After establishing the diagnosis of polyneuropathy of the lower extremities of complex genesis, stage 1.

Polyneuropathy, or peripheral neuropathy, occurs as a result of damage to the peripheral nerves and often results in symptoms such as weakness, numbness and pain, usually in the arms and legs. But polyneuropathy can also affect other areas of the body. Peripheral neuropathy may develop in one nerve (mononeuropathy), two or more nerves in different areas, or may involve many nerves (polyneuropathy).

The peripheral nervous system transmits information from the brain and spinal cord (central nervous system) to the rest of the body. Peripheral neuropathy can result from traumatic injuries, infections, metabolic disorders, hereditary causes, and exposure to toxins. One of the most common causes of polyneuropathy is diabetes mellitus.

Patients with peripheral neuropathy typically describe pain as a tingling or burning sensation. In many cases, symptoms decrease if compensation occurs for the underlying disease.

Each nerve in the peripheral nervous system has a specific function, so symptoms depend on the type of nerve that is damaged. Nerves are divided into:

Sensory nerves that receive sensations from the skin, such as temperature, pain, vibration, or pressure
Motor (motor) nerves that control muscle movement
Autonomic nerves that control functions such as blood pressure, heart rate, digestion, and bladder function

Symptoms

Symptoms of polyneuropathy may include:

Gradual onset of numbness and tingling in the legs or arms that may spread up the arms and legs
Sharp stabbing or burning pain
Increased sensitivity to touch
Lack of coordination and falling
Muscle weakness or paralysis if motor nerves are damaged

If autonomic nerves are involved, symptoms may include:

Heat intolerance, as well as changes in sweating
Digestive, bladder, or bowel problems
Changes in blood pressure, which may cause dizziness

Treatment of polyneuropathy

First, it is necessary to correctly establish the diagnosis, because the disease can easily be confused with polio, encephalitis, Charcot-Marie disease (nervous amyotrophy) and other diseases.

Treatment is based on the identified pathogenesis and is carried out in the form of etiotropic therapy, that is:

it is necessary to treat autoimmune pathology first;
eradicate sources of infection, intoxication and allergies;
restore metabolism in the nerves.

Drug treatment

Appointed:

antibiotics and antiviral agents (for infections);
GCS (prednisolone for one to two weeks);
immunoglobulin and plasmapheresis;
antihistamines;
medications to improve nerve and muscle conduction (prozerin, potassium salts, galantamine, vitamin B-complexes);
ascorbic and alpha lipoic acid.

To treat intoxication the following is prescribed:

washing with solutions (hydration and dehydration);
hemodesis;
adenosine triphosphate (ATP) drugs;
cocarboxylase.

During the period of illness, a protein diet is established.

Treatment of paresis and paralysis

In cases of rapid ascending Landry paralysis, emergency resuscitation with artificial ventilation is performed.

Paralysis, paresis of the limbs and contractures are treated with:

Exercise therapy, massage, therapeutic physiotherapy ((UHF, microwaves, Sollux, electrophoresis with novocaine, balneotherapy, electromyostimulation, dry heat, mud therapy)
Electrophoresis is also used further, combining it alternately with iodine, proserine, galantamine, and vitamin B1.
Balneotherapy: for paresis, galvanic baths are recommended;
vegetative-trophic disorders - sulfide;
for pain or sensory disorders - radon baths.

Causes

A number of factors can lead to the development of neuropathy, including:

Alcoholism. A poor diet can lead to vitamin deficiencies.
Autoimmune diseases. These include diseases such as Sjögren's syndrome, systemic lupus erythematosus, rheumatoid arthritis, Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy and necrotizing vasculitis.
Diabetes. More than half of people with diabetes develop some type of neuropathy.
Exposure to poisons. Toxic substances include heavy metals or chemicals.
Medicines. Some medications, especially those used to treat cancer (chemotherapy), can cause peripheral neuropathy.
Infections. These include some viral or bacterial infections, including Lyme disease, shingles, Epstein-Barr virus, hepatitis C, leprosy, diphtheria, and HIV.
Hereditary diseases. For example, a disease such as Charcot-Marie disease is a hereditary type of neuropathy.
Injury or compression on a nerve. Injuries such as car accidents, falls, or sports injuries can damage or even sever peripheral nerves. Nerve compression can occur when peripheral nerves are continuously impacted.
Tumors. Malignant and benign tumors can damage or put pressure on nerves.
Vitamin deficiency. B vitamins, including B-1, B-6 and B-12, vitamin E and niacin are important for nerves.
Bone marrow diseases. These include the presence of an abnormal protein in the blood (monoclonal gammopathies), multiple myeloma, lymphoma and amyloidosis.
Other diseases. These include kidney disease, liver disease, connective tissue disease and thyroid disease (hypothyroidism).

