What Is a Peripheral Nerve?

Peripheral nerve refers to all nerves except the brain and spinal cord, including ganglia, neural stem, plexus, and nerve terminal devices; peripheral nerves can be divided into brain nerves connected to the brain and spinal cords connected to the central part Spine nerves; there are 12 pairs of brain nerves and 31 pairs of spinal nerves. Peripheral nerves can also be divided into somatic nerves and visceral nerves according to the distribution of objects; somatic nerves are distributed on the body surface, bones, joints and skeletal muscles, and splanchnic nerves are distributed on the viscera, cardiovascular, smooth muscle and glands.

Peripheral nerve

Peripheral nerve refers to the brain and

There are 12 pairs of brain nerves connected to the brain. The first pair is

The spinal nerve is connected to the spinal cord by its anterior and posterior roots, with a total of 31 pairs. There are 8 pairs of cervical nerves, 12 pairs of thoracic nerves, 5 pairs of lumbar nerves, 5 pairs of sacral nerves and 1 pair of tail nerves. The anterior root of the spinal nerve is mobile and may contain somatic motor fibers that govern skeletal muscle and

Common peripheral nerve lesions are:

Neuralgia refers to severe pain in the affected sensory nerve distribution area without significant changes in nerve conduction function and neurotransmitters. Such as: trigeminal neuralgia.

Neuropathy refers to a group of diseases and injuries caused by inflammation, poisoning, ischemia, nutritional deficiencies, metabolic trauma, etc. in certain parts of peripheral nerves. Those with inflammatory properties are commonly called neuritis.

The main clinical manifestations of peripheral nerve inflammation and injury are:

Sports

The treatment of these lesions includes drug treatment, surgical treatment and rehabilitation treatment. General drug treatment is mainly used for lesions. Early surgical treatment is used for injuries that are ineffective for conservative treatment and suitable or require surgical treatment.

After peripheral nerve lesions, in addition to carefully and comprehensively collecting medical history,

Peripheral nerve lesions are easily confused with single nerve damage and multiple nerve damage.

Easily complicated by edema, contracture and secondary trauma.

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 from

Neural connections and information are transmitted through

Peripheral neuromuscular irritating disease

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. Leolamin (Baker Rofin) reduces muscle rigidity and sometimes relieves muscle spasms. Other drugs can reduce spasm and saliva production.

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

Peripheral neuromuscular transmission disorder

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.

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 it usually appears as a symptom of some cancers, especially lung cancer.

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.

Peripheral 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. Sometimes doctors give corticosteroids to treat acute brachial plexus neuritis and other plexus diseases that are suspected to be caused by autoimmunity, but these drugs have not proven effective. When plexus disease is caused by injury, nerve repair takes longer.

Peripheral thoracic exit 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 because making an exact diagnosis is difficult and often the symptoms persist after surgery.

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).

Anti-infective drugs that can cause nerve damage

Imidin

Tert-butyl alcohol

Sulfa

Furantoin

Anti-cancer drugs

Vinblastine

Antiepileptic drugs

Phenytoin

Industrial toxic substances

Heavy metals (such as lead or mercury)

Carbon monoxide

O-cresol triphosphate

O-dinitrophenol

Various solvents

Analgesics

Cyclohexyl barbitur

Barbitur

- Peripheral Nerve -Pap 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.

Peripheral neurogenetic 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.

Peripheral 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.