Arachnoiditis

Description:

Arachnoiditis - an inflammation of a soft cover of a head or spinal cord with preferential defeat of an arachnoid membrane.

Arachnoiditis symptoms:

The disease develops subacutely with transition to a chronic form. Clinical about the phenomena represent a combination of the all-brain frustration more often connected with intracranial hypertensia, is more rare with likvorny hypotension, and the symptoms reflecting preferential localization of the shell process. Depending on dominance of the general or local symptoms the first manifestations can be various. From all-brain symptoms the headache, the most intensive early morning hours and sometimes followed by nausea and vomiting often meets. The headache can be local, amplifying at a natuzhivaniye, tension or the awkward movement with a firm support on heels (a jump symptom – a local headache when jumping with unamortized lowering on heels). Also dizzinesses of not system character, memory easing, irritability, the general weakness and fatigue, sleep disorders belong to all-brain symptoms.

Focal symptoms depend on localization of an arachnoiditis. Konveksitalny arachnoidites характериз utsya by the most part dominance of the phenomena of irritation of a brain over signs of loss of functions. One of the leading symptoms are generalized and jacksonian epileptic seizures. At a basal arachnoiditis all-brain symptoms and disturbances of functions of the nerves located on a base of skull are observed. Decrease in sharpness and change of fields of vision can come to light at an optiko-hiazmalny arachnoiditis. Clinical manifestations and a picture of an eyeground can remind symptoms of an optic neuritis. These manifestations often are followed by symptoms of vegetative dysfunction, a sharp dermographism, the strengthened pilomotor  reflex, plentiful sweating, a Crocq's disease, sometimes thirst, the strengthened urination, a hyperglycemia, adiposagenital obesity). Decrease in sense of smell can be in certain cases revealed. The arachnoiditis in legs of a brain is characterized by emergence of pyramidal symptoms, signs of defeat of third cranial nerves, meningeal signs. At an arachnoiditis of a mostomozzhechkovy corner arise a headache in occipital area, noise in an ear and pristupoobrazny dizziness, sometimes vomiting. The patient reels and falls in hundred Rhone on razheniye, especially in attempt hundred ять on one leg. The ataxic gate, a horizontal nystagmus, sometimes pyramidal symptoms, a phlebectasia on an eyeground as a result of disturbance of venous outflow are noted. Symptoms of damage of the acoustical, trigeminal, taking-away and facial nerves can be observed. The arachnoiditis of the big (occipital) tank develops sharply, temperature increases, there are vomiting, the nape and neck pains amplifying at turns of the head, the sharp movements and cough; damage of cranial nerves (IX, X, XII couples), nystagmus, increase in tendon jerks, pyramidal and meningeal symptoms. At an arachnoiditis of a back cranial pole defeat V, VI, VII, VIII pairs of cranial nerves is possible. Intracranial hypertensia, cerebellar and pyramidal symptoms are quite often observed. Differential diagnosis with tumors of a back cranial pole is obligatory. The lumbar puncture is made only in the absence of developments of stagnation on an eyeground.

Arachnoiditis reasons:

Arachnoiditis - a polyetiological disease. Causative factors are flu, rheumatism, an adenoid disease, rinosinusita, otitises, systemic infections (measles, scarlet fever), the postponed meningitis and a craniocereberal injury.

Treatment of the Arachnoiditis:

It is necessary to eliminate an infection source (otitis, sinusitis, etc.). Appoint antibiotics in therapeutic doses. The desensibilizing and antihistaminic drugs (Dimedrol, Diazolinum, Suprastinum, tavegil, Pipolphenum, calcium chloride, hystoglobulin) are shown. Pathogenetic therapy is counted on prolonged course treatment by resorptional means, normalization of intracranial pressure, improvement of cerebral circulation and metabolism. Apply biogenic stimulators (an aloe, a vitreous, FIBS) and iodide drugs (бийохинол, potassium iodide). Use also a lidaza in the form of subcutaneous injections on 0,1 g of the dry matter dissolved in 1 ml of 0,5% of solution of novocaine every other day on a course of 15 injections. Courses are repeated in 4–5 months. Pyrogenal has resorptional effect. The first intramuscular injections of pyrogenal begin with a dose 25 MPD, in the next days increase a dose daily on 50 MPD and lead up it to 1000 MPD; on a course of treatment to 30 injections. At increase in intracranial pressure apply antiedematous and diuretics (Mannitolum, furosemide, Diacarbum, glycerin, etc.). At convulsive syndromes use antiepileptic drugs. Carry out metabolic therapy (glutaminic acid, piracetam, Aminalonum, Cerebrolysinum). According to indications apply symptomatic means. Lack of improvement after performing treatment, increase of intracranial pressure and focal symptomatology, an optikokhiazmalny arachnoiditis with steady decrease in sight are surgical indications.

Forecast. Concerning life usually favorable. The arachnoiditis of a back cranial pole with occlusal hydrocephaly can constitute danger. The labor forecast worsens at a frequent recurrence or the progressing current with frequent hypertensive crises, epileptic seizures, at an optiko-hiazmalny form.

Working capacity. Patients admit disabled people of the III group if work the device or transfer into easy work leads to reduction of volume of production activity. Disability of the II group is established in the presence of frequent epileptic seizures, considerable decrease in visual acuity on both eyes (from 0,04 to 0,08 with correction). Disabled people of Igruppy patients with the optiko-hiazmalny arachnoiditis which is followed by a blindness admit. Work at height, at fire, about moving mechanisms, on transport is contraindicated to patients with liquorodynamic disturbances, epileptic seizures and vestibular crises. Are contraindicated work in unfavorable weather conditions, in noisy rooms, in contact with toxics and in the conditions of the changed atmospheric pressure, and also the work connected with constant vibration, changes of position of the head.