase the amount of acetylcholine are beneficial. Using one of them experimentally can help confirm the diagnosis.

Some patients with myasthenia gravis have thymoma, which may be the cause of abnormal immune system function. A CT scan of the chest can determine the presence of thymoma.

Treatment

Oral medications can increase acetylcholine levels.

If the dose of acetylcholine supplement is too large, it can also cause muscle weakness, and it is difficult for doctors to identify this condition. However, these drugs may fail after long-term use, so the dosage of the drugs must be adjusted. Doctors need to evaluate whether myasthenia gravis or the effectiveness of the drug is reduced in the practice of treating myasthenia gravis.

Surgical treatment can be used when the drug does not relieve or when the patient has a weakness crisis.

Other neuromuscular transmission disorders

Myasthenic syndrome is similar to myasthenia gravis. It is also an autoimmune disease that can cause myasthenia gravis, but myasthenic syndrome is due to insufficient release of acetylcholine, not due to abnormal antibodies to the acetylcholine receptor. Myasthenic syndrome can occur on its own, but usually as a symptom of some cancer, especially lung cancer (see section 79).

Botox is a disease caused by ingestion of food contaminated with botulinum toxins. This toxin can cause muscle paralysis by inhibiting the release of acetylcholine from the nerves.

Many drugs, such as certain insecticides (organophosphorus pesticides) and nerve gas used in chemical warfare, can affect neuromuscular junctions. Some of these poisons prevent the natural breakdown of acetylcholine, which is released after nerve impulses are transmitted to muscles. Large doses of certain antibiotics can cause muscle weakness in the same way.

-Plexus disease

The nerves emitted by the plexus are like the electrical junction box that cuts out many wires to different parts of the house. Damage to the nerves in the plexus will cause limb dysfunction dominated by these nerves. The main nerve plexus in the body is the brachial plexus, which is located in the neck and divides many nerves into the arm. The other major plexus is the lumbosacral plexus, which is located below the back (waist) and divides nerves into the pelvic cavity and lower limbs.

Cause

The plexus is often damaged when antibodies produced by the body attack its own tissues, an autoimmune response. The autoimmune response may cause acute brachial plexus neuritis, at which time the brachial plexus suddenly becomes dysfunctional. When the body is damaged or cancerous, the plexus is damaged more often. Accidents Pulling the arm at the shoulder joint or making the arm excessively bent may damage the brachial plexus. Similarly, a falling (falling) external force can damage the lumbosacral plexus. Tumors growing in the apical area of the lung can invade and destroy the brachial plexus, while tumors of the small intestine, bladder or prostate can invade the lumbosacral plexus.

. Symptoms and diagnosis

Brachial plexus dysfunction will cause arm pain and weakness, and weakness can affect only one part of the arm, such as the forearm biceps or the entire arm. When the cause is an autoimmune disease, the arm can lose muscle strength within a day to a week, and the muscle strength recovers slowly, taking more than several months. Injury recovery is also slow, over several months; some severe injuries can lead to permanent muscle weakness. Abnormalities of the lumbosacral plexus cause pain in the lower back and thighs, and cause weakness in some or all of the lower limbs. Weakness can be limited to the movement of the foot or gastrocnemius muscle or cause paralysis of the entire lower limb. Recovery depends on the cause. Because the autoimmune disease damages the plexus, it can slowly recover after several months.

From the combined impairment of sensory and motor, doctors can determine the plexus damage and know from the location which plexus is involved. Studies of electromyograms and nerve conduction can help localize. A CT or MRI scan can help determine whether it is a cancer or another plexus disease caused by a new organism.

Treatment

Treatment depends on the cause of the plexus disease. Cancers near the plexus can be treated with radiotherapy or chemotherapy. Occasionally, tumors or blood clots that harm the plexus must be removed by surgery. When plexus disease is caused by injury, nerve repair takes longer.

