Toxic polyneuropathy ICD code. Toxic polyneuropathy - symptomatology and may be accelerated

Most often the enmity of the enemy is the feet and hands, lowering the quality of the muzzles, the blood circulation in the pictures, the lowering the sensitivity. The traces of polyneuropathy are not safe, which can lead to a partial loss of the sensitiveness of the pictures, or to the general agony of the little girls.

Polyneuropathy is the most frequent enemy of the lower and upper symptoms, with many neglected pathologies, there is a greater degree of parallels in the diagnosis

Peculiarities of incapacity and development

In the case of walnut polyneuropathy, it means "fellow citizens of the nerves." The reasons for the diagnosis of pathology of developmental disease are that it is practically possible for a bureaucrat to suffer from polyneuropathy, if he wants to break a negative inflow into the peripheral nervous system.

So, as the life of the body lies in the transmission of nerve endings of commands to the brain, during the development of polyneuropathy, the destructiveness of the sensitive and rudimentary function of the children occurs.

Important! Polyneuropathy of the lower cues is developed more often, because there is a great deal of pressure on the legs, lower on the upper part of the body.

In case of polyneuropathy, it is easier for the nerves to become prickly, because the myelin sheath is thin, and it is easier for the diabetic words to penetrate into the nerve. To that, most often the polyneuropathy of the upper and lower symptoms is the striking of the feet and hands.

When you make a diagnosis, the patient does not just write the word "polyneuropathy of nig or hands"; The international classification of ailments includes a few types of polyneuropathy (code for the ICH - G60-G64), which are developed by localization, by world and by region, for reasons of diagnosis.

As long as the peripheral nervous system has given the last time, then the reasons for the diagnosis of polyneuropathy can be

Behind the step and the area

Nerve fibers can be divided into groups of species - rods, vegetative, sensitive. This is due to the fact that some nerves are broken down, classification and polyneuropathy:

Rukhova (motor). The normal state of muses is to lose weight, to bring up to the mind in their robots: the weakness in the muses, sudomi, atrophy and hypotrophy of the muses. Symptoms broaden from bottom to top and may lead to further loss of debris.

Vegetative. The autonomic nerves of the fibers are observed, from which the internal organs lie. The winners are better able to see them, problems with secular visions, the strength to fix, the dryness of the shkiri appears.
Sensory polyneuropathy. There are sensitive issues: seeing pokryuvannya, pechinnya, oniminnya, "goose bumps", sickly and prickly seeing with a light dot to the point.
Sensorimotor polyneuropathy. Ob'є
Zmishana. Including signs of all types of rozladiv.

With a pure vigilance of the form, it is possible to reach the end of it quickly, to diagnose sensory-vegetative, motor-sensory and іnshі changes in type and inconvenience.

For the type of pathological process

Polyneuropathy of the hostile nerve fibers, which are stored in axons and muscle membranes. Already from the level of development:

Axonal polyneuropathy - vinikє in case of axon distress in case of destructive metabolic processes: in case of intoxication with mish'yak, lead, mercury, alcohol;
Demilіnіzucha polyneuropathy - in the demієlіnіzіy of nerve fibers, ailments develop rapidly, in the first place motor and sensory fibers are affected.

In a pure vigilance, this type of feeling is not good: when the axon is affected, the demenilizing dislocation is demeaning, and when the axon is being damaged, it is an axonal type.

Distal polyneuropathy and proximal polyneuropathy are evident from localization: with distal polyneuropathy, the disease grows at the bottom, while in the proximal area, there is a growth of the disease.

Causes of the blame

In order for the treatment of polyneuropathy to give results, it is necessary to identify the causal factor, її wiklikak.