Complications of polyneuropathy may include

Burns and skin injuries. If there is numbness in parts of the body, the patient may not feel temperature changes or pain.
Infections. The legs and other areas of the body with reduced sensation may become unnoticed. It is necessary to monitor the integrity of the skin, especially if you have diabetes, since even minor damage to the skin can lead to tissue infection.

Polyneuropathy of the upper extremities: symptoms, diagnosis, treatment, prognosis of the disease

Polyneuropathy is a dangerous and serious disease that primarily affects the peripheral nervous system.
This disease can lead to weakness of the limbs, loss of sensitivity, flaccid paralysis and other unpleasant consequences. In older people, this disease occurs several times more often. Polyneuropathy does not go away on its own and can progress, so timely diagnosis and properly selected treatment are necessary.

What is polyneuropathy and why does it occur?

Polyneuropathy of the hands occurs due to damage to the nervous system and leads to paralysis

Nerves are conductors that carry signals from the brain to other parts of the body. If conductivity is impaired, sensitivity problems arise. Polyneuropathy is translated as a disease of many nerves. With this disease, several branches of the peripheral nervous system are affected at once. The disease leads to impaired motor function of the limbs.

To find out how polyneuropathy of the upper extremities manifests itself, symptoms, treatment and prognosis of this disease, you need to consult a neurologist. The course of the disease can be varied: slow and unnoticeable or rapid and lightning fast.

Polyneuropathy often develops against the background of another disease. The causes of the development of the disease may be:

Avitaminosis. The functioning of the nervous system largely depends on the amount of vitamins in the body. B vitamins are especially important for nerves. If there is a chronic deficiency, various diseases of the nervous system occur, including polyneuropathy.
Diabetes. Diabetes mellitus leads to metabolic disorders. Glucose is not absorbed by the body, as a result, cells do not have enough energy to function normally. For this reason, blood vessels and nerve fibers become more fragile. However, diabetics are more likely to experience polyneuropathy of the lower extremities.
Toxic poisoning of the body. This can be either alcoholic or viral, parasitic intoxication, poisoning with chemicals such as arsenic, carbon monoxide. The accumulation of harmful substances in the body leads to damage to the nervous system and the development of chronic diseases.
Injury. Injuries after impacts or surgery can lead to pinched nerves and neuropathy. Also, the cause of polyneuropathy can be compression of the nerves due to displacement of the vertebrae.

It is known that polyneuropathy can be hereditary. It is not the disease itself that can be transmitted genetically, but the predisposition to it.

Polyneuropathy of the upper extremities cannot be called a common disease. It is diagnosed in approximately 2.5% of people. In older age, the disease is more common (approximately 8%).

Types of neuritis of the upper extremities and their features

In medicine, there are several forms and stages of the disease.

To choose the right treatment, it is necessary to determine the stage and form of the disease. Polyneuropathy has several varieties:

Sensory. With sensory polyneuropathy, sensitivity is primarily impaired. The patient experiences goosebumps, tingling and other unusual sensations in the area of the affected limb. The palm may become numb or, on the contrary, burn.
Motor. The main symptoms of motor polyneuropathy are impaired motor functions. The patient has difficulty raising his arm or cannot rotate his hand or bend his fingers. This is associated with progressive muscle atrophy.
Sensorimotor. This type of polyneuropathy combines sensory and motor disorders and is more common than all others.
Vegetative. With autonomic polyneuropathy, all symptoms are associated with damage to the autonomic nervous system, that is, sweating, pallor, as well as signs not related to the limbs. In this case, the nerves that control the functioning of various internal organs are affected.
Mixed. With mixed polyneuropathy, the damage is extensive, so all of the above symptoms appear, gradually or simultaneously.

If we talk about polyneuropathy of the upper extremities, then there is also a classification depending on the affected nerve. For example, there is neuropathy of the radial nerve, which runs through the entire arm. In this case, the symptoms will depend on the specific affected area. Drop hand syndrome often occurs, that is, the hand simply hangs when you raise your arm up.

Median nerve neuropathy can result from injury or a failed injection into a vein in the elbow.