-Thoracic outlet syndrome

Thoracic exit syndrome is a disease that has not been precisely defined, and they are grouped together because all these diseases cause pain and unusual sensations (paresthesias) in the hands, neck, shoulders, or arms.

Cause

Thoracic outlet syndrome, which is more common in women than in men, usually affects those between 35 and 55 years of age. The different causes of these diseases are often uncertain, but they may occur at the exit of the thorax, where the esophagus, large blood vessels, trachea, and some structures between the neck and thorax pass through in the channel at the top of the thorax (bottom of the neck). This pathway is very crowded, and when the blood vessels or nerves to the arm are compressed between the ribs and muscles, various symptoms can occur.

. Symptoms and diagnosis

Hands, arms, and shoulders may be swollen or purple (cyanosis) due to hypoxia. There are no tests that specifically identify thoracic outlet syndrome, but doctors can rely on information from a medical history, physical examination, and some tests to make a judgment.

There are two tests that can help doctors determine if the chest exit path is narrow and affects blood flow in the arm. Edson test: When the patient's head is tilted backwards and turned to the opposite side, maintain a deep inhalation state and determine whether the wrist pulse weakens or disappears. Allen test: Raise your arm and cut your pulse as you turn your head to the unaffected side. Doctors can hear abnormal blood vessel sounds through a stethoscope, which indicates abnormal blood flow in the affected arteries. Angiography (post-tracing X-ray film injected into a blood vessel with a special stain) can show abnormal blood flow to the arm. But not all of these findings confirm the diagnosis of thoracic outlet syndrome, and a negative test does not completely rule out the diagnosis.

Treatment

Most people with symptoms of thoracic outlet syndrome improve with physical therapy and training. Surgery can be used on a small number of people with a well-defined abnormality, such as a small rib (cervical rib) on the neck that compresses an artery. However, most doctors try to avoid surgery.

When is the foot numb?

When the foot nerve is compressed, the foot becomes numb. Pressure forces the foot nerve's blood supply to be blocked, and the nerve sends an abnormal signal (tingling sensation) called paresthesia. Move for a while to eliminate the pressure and restore the blood supply, so that the nerve function returns to normal and the paresthesia disappears.

-Peripheral neuropathy

Peripheral neuropathy (peripheral nerve damage) is a malfunction of peripheral nerves.

Peripheral neuropathy causes abnormalities in the senses, muscle activity, or internal organs. Symptoms can occur alone or in combination. For example, after the nerve is damaged, the inner muscles become weak or atrophic. Pain, numbness, acupuncture, swelling and redness can occur in different parts of the body. The above manifestations can occur regardless of damage to one nerve (mononeuropathy), two or more nerves (multiple mononeuropathy), or damage to many nerves in the whole body (polyneuropathy).

Mononeuropathy

Mononeuropathy occurs when a single peripheral nerve is damaged.

Injuries are the most common cause of mononeuropathy. Injuries are often caused by pressure that continues to act on a nerve that is near a bone bulge near the body surface, such as the elbow, shoulder, wrist, or knee. The persistence of stress during deep sleep is enough to damage the nerves, especially patients under anesthesia or intoxication, elderly people who have been bedridden for a long time, and people who cannot move or stand up due to paralysis. There are also many uncommon causes of long-term nerve compression: improper use of splints and crutches; local spasms persist; elbows are placed on the table for long periods of time when planting flowers or playing cards; accidents, long exposure The use of radiation in cold or hot environments or when treating cancer can damage nerves.

An infection can cause a single neuropathy by damaging a nerve. Leprosy is sometimes a cause of neuropathy in some countries.

Some peripheral nerves are damaged more often than others because they are in a vulnerable area. For example: the median nerve in the wrist (carpal tunnel syndrome), the ulnar nerve in the elbow, the radial nerve in the upper arm, and the peroneal nerve in the gastrocnemius muscle.