What is the diagnosis of polyneuropathy of the upper symptoms and nig:

Diabetic factor. Determination of other vessels, such as an accelerated diabetes mellitus, winners of more patients, who are suffering at the price of sickness. This is the first reason to suffer polyneuropathy. Winikak will be quicker to call on the quiet ones who are hungry for a diabetic for a trivial period of time (5-10 years).
Toxic form. Winnick when it gets into the shelter of alien to the human body of speech: mish'yak, lead, methanol, mercury and other chemical spoluks. Inodi toxic polyneuropathy can be diagnosed with trivial implantation of drugs, or in a broader form - alcoholic polyneuropathy. The alcoholic form develops in approximately 2-3% of people who suffer from alcoholic depletion, and, according to the frequency of occurrence, are in another place of developing diabetic form of illness.
Marriage of vitamins of groups V. Deyaki vidi vitamins of groups B (B12, B1, B6) produce a neurotropic effect, positively infusing on the peripheral nerves and the central nervous system. To that їkh failure, you can suffer from chronic axonal polyneuropathy.
Dismetabolic type. Infections of the winery are caused by the destruction of the processes of the functioning of the nerve tissues as a result of the occurrence of words, which are violated in the organisms of the transfer of the singing ailments.
Injury. As a result of injuries, there can be a number of mechanical nerves, which can lead to the development of neuropathy of the upper and lower symptoms.

Brutal respect! Polyneuropathy often gets sick, when an accumulation of high-pitched words occurs in the body, which negatively infuses on the nervous system.

Before the first types of disease, it is assumed to be a decongesting form of polyneuropathy and an ideopathic form (Hyun-Barre syndrome). Ethiology of the cich forms until the end is not marked, but it is often easier to get sick.

To the second forms of polyneuropathy of the upper and lower symptoms, there are types that are diagnosed as a result of infectious diseases, metabolic disorders, bran, pathologies of small liver, and internal defects of the robotic hall.

Symptoms and development of sickness

Polyneuropathy is able to complete a characteristic twisted classic picture. The head symptom of an affliction can be the symmetry of the lower and upper symptoms, so that the pathology of speech circulates through the blood.

Naybils are often seen signs of illness:

It is of a more adventurous character, which may have neuropathic ("baking") appearance.
Tremming of fingers on the hands.
The appearance of meazy posmikuvan, yaki winny mimovolі.
Loss of sensitivity (painful, tactile, temperature). When developing a sick person, the patient may not see a stone at the swelling, the surface is hot and іnshі teens.
Weakness in the meat, difficult with the collapse of great amplitude.
Nabrekannya lower kintzivok;
Chastkovo onіміння ніг.

Prior to vegetative symptoms, there will be signs of chilliness, weakness in the fingers, impaired blood circulation (marmurous coloration of kintzivok, foul wounds and wounds), Bring in the heat.

Diabetic polyneuropathy of the lower symptoms of the wiklikє will come to the clinically picture:

The appearance of large, severe pains in the legs and feet, which grow stronger at warm temperatures:
There is weakness in the feet of the vine;
Grow vegetative signs;
More step-by-step build up, at the same time there is a sverbіzh і color of shkіrnyh curves change (dark violet, mayzhe chorny);
To form a diabetic foot.

Alcoholic polyneuropathy develops step by step, її symptoms appear as a result of toxic ethanol infusion on the central nervous system and metabolic damage in the nerves:

A lot of people are found in the area of litoks, as they will do it in case of an onslaught
The insistence of weakness, there are parallels, both in the upper and in the lower ones;
There is an atrophy of paretic muscles;
There is a primary degradation of sensitiveness (this is how it is called by the type of "small boxes and mittens");
The winery is more potent than the visibility, the increase in the distal appearance of the pictures, the change in the range of the small curves.

Polyneuropathy can be diagnosed through the superficial implantation of alcohol, in addition to which the central nervous system is removed with ethanol

Polyneuropathy does not become dependent on a step-by-step: with a hostile form, symptoms can develop with a stretch of tension, with a subacute type - manifest a growth close to a month, with a chronic form - a disease can develop with rocks.

ways of lіkuvannya

Before the mediocre diagnostics of polyneuropathy, a diagnostic test is carried out, when it is analyzed, it is possible to manifest an illness, and a reason arises, with the appearance of pathology, which manifests itself with similar signs.