Symptoms primarily concern the ability to move the hand: it does not rotate, does not bend, and it is difficult for the patient to move his fingers. As the disease progresses, the symptoms worsen, the muscles become increasingly weaker, and the patient cannot clench his hand into a fist.

Ulnar nerve neuropathy can be occupational and occurs more often in those whose work involves relying on the elbows. With serious lesions, the patient loses sensitivity in the area of the little finger and ring finger.

Diagnostics and drug therapy

The results of electroneuromyography will help confirm the diagnosis.

Diagnosing the disease is often difficult because the symptoms can be vague and similar to those of other diseases.

First, the neuropathologist collects an anamnesis, but it is impossible to make a diagnosis based on the anamnesis, so further examination is prescribed.

The doctor will check reflexes, prescribe a blood test, as well as electroneuromyography, which is fundamental in the diagnosis of polyneuropathies.

The essence of the method is to assess the electrical activity of muscles and nerve fibers. The procedure does not require special preparation. It is enough to come to the office on an empty stomach and not take medications on the day of the examination.

During the procedure, electrodes are attached to the body (namely the injured limb). Electrical impulses cause contractions of a particular muscle. The doctor may ask you to tense your arm or move it several times.

The procedure is quite quick and non-invasive. The result is obtained in the form of a graph, as with an ECG.

If the patient has been diagnosed with polyneuropathy of the upper extremities, it is necessary to begin treatment as early as possible. Drug therapy includes:

Painkillers. Polyneuropathy can be accompanied by severe pain. But since this pain is neurological in nature, it is very rarely possible to completely relieve it. Painkillers and anticonvulsants are recommended, such as Gabapentin, Neurontin. Conventional painkillers such as Analgin will not give any effect.
Vitamins. Multivitamin complexes or injections with B vitamins are prescribed to strengthen nerve fibers and improve their conductivity. There are special complex preparations that contain vitamins and lidocaine. When injected they relieve pain. A course of vitamin therapy lasts about a month.
Metabolic agents. As a rule, these are complex drugs that improve metabolism, normalize blood flow and conduction of nerve impulses. Such drugs include Actovegin, Instenon, Cytochrome C. However, not all of them are effective in treating certain types of polyneuropathies.

Drugs are prescribed depending on the underlying causes of the disease. First of all, it is necessary to eliminate these causes and cure the disease that led to polyneuropathy.

Surgical and alternative treatment

During the treatment period, you must adhere to a balanced diet and give up bad habits.

Surgery for polyneuropathy is not always effective. If damage to peripheral nerves is caused by infection, diabetes mellitus or another disease, conservative treatment, physiotherapy, massage, physical therapy, etc. are prescribed.

Surgery is recommended if polyneuropathy is caused by a pinched nerve and the symptoms become more severe. For example, surgery is prescribed for tunnel neuropathy.

The muscles compressing the nerve are cut, and the ligaments are cut to stop pinching the nerve. In most cases, surgery eliminates all unpleasant symptoms.

However, the effectiveness of surgery largely depends on proper rehabilitation.

As a rule, polyneuropathy is not treated exclusively with traditional methods, but they often complement drug therapy and allow you to quickly cope with the disease.

The most common folk methods of treating polyneuropathy are:

Clay. Natural clay has many healing properties. It is used topically. Blue or green clay powder is diluted with water to a thick paste. This paste should be applied in a thick layer to the injured hand and wait until it dries. You can also make warm compresses with clay.
Massage. The correct massage technique will help not only relieve pain, but also improve blood circulation. Warming ointments or castor oil are used for massage. Rub your hand with gentle movements until the skin appears red. Then you can rub in vodka, wrap your hand in a warm cloth and leave it overnight.
Phytotherapy. For polyneuropathy, herbal decoctions are recommended to be taken orally. To restore the functioning of the nervous system, you can take decoctions and infusions of burdock, dill, rosemary, and cloves. Burdock root can be chewed raw. It is believed that this way it is more effective.
Kefir. Fresh kefir must be mixed with parsley and sunflower seeds. The result is a medicine that will not only strengthen the nervous system, but also remove toxins from the body.

Traditional methods of treating polyneuropathy have their contraindications. They may cause an allergic reaction. Before using the product, you should consult a neurologist.

Prognosis and possible complications

Polyneuropathy can cause disability!

With timely treatment of acute polyneuropathy, the prognosis is favorable. However, treatment for the chronic form of the disease lasts a lifetime. Full recovery does not occur, but the patient’s quality of life can be improved.