Carpal tunnel syndrome

Carpal tunnel syndrome is caused by compression of the median nerve that runs on the wrist and governs the thumb side of the hand. This compression produces paresthesia, numbness, acupuncture, and pain in the thumb and radial three fingers. Occasionally, there is pain and paresthesia (burning or acupuncture) in the arms and shoulders. Pain may be worse during sleep because the hand is confined to a certain position. Over time, the muscles on the thumb side can become weak and atrophic.

Carpal tunnel syndrome is a common disease, especially in women, and can affect one hand or both hands, especially those who need to repeatedly stretch their wrists while working, such as those using wrenches. Prolonged use of a computer keyboard is also thought to cause carpal tunnel syndrome. Pregnant women and people with diabetes or patients with hypothyroidism also increase the risk of carpal tunnel syndrome.

The best treatment for this disease is to avoid excessive wrist extension or external forces acting on the median nerve. The wrist splint and the angle of the computer keyboard are helpful. Local injection of corticosteroids into the nerves can sometimes bring temporary relief. For severe pain or muscle atrophy, weakness, surgery is the best nerve decompression method. The surgeon loosens the fibrous tissue of the median nerve. Before surgery, a nerve conduction velocity test can be performed to confirm that the lesion is carpal tunnel syndrome.

Ulnar nerve paralysis

The ulnar nerve runs close to the skin on the elbow. The elbow often leans on the table or is easily damaged when there is abnormal bone hyperplasia in this area. Severe chronic ulnar nerve paralysis can cause muscle atrophy and "claw-shaped hand" deformities. Nerve conduction studies can help locate damaged nerves. Because surgical repairs are often unsuccessful, the disease is usually treated with physical therapy and avoids elbow compression.

Radial nerve palsy

Radial nerve palsy occurs when the radial nerve running under the upper arm bone is compressed for a long time. The disease is sometimes referred to as "weekend night paralysis," because it often occurs in people who hang their arms on the back of their chairs or under their heads after a heavy drink. After the radial nerve damage, the wrists and fingers are weakened, the wrist is bent down, and the fingers are flexed (ptosis of the wrist). Sometimes the back of the hand can lose sensation. After the stress is relieved, radial nerve palsy usually improves.

Peroneal palsy

When the peroneal nerve under the soft skin folds located behind the upper knee of the lower leg is compressed, it can cause paralysis of the peroneal nerve. Make the muscles weak, unable to raise the affected foot, and cause the foot to sag. Patients who are bedridden, patients who are incorrectly strapped to a wheelchair, and those who are accustomed to crossing their legs for a long time are most likely to have peroneal palsy.

Substances that can cause nerve damage

Anti-infective drugs

Anti-cancer drugs

Antiepileptic drugs

Industrial toxic substances

Heavy metals (such as lead or mercury)

Carbon monoxide

Various solvents

Analgesics

Polyneuropathy

Polyneuropathy is the simultaneous dysfunction of many peripheral nerves throughout the body.

Cause

There are many different causes of polyneuropathy. Infection can cause polyneuropathy, sometimes caused by toxins (such as diphtheria) produced by certain bacteria, or autoimmune reactions (such as Gibb-Barr syndrome). Toxins can damage peripheral nerves and cause polyneuropathy or rare mononeuropathy. Cancer can also cause polyneuropathy by directly infiltrating, compressing the nerves, or producing toxins.

Nutritional deficiencies and metabolic disorders can cause polyneuropathy, such as vitamin B deficiency. However, neuropathy associated with nutritional deficiencies is uncommon in the United States.

Diseases that can cause chronic polyneuropathy include diabetes, renal failure and severe malnutrition. Chronic polyneuropathy develops slowly, often over months or years, often starting on the feet and sometimes with both hands. In patients with diabetes, poorly controlled blood glucose levels can cause several types of polyneuropathy. The most common is diabetic neuropathy, with distal polyneuropathy causing tingling or burning in hands and feet. Diabetes can also cause mononeuropathy or multiple mononeuropathy, which will cause muscle weakness, typically the muscles of the eyes and thighs.