Yak carried out diagnostics:

The patient's scarg is analyzed.
The term will be established, if the first symptoms of illness appear.
Find out, why the patient’s activity is tied to contacts with chemistry.
It appears, which is dumb at the ailing alcoholic debris.
Officials recession re-emerge.
Blood analysis is carried out.
The biopsy of the nerve ends is meant.
Electroneimography is carried out.
To have a look around at a neurologist, in some cases - at an endocrinologist, a therapist.

So, as polyneuropathy is not self-destructive, it is mainly directed at the desertion of officials, who were called to become ill. However, therapeutic approach is guilty in a complex way, one hour at once with the main symptoms of polyneuropathy.

drug therapy

The preparations are expressed in fallowness of type and type of disease, as well as stages of polyneuropathy and development of symptoms:

Vitamin. The transfer is recognized by the group B vitamins in a combination with the largest minerals and vitamins. Vitamin preparations paint the health of nerves until the renewal of the structural components, antioxidant zakist.
Znebolyuchі drugs. In order to stop most of the symptoms, we are sick with analgesics (tramal, aspirin) or non-steroidal antiapaline drugs, and in especially important cases we give codeine or morphies.
Hormone therapy and immunosuppressants. Schemes of therapy with hormones (methylprednizolone) are indicated as a drug for increasing the increase and for a small change in dosage. Hormone therapy will be supplemented with the characteristics of immunoglobulin (sandoglobulin), and moreover, it is carried out only in stationary minds.
Lykarski zasobi, so that the circulation of blood in the area of nerve fibers (tintal, vase, pentoxiphilin).
Preparations, scho accelerate the process of delivery of living words to tissues (piracetam, medronate).

With polyneuropathy, there is a lack of intelligence, but it is not possible to get lost for help. Chimalu role in the therapy of ailing is given the correct regime, feeding, rehabilitation, come in, as well as a special look and post-turbot about a sick person.

physiotherapeutic come in

Physiotherapy has an important role in the treatment of polyneuropathy, especially when it becomes ill with spadkov or chronic form.

Please follow these procedures:

Infusion to the peripheral nervous system with magnetic fields;
Likuvalny massage;
electrophoresis;

Massage for polyneuropathy spirits to change the muscles, to reduce and stimulate their praise. The managers of the whole rukhovi funktsii shvid more vіdnovlyuyutsya, the risik of atrophy of mujazіv significantly changes. However, slid vrahovuvati, scho with gostrich forms of ailments, massage is not carried out.

Brutal respect! In case of toxic, and especially alcoholic polyneuropathy, therapeutic procedures, only blood purification is carried out, which is violated in stationary minds.

Right on exercise therapy can be carried out, both independently in the minds of the home, as well as in the course of the doctor. The stench will add to the stimulation of the robot's speech, so that it allows for a small amount of time to increase the recognition of the quality of the pictures.

folk methods

The polyneuropathy of the lower ends is good for the scabbard bath: 100 grams of water and kitchen water (300 g) are dispensed from the water (3 years), the water will be lowered into the bath every month.

Folding and forecast

If you don’t turn up for the Likarsky help for a moment, then you can get sick to the point of serious acceleration.

In the first place, polyneuropathy can grow into a chronic form, as it does not increase. In an hour, people will stop seeing their pictures, and the muzy will come in such a form that people can become invalids, which will cause them to deteriorate their health.

Important! On the other hand, vilikuvati from polyneuropathy is possible with such types of discomfort as infectious, alcoholic, toxic. In case of diabetic form, it is possible to deprive of frequent changes in symptoms of ailment.

In case of important forms of discomfort in case of impaired functioning of the nerves, which appear to be the heart of the robot, a strong arrhythmia can be manifested, which can lead to a lethal result.