If treatment does not have an effect, the person becomes disabled. Polyneuropathy can lead to various unpleasant consequences. Constant pain and muscle weakness lead to the fact that a person cannot work fully. The rapidly progressing disease can be fatal.

Severe complications of polyneuropathy of the upper extremities include:

Sudden cardiac arrest. Disruption of the peripheral nervous system is often accompanied by serious heart failure, arrhythmia, tachycardia, etc. A severe attack of arrhythmia can lead to sudden cardiac death.
Respiratory disorders. The nervous system performs many functions, one of which is sending impulses to the muscles. If the connection with the respiratory muscles is disrupted, shortness of breath, asthma and other respiratory problems develop, which can also be fatal.
Irreversible movement disorders. Serious damage to the peripheral nerves leads to the inability to move the arm normally, even to the point of paralysis. These effects may be reversible or irreversible in the chronic, progressive form of the disease.

More information about polyneuropathy can be found in the video:

Source: //organserdce.com/vessels/polinejropatiya-verhnih-konechnostej-simptomy-lechenie.html

Diagnostics

When diagnosing polyneuropathy, a doctor may be primarily interested in answers to the following questions:

Does the patient have any medical conditions such as diabetes or kidney disease?
When did the symptoms begin?
Were the symptoms constant or sporadic?
How severe are the symptoms?
What causes symptoms to increase or decrease?
Did anyone in the patient's family have similar symptoms?
The doctor needs a complete medical history. The doctor will review the patient's medical history, including symptoms, lifestyle, exposure to toxins, bad habits, and family history of neurological diseases.
During a neurological examination, the doctor can check tendon reflexes, muscle strength and tone, the ability to feel certain sensations, and coordination.

The doctor may order an examination

Imaging or MRI tests can detect various diseases (including tumors).
Neurophysiology. Electromyography records electrical activity in muscles, which can help determine whether symptoms, including weakness, are caused by muscle tissue damage or nerve damage. ENMG checks the conduction of impulses along the nerves and allows you to determine the degree of damage to the nerve fibers. Neurophysiological studies of the autonomic nervous system may also be performed - sensory tests that record how the patient feels touch, vibration, cold and heat.
Nerve biopsy. A doctor may recommend removing a small portion of a nerve, usually a sensory nerve, to examine morphological changes in the nerve to determine the cause of the nerve damage.
Skin biopsy. In this test, a small portion of skin is removed to examine the number of nerve endings. A decrease in the number of nerve endings indicates neuropathy.
Laboratory research methods are necessary to exclude various diseases, such as diabetes mellitus, autoimmune diseases, kidney disease, etc.

Hereditary polyneuropathy of the lower extremities

Neurologists distinguish polyneuropathies with a known metabolic basis (hereditary amyloidoses, lipid metabolism diseases, porphyrias, diseases accompanied by impaired DNA repair) and polyneuropathies in which the cause of the defect is unknown (hereditary motor-sensory, hereditary sensory and autonomic polyneuropathies, neuropathy with hereditary ataxias and mixed forms of the disease). Polyneuropathy can be inherited in a dominant or recessive manner.

Hereditary polyneuropathies are considered systemic diseases, which are characterized by damage to several organ systems. Metabolic disorders occur in the following hereditary polyneuropathies:

metachromatic leukodystrophy (impaired cellular metabolism of sulfatides in oligodendroglial cells of the central nervous system and in Schwann cells of peripheral nerves;
Fabry disease (glycosphingolipidosis);
atactic polyneuritis-like heredopathy;
Bassen-Kornzweig disease.

A group of peroneal muscular atrophies (Charcot-Marie-Tooth syndrome) also develops due to family history. Hereditary polyneuropathy of the lower extremities is characterized by the presence of the following symptoms: distal hypotrophy of the legs (in this case, the legs take the shape of “bottles”, turned upside down), as well as bone deformities of the feet with the formation of a high arch and contracture of the Achilles tendons. Patients' legs tremble and sensitivity is impaired.

There is no specific treatment for hereditary polyneuropathies of the lower extremities. Foot weakness can be corrected with bracing or orthopedic surgery. A medical psychologist prepares young patients for the progression of the disease. You can undergo diagnostics and treatment for chronic, autoimmune and hereditary polyneuropathy at the neurology clinic by making an appointment with a neurologist by calling the Yusupov Hospital.

