What is Neuropathy?

Neuropathy (neuropathy) refers specifically to peripheral nerve disease, also known as neuritis, is a type of organic disease that occurs in the peripheral nervous system. According to the location and function of the nerve, the nervous system can be divided into the central nervous system and the peripheral nervous system. Neuropathy refers to the anatomical pathological features of peripheral nerve damage, and its main feature is the organic lesions of peripheral nerves. In non-professional areas, neuropathy is often confused with mental illness. Mental illness is often dominated by mental symptoms, while neurological manifestations are pain, numbness, or weakness, paralysis. Doctors can distinguish the two based on symptoms, tests, and various tests.

Basic Information

nickname

Neuritis

Visiting department

Neurology

Common locations

Peripheral nervous system

Common causes

Infections, poisoning, genetic defects, nutritional disorders, immune damage, etc.

Common symptoms

Irritation symptoms such as pain, numbness, or damage symptoms such as weakness, paralysis, etc.

Causes of neuropathy

Neuropathy can be caused by a variety of causes, and many neuropathies are unknown. Diseases for which no cause is found are often referred to as "primary."

Infection

Including bacterial infections, such as suppurative meningitis, brain abscesses, caused by various types of pyogenic bacteria; viral infections, such as epidemic encephalitis caused by Japanese encephalitis virus, and epidemic caused by type B Cooksaki virus Polio caused by sexual chest pain, polio virus, Kuru disease or lentivirus infection, while subacute sclerosing panencephalitis may be caused by mutant strains of measles virus; parasite infections, such as cerebral malaria, brain Parasitic trematode disease and cerebral cysticercosis; fungal infections such as Candida albicans and cryptococcal meningitis; Leptospira can also cause meningoencephalitis. Part of the cause of epilepsy is the formation of focal scars after infection of the meninges or cerebral cortex.

2. Poisoning

Including metal poisoning, such as lead poisoning can cause peripheral motor nerve palsy, lead poisoning encephalopathy, mercury, arsenic, and radon poisoning also affect the nervous system; organic poisoning, such as alcoholism, barbiturosis, can inhibit the central nervous system, organophosphorus Poisoning makes cholinergic nerves over-excited; bacterial toxin poisoning, such as botulism, can cause cerebral nerve palsy and limb weakness, diphtheria toxin can cause nerve paralysis, tetanus toxin can cause systemic skeletal muscle tonic spasm; animal poisoning Toxins in animals, shellfish, mosquitoes, spiders, puffer fish, etc.) can also cause neurological symptoms (muscle weakness, paralysis, convulsions, ataxia, etc.).

3. Genetic defects

Many metabolic diseases affecting the nervous system (such as phenylpropionuria, glycogen storage disease, mucopolysaccharidosis, lipid storage disease), degenerative diseases (such as white matter malnutrition, Parkinson's disease, amyotrophic lateral sclerosis , Hereditary optic nerve atrophy, etc.) and myopathy (such as progressive muscular dystrophy) are genetic diseases, mostly autosomal recessive. And hyper and hypokalemia periodic paralysis is autosomal dominant inheritance.

4. Nutrition disorders

Patients with Kwaoshio disease (a type of protein thermal malnutrition) may have neurological symptoms such as tremor, slow movement, and myoclonus. Vitamin A deficiency or poisoning can cause intracranial hypertension. Vitamin B deficiency can affect the nervous system, such as vitamin B ₁ deficiency (beriberi) manifests most peripheral nerve damage, and vitamin B ₁₂ deficiency can cause subacute joint degenerative changes.

5. Immune damage

Post-vaccination encephalitis may be caused by allergic reactions caused by protein antigens contained in the vaccine. Infectious polyradiculoneuritis, facial nerve palsy, abductive nerve palsy after infection, and glossopharyngeal nerve palsy after infection may be allergic diseases of peripheral nerves. Connective tissue diseases such as rheumatic fever, systemic lupus erythematosus, and nodular polyarteritis are autoimmune diseases that can affect the nervous system. For example, rheumatic fever can manifest Westenham's chorea. CNS demyelinating diseases may be autoimmune diseases caused by viral infections, such as diffuse sclerosis, acute disseminated encephalomyelitis, multiple sclerosis, subacute sclerosing panencephalitis, optic neuromyelitis, and transverse myelitis , Acute cerebellar ataxia, central pontine myelin fusion and so on. Myasthenia gravis is also an autoimmune disease.

6. Metabolic Disorders

In addition to the aforementioned genetic metabolic diseases (such as glycogen storage disease, etc.) can affect the nervous system, acquired acquired metabolic diseases such as hypoxia, hypernatremia, hyponatremia, hypocalcemia, uremia, hypoglycemia And hepatic encephalopathy can be accompanied by neurological symptoms.

7. Endocrine disorders

Thyroid hormone can promote myelinization of the brain, stimulate RNA and protein synthesis, retard brain development in children with Cretin disease, and have cerebellar ataxia. Hyperthyroidism can be associated with tremor and tendon reflexes. Insufficient insulin secretion during diabetes leads to demyelination of peripheral nerves and neurological disorders.

8. Congenital Malformation

Caused by teratogenic factors such as viruses or toxins, or hereditary. Such as spina bifida, congenital hydrocephalus, perforation of the brain and so on.

9. Blood circulation disorders

Vascular disorders, changes in blood components, hemodynamic disorders, emboli, etc. can cause cerebrovascular diseases.

10. Abnormal hyperplasia

Tissue abnormal proliferation can form tumors. Can be found in the central and peripheral nerves.

Clinical manifestations of neuropathy

Headaches, dizziness, abnormal sleep, tremor, unstable walking, paralysis of the lower limbs, hemiplegia, limb numbness, convulsions, coma, uncontrollable size and size, muscle atrophy, and weakness are the most common manifestations.

In a nutshell, symptoms can be divided into two categories, one is irritation, manifested as pain and numbness; the other is destruction of symptoms, manifested as weakness, paralysis.

Neurological examination

Directional examination of neurological diseases:

1. With or without neurological damage.

2. Neuropathy can reflect whether it is a primary neurological disease or a complication of other systemic diseases.

The various systems and organs of the human body are not affected and dominated by the nervous system. Sooner or later, most diseases will have neurological manifestations or symptoms, such as headache, dizziness, coma, and brain death. Neurology has a wide range of connections with other clinical disciplines. Therefore, the overall concept of the whole body should be emphasized in the diagnosis of neurological diseases.

Neurological diagnosis

In the diagnosis of neurological diseases, medical history and physical examination are very important. Cerebrospinal fluid examination and other laboratory tests, EMG, and EEG also often provide important clues. Neurological imaging plays an important role in the diagnosis of some diseases. New technologies such as positron emission tomography, single photon emission computed tomography, transcranial Doppler, quantitative EEG, nervous system evoked potentials, digital subtraction cerebral angiography, and nystagmus can help the nervous system Diagnosis of the disease.

Neuropathy treatment

Diseases with clear etiology and eradicable pathogens (such as epidemic meningitis) can be cured with appropriate treatment measures. Some immune diseases can be treated with immunosuppressive drugs. Some deformities can be treated with surgery. Many degenerative and metabolic diseases have no special treatment, and many are symptomatic.