20Mar

Plexitis: symptoms, types( traumatic, etc.), treatment of the disease

Contents:
  • Reasons
  • Classification
  • Clinical picture
  • Diagnosis
  • Treatment
  • Folk recipes

The inflammatory process of the nerve plexuses that are formed by the anterior branches of the spinal nerves is called plexitis. The disease occurs at any age, including in newborns. If the doctor does not contact the doctor in time, the pathology causes loss of ability to work and formation of disability.

Reasons for

The peripheral nervous system is a cluster of nerve fibers that form nerves and plexuses. In the human body, there are three major nerve plexuses: cervical, brachial, lumbosacral. They participate in the transfer of nerve impulses from the central departments to the periphery, are responsible for the motor, sensitive and autonomic innervation of organs and systems.

Plexitis is influenced by the following adverse factors:

  • trauma of the nerve plexus in bone fractures, compromised soft tissue integrity, difficult delivery;
  • ischemia( lack of oxygen) of the nervous tissue due to prolonged compression by neoplasm, immobilization of limbs, complex surgical interventions, use of inconvenient crutches for movement;
  • infectious disease in tuberculosis, brucellosis, angina, influenza, syphilis;
  • allergic reaction to the use of medicines, food, vaccination;
  • intoxication with drug overdose, harmful working conditions, living in adverse environmental conditions;
  • disorders of metabolic processes in the body in diabetes mellitus, gout, thyrotoxicosis.

In a child of the first months of life, the disease develops as a result of birth trauma, which is caused by a large body weight, leg or gluteal presentation, fetal squeezing, maternal weak labor.

Classification of

A classification of plexitis has been developed that reflects the cause of the pathological process, its localization, the degree of neural plexus lesion, the stage of the disease development.

Cervical and brachial plexus
Schematic representation of the cervical and brachial plexus

Localization of the disease:

  • cervical plexitis - inflammation develops in the cervical plexus;
  • brachial plexitis - inflammation affects the brachial plexus, extends to the upper humeral girdle and arm;
  • lumbar and sacral plexitis - the inflammation is in the lumbar plexus, it affects the gluteal muscles, the sacrum area, the lower limb is involved in the pathological process.

For the etiologic factor, the following are distinguished:

You can also read: Pain in the shoulder joint Tendonitis of the supraspinatus of the shoulder joint
  • is traumatic;
  • is compression-ischemic;
  • is infectious;
  • is allergic;
  • intoxication;
  • is a metabolic;
  • is a generic post-traumatic.

The prevalence of the pathological process is as follows:

  • unilateral plexitis( right-sided or left-sided);
  • double sided.

By severity of nerve plexus lesions:

  • partial( separate neural trunks or nodes are involved in the inflammatory process);
  • total( all structures of the nervous plexus are affected).

At the stage of the disease course:

  • neurological phase;
  • is a paralytic phase.

In the international classification of diseases of the ICD, 10 plexitis belongs to the category G54, G55, M50-M51, depending on the cause of the pathology.

Clinical picture

Clinical manifestations of the disease depend on the localization and the stage of the pathological process. The first sign of the disease is a pain syndrome, which has a constant character of varying degrees of intensity. Painful sensations are intensified when limbs move, walking, performing daily work.

Symptomatic of cervical plexitis

In case of localization of the inflammatory process in the cervical plexus, the pains appear on the anterior and lateral surfaces of the neck, intensifying with the turns and inclinations of the head. The disease manifests itself in the neurological phase with the following symptoms:

  • neck pain, sometimes paroxysmal with spreading to the nape, parotid and interlobular area;
  • obstruction of head movements due to tension or weakness of the neck muscles;
  • a sensitivity disorder in the lesion site;
  • excruciatingly exhausting hiccups due to irritation of the diaphragmatic nerve;
  • extinction of neurologic reflexes.
The lumbosacral plexus
Schematic illustration of the lumbosacral plexus

When progressing, the disease passes into a paralytic phase, which is characterized by motor impairment of the neck muscles, which causes the development of paralysis or paresis. Pathology is accompanied by difficulty breathing. Breathing movements become superficial, the stomach is not drawn in by inhalation. This is due to the involvement of the diaphragm in the process of the diaphragmatic nerve and the paralysis of the muscles. Sometimes the patient can not make coughing movements, laugh, speak freely.