Treatment

The goal of treatment for polyneuropathy is to treat the underlying disease and minimize symptoms. If laboratory tests and other examinations indicate that there is no underlying disease, the doctor may recommend watchful waiting to see if the symptoms of neuropathy improve on their own. If there is exposure to toxins or alcohol, your doctor will recommend avoiding these substances.

Drug treatment

Medicines used to relieve pain from polyneuropathy include:

Painkillers such as paracetamol or NSAIDs reduce pain
Medicines containing opioids, such as tramadol (Conzip, Ultram ER and others) or oxycodone (Oxycontin, Roxicodone and others), can lead to dependence and addiction, so these drugs are generally prescribed only when other treatments have no effect.
Anticonvulsants. Medications such as gabapentin (Gralise, Neurontin) and pregabalin (Lyrica), developed to treat epilepsy, can significantly reduce the pain of neuropathy. Side effects of these drugs may include drowsiness and dizziness.
Capsaicin. A cream containing this substance (found naturally in hot peppers) can be used to provide some relief from the symptoms of neuropathy. But given the irritating effect of capsaicin on the skin, not all patients can tolerate the effects of capsaicin creams.
Antidepressants. Some tricyclic antidepressants, such as amitriptyline, doxepin, and nortriptyline (Pamelor), can be used to reduce neuropathy pain through their actions on the central nervous system.
The serotonin and norepinephrine reuptake inhibitor duloxetine (Cymbalta) and the antidepressant venlafaxine (Effexor XR) may also relieve pain from peripheral neuropathy caused by diabetes. Side effects may include dry mouth, nausea, drowsiness, dizziness, decreased appetite, and constipation.
Intravenous immunoglobulin is the mainstay of treatment for chronic inflammatory demyelinating polyneuropathy and other inflammatory neuropathies.
Alpha lipoic acid. Used to treat peripheral neuropathy in Europe for many years. This antioxidant helps reduce symptoms. You should discuss taking alpha lipoic acid with your doctor because it may affect your blood sugar levels. Other side effects may include stomach upset and skin rash.
Herbs. Some herbs, such as evening primrose oils, may help reduce neuropathic pain in patients with diabetes.
Amino acids. Amino acids such as acetyl-L-carnitine may help improve symptoms of peripheral neuropathy in patients undergoing chemotherapy and in patients with diabetes. Side effects may include nausea and vomiting.

In addition to drug treatment, other treatment methods may be used.

Myostimulation allows, to a certain extent, to restore the conduction of nerve impulses through the muscles.
Plasmapheresis and intravenous administration of immunoglobulin.
Exercise therapy. If you have muscle weakness, physical activity can improve muscle strength and tone. Regular exercise, such as walking three times a week, can reduce neuropathy pain, improve muscle strength, and help control blood sugar levels. Exercises such as yoga and tai chi can also be quite effective.
Acupuncture. Impact on biologically active points improves the sensitivity of nerve receptors and reduces pain.

Recommendations for patients with polyneuropathy

It is necessary to take care of your feet, especially if you have diabetes. You should check your feet daily for blisters, cuts, or calluses. Soft, loose cotton socks and soft boots should be worn.
You need to quit smoking. Smoking can affect circulation in the extremities, increasing the risk of foot problems and other neuropathy complications.
Eat healthy. A healthy diet is especially important to ensure that the patient receives the necessary vitamins and minerals.
We must avoid drinking alcohol. Alcohol can worsen the symptoms of polyneuropathy.
Monitoring blood glucose levels in the presence of diabetes will help keep blood glucose levels under control and may help improve neuropathy.

Symptoms of polyneuropathy

The clinical picture of the disease in question, as a rule, combines signs of damage to the autonomic, motor and sensory nerve fibers. The predominance of autonomic, motor or sensory symptoms depends on the degree of participation of different types of fibers.

Polyneuropathies of various etiologies are characterized by a specific clinical picture, which will depend on the damaged nerve. For example, muscle weakness, flaccid paresis of the limbs and muscle atrophy are caused by a pathological process developing in the motor fibers.

So, flaccid paresis occurs due to damage to motor fibers. Most neuropathies involve the extremities with distal muscle weakness. Acquired demyelinating polyneuropathies are characterized by proximal muscle weakness.

Hereditary and axonal neuropathies are characterized by a distal distribution of laxity in the muscles; damage to the legs often predominates; weakness is more pronounced in the extensor muscles than in the flexors. With severe laxity of the peroneal (peroneal) muscle group (three muscles located on the lower leg), a stepping gait or “cock gait” occurs.