Symptoms

Chronic polyneuropathy often has acupuncture sensations, numbness and burning pain in the arms, legs, and multiple joints, as well as abnormalities in vibration and position. Pain often aggravates at night, and the pain can worsen when touching the affected area or when temperature changes. Due to temperature and pain disorders, patients with chronic polyneuropathy are often burned, and prolonged stress or injury can easily cause ulcers. Due to the loss of pain, too strong external forces cannot be predicted, making the joints vulnerable to damage (Charcoal joints. Can't feel the position causing walking instability or even standing instability. Finally, muscles can become weak and atrophy.

Many patients with peripheral neuropathy also have abnormalities in the autonomic nervous system. This system controls the body's autonomous functions such as heartbeat, bowel function, bladder function, and blood pressure. When peripheral neuropathy affects the autonomic nerve, it is mainly manifested as diarrhea or constipation, inability to control intestinal or bladder function, impotence and hypotension or hypertension, most notably orthostatic hypotension. The skin can become paler and drier, and sweating may increase.

. Diagnosis

Doctors can easily make a diagnosis based on various symptoms of chronic polyneuropathy. Physical examinations and special tests such as electromyography and nerve conduction velocity tests (see section 60) can also provide some diagnostic evidence. However, the diagnosis of polyneuropathy is only the beginning, and the cause must be found. If the cause is a metabolic disease rather than a physical injury, a blood test can reveal the cause. For example, a blood test can indicate pernicious anemia (vitamin B12 deficiency) or lead poisoning. Elevated blood glucose levels indicate that diabetes is not under control, elevated blood creatinine levels indicate renal failure, and urine tests may indicate heavy metal poisoning or multiple myeloma. Some people need a thyroid function test or vitamin B level measurement. Occasionally, a nerve biopsy is necessary.

. Treatment and Prognosis

The treatment and outcome of chronic polyneuropathy depends on the cause. When neurological diseases are associated with diabetes, careful control of blood glucose levels can prevent the disease from progressing and improve symptoms, but recovery is slow. Treatment of multiple myeloma and renal failure may also accelerate the recovery of neurological diseases. Nerve damage due to trauma and compression requires surgery. Physical therapy can sometimes reduce muscle spasms or weakness.

-Gibbs-Pale syndrome

Gypsy-Pasteur syndrome (acute ascending polyneuritis) is a type of acute polyneuropathy that rapidly weakens muscles and sometimes causes paralysis.

A possible cause is an autoimmune response-the body's immune system attacks the myelin sheath. In about 80% of patients, symptoms begin with mild infections, surgery, or 5 to 3 weeks after immunization.

Symptoms

Geiger-Pasteur syndrome often begins with weakness in both lower limbs, loss of acupuncture, and sensation. Then, it progresses up to both upper limbs. Myasthenia is the most prominent symptom. In approximately 90% of patients, muscle weakness reaches its peak within 2 to 3 weeks; in 5% to 10% of patients, respiratory muscle weakness occurs that necessitates the use of a ventilator; about 10% of patients require facial and swallowing muscle weakness Eating via intravenous infusion or vial.

When the disease is very severe, there may be fluctuations in blood pressure, abnormal heart rhythms, or other abnormalities in the autonomic nervous system. There are rare types of Gibbs-Pasteur syndrome that include eye movement disorders, ataxia, and disappearance of normal reflexes. About 5% of people with Gibbs-Pale syndrome die from this disease.