Symptom of shoulder plexitis

When inflammation of the brachial plexus, there are pains in the region of the upper humeral girdle that extend to the left or right arm, depending on the localization of the pathology. Painful syndrome increases when performing active and passive movements. In the neurological phase, the disease manifests itself by the following symptoms:

  • intense paroxysmal pain that spreads into the supraclavicular and subclavian area, the elbow joint, the arm on the side of the lesion;
  • impaired sensitivity on the site of the nerve plexus and the nerves emerging from it( shoulder, forearm, hand);
  • weakness of the muscular groups of the affected upper limb, restriction of the execution of movements, the hand hangs like a whip, while the motor activity of the fingers is preserved;
  • vegetative-trophic disorders - swelling of the soft tissues of the hand, blanching of the skin with areas of cyanosis( cyanosis), lowering of the local temperature, increased sweating of the brushes, fragility and disruption of the growth of nails and hair;
  • decreased neurologic reflexes.
MRI of the shoulder joint
Layered shots for computed tomography for the diagnosis of brachial plexitis

The paralytic stage develops a persistent paresis of the upper limbs, which impedes the motor activity of the hands, leads the patients to disability and dependence on surrounding people in everyday life. More details about shoulder plexite are described in this article.

Symptom of lumbosacral plexitis

Inflammation in the lumbosacral plexus causes pain in the lumbar region and lower limb on the side of the lesion, which are intensified during movement. Symptoms of plexitis in the neurological stage:

  • pain from the lumbar region extends to the buttocks, sacrum, hip, lower leg, foot, pelvic organs( uterus, bladder, rectum);
  • decreased foot sensitivity;
  • impaired motor activity of the lower limbs due to muscle weakness;
  • vegetative-trophic disorders in the form of fever and sweating of the feet, pallor or cyanosis of the skin of the legs, disruption of nail and hair growth, edema of the soft tissues of the lower limbs;
  • fading neurological reflexes.

In the paralytic stage, the atrophy of the muscles of the legs leads to a change in gait, the appearance of lameness, a decrease in the supporting and motor function of the lower limb. This causes disability and restricts freedom of movement.

Diagnosis

The first time you go to a medical institution, the doctor looks at the history( history) of the disease and conducts an analysis of the patient's complaints. At the reception specialist finds out how long the symptoms of the disease appeared, which preceded the emergence of painful sensations, what concomitant diseases the patient suffers. After that, the doctor( neurologist) starts the examination:

  • physical neurological examination - revealing the muscular strength of the hands, legs or neck, checking neurological reflexes and muscle tone, assessing the condition of the skin, nails and hair on the limbs;
  • laboratory diagnosis - blood sampling for general or biochemical analysis to detect inflammatory processes and metabolic disorders;
  • electromyonography - estimates the speed of nerve impulses propagation along nerve fibers, determines the level of neural plexus lesion and signs of muscle atrophy;
  • computed tomography( CT) and magnetic resonance imaging( MRI) - allows to obtain layered photographs, to reveal specificity( trauma, tumor, aneurysm) and localization of the pathological process in the plexus neural tissue.
The doctor examines the patient
Physical examination includes evaluation of neurological reflexes

Thanks to instrumental examination methods, differential diagnostics of plexitis with other neurological diseases, such as neuritis, radiculitis, polyneuropathy, is carried out.

Treatment of

After the final diagnosis is given, a complex therapy of the disease is prescribed. First of all, the treatment of plexitis should be aimed at the disease, which led to an inflammatory process in the nerve plexus.

Etiological therapy includes:

  • antibacterial agents and antiviral drugs for the infectious cause of inflammation;
  • restoration of the hormonal background in the case of endocrine diseases, normalization of blood glucose level in diabetes mellitus by hypoglycemic agents, decrease in the level of salts in the body with gout hypoecricum drugs;
  • surgical intervention in the ischemic and traumatic nature of the disease, an operation to remove an aneurysm, a tumor, bone fragments, blood clots.
Massage session
Massage is prescribed when the acute phase of the disease subsides and the pain

is eliminated. In the acute period of the disease, a bed rest with a restriction of the motor activity of the head, upper or lower extremities is prescribed. Exclude hot, fried, spicy, fatty foods. The ration is enriched with fresh vegetables, herbs, fruits, cereals and dairy products.