A rare symptom of this disease is polyneuropathy, contracture of the muscles of the lower extremities, manifested by muscle stiffness. The severity of motor impairments with this disease can be different - from mild paresis to paralysis and persistent contracture.

Acute inflammatory polyneuropathy of the lower extremities is characterized by the development of symmetrical laxity in the extremities. The typical course of this form of the disease is characterized by painful sensations in the muscles of the calves and paresthesia in the fingers (tingling and numbness), followed by mild paresis. Muscle flaccidity and malnutrition are noted in the proximal sections.

Chronic inflammatory polyneuropathy of the lower extremities is accompanied by a slow worsening of movement disorders and sensory impairments. Typical symptoms of this form of pathology are hypotrophy of the limbs, muscle hypotonia, areflexia (absence of one or more reflexes) or hyporeflexia (decreased reflexes), numbness or paresthesia in the limbs. The chronic form of the disease in question is characterized by a severe course and the presence of serious associated complications. Therefore, after a year from the date of the onset of this pathology, fifty percent of those affected suffer partial or complete loss of ability to work.

Polyneuropathies are characterized by relative symmetry of manifestations. Periosteal and tendon reflexes are most often reduced or absent. In the first turn, the Achilles reflexes decrease; with further escalation of symptoms, the carporadial and knee reflexes decrease, while the reflexes from the tendon of the biceps and triceps brachii muscles may remain unchanged for a long time.

Sensory disorders in polyneuropathies are most often also relatively symmetrical. At the onset of the disease, they appear in the extremities (like “gloves” or “socks”) and are distributed proximally. The onset of polyneuropathy is often marked by positive sensory symptoms, such as paresthesia (feelings of numbness, tingling, pins and needles), dysesthesia (perversion of sensation), hyperesthesia (increased sensitivity). As the disease develops, the described symptoms are replaced by hypoesthesia, that is, dullness of sensations and their inadequate perception. Damage to thick myelinated nerve fibers leads to disorders of vibration and deep muscle sensitivity, in turn, damage to thin fibers leads to impaired temperature and pain sensitivity. Pain is considered a common symptom of all types of polyneuropathies.

Autonomic dysfunction is more pronounced in axonal polyneuropathies (predominantly the axonal cylinder is affected), since the autonomic fibers are not myelinated. The following symptoms are most often observed: dysregulation of vascular tone, dry skin, tachycardia, decreased erectile function, orthostatic hypotension, dysfunction of the digestive system. Signs of autonomic failure are more pronounced in diabetic and hereditary autonomic-sensory forms of polyneuropathies. A disorder of the autonomic regulation of cardiac activity often causes sudden death. Also, vegetative symptoms in polyneuropathy can manifest as hyperhidrosis (increased sweating) and impaired vascular tone.

Thus, the clinical picture of the disease in question consists of three types of symptoms: autonomic, sensory and motor. Autonomic disorders are more common.

The course of the disease in question is varied. Often, from the end of the second or third decade of development of the disease, a reverse development of paresis occurs, which begins from the areas last involved in the pathological process. Sensitivity is usually restored faster, atrophy and autonomic dysfunction remain longer. The recovery period can last up to six months or more. Sometimes there may be incomplete recovery, residual effects remain, for example, polyneuropathy, contracture of the muscles of the lower extremities, which leads to disability. It is also often a relapsing course, manifested by periodically occurring aggravations of symptoms and an increase in the manifestations of the disease.

15% of cases of diseases associated with diabetes mellitus result in disability. Chronic polyneuropathies of various etiologies, namely diseases caused by toxicosis, autoimmune reaction or diabetes, most significantly and for a long time limit the vital activity and performance, and also cause social insufficiency of patients.

Reasons for the development of pathology

The most common causes of polyneuropathy of the extremities are the following factors:

The person has an infection.
The occurrence of external and internal intoxication.
The appearance of metabolic disorders.
Development of vitamin deficiencies in the patient.

The range of somatic pathologies that cause polyneuropathy of the upper and lower extremities is very diverse. The causes of damage to peripheral nerves can be diabetic, hyperthyroid and hypothyroid endocrinopathies. Pathological processes develop in various systemic diseases, for example, against the background of periarteritis nodosa, lupus erythematosus, scleroderma, and so on. The disease occurs in people with a uremic, hepatic, amyloid or metabolic disorder. Polyneuropathy of the upper extremities is sometimes a manifestation of blood pathologies, alcohol and drug intoxication, as well as paraproteinemia.