Plexopathy

Description:

Plexopathy – defeat of neuroplexes (cervical, humeral and lumbosacral) owing to an injury or other reasons (a chronic compression, infiltration by a malignant tumor, radiation therapy).

Allocate three types of a humeral plexopathy. At damage of roots of C5 and C6 there is a syndrome of Erba: paralysis of a deltoid muscle (incredibility of assignment of a hand), paralysis of two-headed humeral and supinatorny muscles (incredibility of bending of a forearm), paralysis over - and podostny muscles (incredibility of outside rotation, loss of a reflex with m. biceps, anesthesia over an outside upper part of a shoulder). At damage of roots of C8 and D1 there is a syndrome Dezherin-Klyumpka: brush paralysis, Horner's syndrome (the instruction on a separation of roots from a spinal cord).

At total defeat of a brachial plexus paralysis of muscles of the half of the same name humeral a belt and all hand and loss of sensitivity in the same zones develops. One of options of a humeral plexopathy is neuralgic amyotrophy: after cruel shoulder pains there is massive atrophic paralysis of proximal departments of an upper extremity. Autoimmune genesis of this suffering is supposed.

Plexopathy reasons:

Considerably the humeral plexopathy which is traditionally caused by an injury meets more often: traumatic childbirth, dislocation of a shoulder joint, a car accident, a prelum during an anesthesia, long carrying weights on a shoulder ("ryukzachny paralysis"), knife wound, bone anomalies (a cervical edge — a hypertrophied cross shoot of C7); idiopathic cases, a prelum a lung top tumor are possible.

The lumbosacral plexopathy arises owing to volume education in retroperitoneal space (a tumor, abscess, an aortic aneurysm or an ileal artery), hemorrhages in an iliolumbar muscle (at hemophilia or overdose of anticoagulants), changes of pelvic bones, operative measures on a hip joint; idiopathic cases are possible.

Plexopathy symptoms:

During a plexitis allocate two stages — neuralgic and paralytic. In a neuralgic stage the spontaneous pains amplifying at the movements or a prelum of a texture are noted. In a paralytic stage peripheral paresis and paralyzes of the muscles innervated by branches of the struck texture develop, the corresponding deep reflexes decrease, all types of sensitivity and a trophicity in an innervation zone are broken that is shown by pastosity, puffiness, vasculomotor frustration, etc.

At defeat of a cervical plexus of pain extend to occipital area, paresis of deep muscles of a neck and a diaphragm develops. As a result of irritation of a phrenic nerve the hiccups appears.

At defeat of a brachial plexus of pain are localized in over - and subclavial areas, irradiate in a hand. Muscles of a shoulder girdle and an upper extremity are surprised, deep reflexes on an upper extremity decrease or disappear. Vegetative and trophic frustration in the form of cyanosis or pallor of a hand, pastosity of a brush, perspiration, disturbance of a trophicity of nails, etc. develop.

The plexitis of a lumbosacral texture is characterized by sensitive, motive and vegetative and trophic frustration in an innervation zone. Pains are localized in a waist and in a leg. Paresis of muscles of a hip, shin and foot, an atrophy of these muscles, pastosity of foot and a shin, trophic disturbances of nails are observed.

Treatment of a plexopathy:

Treatment can be carried out on an outpatient basis, in hard cases — in the conditions of a hospital. At infectious plexites carry out antiinflammatory therapy, apply soothing, dehydrating means, physiotherapeutic procedures (an ionophoresis with novocaine solution, diadynamic currents, amplipulsetherapy), novocainic blockade. After removal of the acute phenomena appoint physiotherapy exercises, massage, a balneoterapiya, B1 and B12 vitamins; at paresis — antikholinesterazny means (прозерин, Galantaminum), ATP, a lidaza, nootropic products.

Carry similarly out treatment of infectious and allergic and intoksikatsionny plexites. At traumatic plexites, also at compression processes (cervical edges, tumors, fractures of vertebras, clavicles, aneurisms of arteries) carry out operational treatment for the purpose of elimination of a prelum and recovery of conductivity of branches of a texture. At a chronic current of a plexitis sanatorium treatment (radonic, hydrosulphuric bathtubs, mud applications) is shown.