DISEASES OF THE NERVOUS SYSTEM : INJURY OF PERIPHERAL NERVES - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
Injury of peripheral nerves are accompanied by sensory and motor disorders.
Symptoms. When the injured radial nerve: hand and fingers pendulous, the main knuckle and forearm bent; sensitivity infringed on the back surface of the I, II, III finger, except the terminal phalanges. Injury of the median nerve is accompanied by limitation of flexion of the hand, the absence of movements of flexion in the middle and terminal phalanges I, II, III finger, it is not possible opposition of the thumb, impossible pronation of the forearm; the monkey brush; sensitivity infringed on the rear surface I, II, III and IV often finger. Often causalgia (see). If the injuries of the ulnar nerve in the wrist flexion deviates outward, it is impossible to bend the end of the phalanges of the fourth and fifth finger; "clawed brush; sensitivity infringed on the Palmar surface V and the inner part of the fourth finger and the radial edge of the back surface of the brush.
Injury of the sciatic nerve accompanied by violation of movements of the foot and toes. Stop hanging (paralytic horse foot). Ankle reflex is absent. The sensitivity of the most broken in the foot, as well as on the back and the outer surface of the lower two thirds of the tibia. With the defeat of peroneal nerve foot hangs (pes equinovarus); standing on the heel and lifting on the toe is impossible. Sensitivity infringed on the rear foot on the front and the outer surface of the lower two thirds of the tibia. When wounded tibial nerve impossible flexion of the foot and toes; the patient cannot come at the toe, the foot takes the position of the heel stop; sensitivity infringed on the rear surface of the tibia, on the sole and the outer edge of the foot. Often a sharp pain, nature causalgia or neuralgia (see). Injury of femoral nerve is characterized by the inability to Flex the thigh at the hip joint. Shin is not unbent. There is no knee-jerk reaction. The reduction of sensitivity at the front of the thigh and the inner surface of the tibia on the inner edge of the rear foot.
If the injuries of peripheral nerves always observed weight loss muscles, innervated by the relevant branches of the affected nerves; the weight loss corresponds to the paralyzed muscle groups. There are often neurogenic contraction, the latter, myogenic origin. In some cases they are the result of psychogenic layers (hysterical contracture). You may experience vasomotor-secretory and trophic disorders:
The diagnosis is made on the basis of accounting for the nature of injury, damage blood vessels, bone and muscle tissue and described the symptoms. It is important to establish whether there is full or partial nerve damage that is determined on the basis of the degree of loss functions and additional data (electric diagnostics, chronometry).
Conservative - Neuralgia, Causalgia, Polyneuritis (see). In case of failure - surgical intervention, the nature of which (neurosis, excision of nerves, nerve stapling, shivanie grafts) is determined based on the condition of the affected area of the nerve and the wounded limb. Should it is possible to begin earlier application of physical culture (special account) and exercise work.