. Diagnosis

Because laboratory tests cannot specifically diagnose Gibbs-Pak syndrome, doctors must recognize the disease from its symptoms. :

Treatment

Gypsophila syndrome is a very serious disease that requires immediate hospitalization because it can worsen rapidly. Establishing a diagnosis is the most important, because the prognosis is better with timely and appropriate treatment. If necessary, close monitoring should be used so that the ventilator can be used to assist breathing in time. Nurses should take measures to prevent bedsores, use soft mattresses and turn patients over every 2 hours. To prevent muscle contracture and protect joint and muscle function, physical therapy is necessary.

People with Gibbs-Pak syndrome can slowly improve on their own. If there is no treatment, the recovery period will take a long time, while those who receive early treatment will improve very quickly, and they can recover within days to weeks without treatment. , Recovery will take several months. Most patients recover almost completely. About 30% (pediatric patients and even higher) of patients have some degree of muscle weakness after 3 years. After initial improvement, approximately 10% of patients may relapse and progress to chronic recurrent polyneuropathy. Immunoglobulins and corticosteroids may be helpful for this recurrent Gibbs-Pasteur syndrome. plasma

-Hereditary neuropathy

Hereditary neuropathy is a type of neurological disease inherited from parents to children. There are three main types of this disease. They are hereditary motor neuropathy that affects only the motor nerve; hereditary sensory neuropathy, which affects only the sensory nerve; -Motor neuropathy, affecting both sensory and motor nerves. Hereditary neuropathy is uncommon, and hereditary sensory neuropathy is particularly rare.

Charcoal-Marie-Tuss disease (also known as peroneal muscular atrophy) is the most common hereditary neuropathy. It affects the peroneal nerve and causes calf muscle weakness and atrophy. This disease is an autosomal dominant genetic disease.

The symptoms of Charcoal-Marie-Tus disease depend on the type of this genetic disease. Children with type I disease develop weakness in their lower limbs during the middle of their childhood, leading to sagging feet and gastrocnemius atrophy (stomach leg deformities). In the future, the muscles of the hands also began to atrophy, and the hands and feet could not feel the decrease in pain and temperature, and the course of the disease progressed slowly without affecting life expectancy. People with type disease progress more slowly and show mild type symptoms after middle age.

De-Sauer's disease (also called interstitial proliferative neuropathy) is less common than Charcoal-Marie-Tuls disease. It develops during childhood and is characterized by progressive weakness and sensory loss in both lower limbs and muscular weakness that progresses more quickly than Charcoal-Marie-Tuls disease.

Examination of the distribution of muscle weakness, age at onset, family history, foot deformities (high arch and clubbing toe), and neurotransmission speed can help doctors distinguish between Charcoal-Marie-Tuls disease and De-Sauer disease and Neuropathy due to other causes. No treatment can stop these diseases from worsening. Wearing a foot rest can help correct foot sagging, and sometimes requires orthopedic surgery.

-Spinal muscular atrophy

Spinal muscular atrophy is a hereditary disease of progressive muscle weakness and atrophy caused by degeneration of nerve cells in the spinal cord and brain stem.

Symptoms

Symptoms first appear in infancy and childhood. Myasthenia caused by acute spinal muscular atrophy (Wednich-Huffman disease) occurs in infants between 2 and 4 months of age. This disease is an autosomal recessive disease, which means that both parents One recessive gene was obtained.

Children with moderate spinal muscular atrophy remain normal for one or two years, then develop weakness, and the lower limbs are heavier than the upper limbs. The disease usually does not involve the respiratory, heart, or cranial nerves, and the course is slow.

Chronic spinal muscular atrophy (Wo-Ku-Webster's disease) begins in adolescents between 2 and 17 years of age and progresses slowly. Therefore, patients with this disease live longer than those with other types of spinal muscular atrophy. Myasthenia and atrophy begin in both lower limbs and then extend to both upper limbs.

. Diagnosis and Treatment

When children have unexplained fatigue and muscular atrophy, doctors should consider these rare diseases because they are hereditary and family history can help make the diagnosis.

There is no specific treatment for this type of disease. Physiotherapy, foot support, and other special devices may sometimes help.