Symptomatic therapy includes:

  • medications for pain relief - non-narcotic analgesics( laspal, aspizol, oxadol);
  • Novocain blockades in the area of ​​the lesion of the nerve plexus;
  • anti-inflammatory drugs - NSAIDs( ibuprofen, diclofenac, movalis);
  • vitamin therapy - preparations of vitamins of group B( milgamma, neurovitan), vitamin A, ascorbic acid, tocopherol;
  • sedatives to eliminate irritability, normalize biorhythms( novopassit, tincture of the pion, valerian);
  • physiotherapy - magnetotherapy, electrophoresis with novocaine, mud therapy, ozocerite;
  • massage, reflexology, balneotherapy in the period of elimination of the acute period of the disease;
  • exercise therapy( LFK) - specially designed exercises for gymnastics with a dosed load contribute to the improvement of muscle tone, normalization of blood flow, activation of metabolism in the pathology site.

For prevention it is necessary to avoid hypothermia, dress according to weather conditions. Do not recommend heavy physical activity in the home, in the performance of professional duties and sports. It is important to have a balanced diet, as well as timely treatment of infectious diseases and injuries.

Folk recipes

Folk treatment of plexitis is prescribed as part of complex conservative therapy and for the prevention of disease under the supervision of a doctor. The independent use of recipes for unofficial medicine can lead to the progression of the disease and the development of severe complications.

Therapeutic bath
Baths based on herbal decoctions are used for folk therapy of plexitis
  1. Ointment for the elimination of pain is prepared from a mixture of medicinal herbs: hops, sweet clover, St. John's wort. Raw materials are taken in equal proportions in the amount of 10 grams, finely chopped, squeezed juice. In the resulting slurry add 60 grams of vaseline heated to liquid state, mix thoroughly, cool and store in a refrigerator. The ointment is rubbed into the painful parts of the body three times a day until the general condition improves.
  2. Compresses from oat flakes reduce pain, normalize metabolic processes and blood flow in the hands, legs, neck. To prepare the compress, you need to take oatmeal( preferably without preliminary heat treatment with the label "extra") in the amount of 30 grams and pour half a liter of hot water. Boil the raw material over low heat until a uniform mass is obtained for about 40 minutes, the cooked porridge should not be liquid. Put compresses daily at bedtime for 30 minutes, gradually bringing the procedure time to an hour.
  3. Herbal decoction based on Veronica officinalis, burdock, wheat grass, string and violet tricolor has anti-inflammatory, analgesic, trophic effect. To make a drug, the crushed raw material is taken in equal parts of 30 grams, a tablespoon of the mixture is poured into a glass of water and pressed for a quarter of an hour in a water bath. After this, the product is filtered, cooled and taken three times a day. Decoction is an effective tool for preventing exacerbation of the disease.
  4. Mumiye in plexitis therapy is taken twice a day to improve metabolism, strengthen immunity and eliminate pain. To do this, the medicine on the tip of the knife is added to a glass of hot milk, flavored with honey and slowly drunk in small sips.
  5. Bath with decoction of mint calms the nervous system, improves blood flow in the upper and lower extremities, normalizes the trophism of tissues. To prepare the broth use the dry raw materials collected during flowering. One part of the mint is diluted with three parts of water, boil on low heat for at least half an hour. The filtered product is poured into a warm bath, where they completely immerse themselves for 30-40 minutes. After the procedure, rub the body with a terry towel, and the sick areas are warmed with a scarf or shawl.

Treatment with folk remedies effectively complements medical therapy and speeds up the recovery process.

Plexitis refers to a neurological disease in which large neural plexuses are affected. Untimely detection of the disease and the rejection of complex therapy worsen the quality of life, reduces the ability to work and leads to the appearance of disability.

shoulder pain