In case of diabetic form, it is possible to bring secondary infections, septic diseases, and wretchedness to wounds.

With an adequate risk of getting sick, the prognosis of getting sick is getting sicker, but it’s better to get ahead of the ailment, it’s not enough to pick it up, it’s suffering from uncommon symptoms.

It is not possible to remember polyneuropathy, but it is possible to change the factor of health and development: it is related to alcohol, it is often infected and infected, and the quest for quality products in living

Diabetic polyneuropathy code according to ICD-10

Polyneuropathy is a complex of ailments, which includes multiple lesions of peripheral nerves. It is most often necessary to move into the chronic stage and by the volodya with the lower path wider, so that the process of collecting the extra fibers and step by step is going to take all the big bugs.

Classification of polyneuropathy according to ICD 10 є officially known, but not for individual specific features, and does not describe the tactics of treatment.

Symptoms and diagnostics

A clever picture in the first place to be grounded on the ruined robots of the support-and-meat apparatus and the heart-vascular system. Patient skarzhitsya on pain in the muscles, their weakness, judgment and the appearance of the building to normal oversaturation (paresis of the lower symptoms). Frequent frequency of the heart rhythm (tachycardia), symptoms of arterial grip, hypothermia and headaches through changes in the tone of the brain and improper blood circulation of the organs of the central nervous system are given to the backward symptomatology.

When the health of the ailing ointment is gone, I will atrophy, the lyudin basically lie, but it is negatively signified on the grating of the soft tissues. In some cases, necrosis develops.

A handful of remedies for goiters to listen to all of the patient's skargi, to take a look around, to reconsider the tendon reflexes and the sensitivity of the pupils for the help of special tools.

Laboratory diagnostics of blood is effective in terms of the presence of specific pathologies and the reasons for the development of the main disease. It is also possible to increase the adjustment of glucose concentration in non-toxic spores, salts of important metals.

І of the modern instrumental methods for the reduction of electrical neuromography and biopsies of the nerve.

lykuvannya

The International Committee has developed a system for the treatment of polyneuropathy. In the first place, there is an infusion of the head causative factor - to become feigned by organisms for the help of antibiotics, to compensate for the impairment of the endocrine system and hormonal therapy, to change the mind of robots, to change the form of being involved in new alcohol intake, to become operative.

In order to unify the development of an accelerated development, a high-calorific value of the day (at a time of day), a complex of vitamins and minerals, which introduce the robot of the immune system and the trophism of a cell, is indicated.

For the knowledge of symptoms, there are no painful drugs, antihypertensive drugs, as well as muscle stimulants.

For an ailment such diabetic polyneuropathy: code for MKH-10, clinical picture and methods of treatment

Polyneuropathy is a complex of ailments, which includes the so-called multiple lesions of peripheral nerves.

The disease is encouraged to move into the so-called chronic form and the long way wider, so that the process of combining the enemy itself with other fibers and, by and large, overflows into more large spikes.

This pathological camp, called diabetic polyneuropathy ICD-10, encrypts and grows in fallowness as a result of walking, overcoming ailments on the onset of the group: ignition and polyneuropathies. So also diabetic polyneuropathy according to ICD?

So tse take?

Polyneuropathy is the so-called acceleration of the diabetic diabetes, the whole essence of the polyagus is in the generalized accelerated nervous system.

Nerve reduction in polyneuropathy

Call yourself out to show yourself through a significant interval of an hour, which has passed at the moment of diagnosis of damage in the robotic endocrine system. More precisely, the disease can appear in twenty five rockets in the form of development of problems with the insulin in people.

Ale, bully vipadki, if a sickle of a bullet has been detected in patients of endocrinologists already through five years since the moment of revealing pathological diseases of the lump. Rizik zvoriti - the same for children with diabetes, as the first type, so and the other.

Causes of the blame

As a rule, in case of a trivial interruption of the disease and the frequent consumption of the tsukru, the breakdown of the metabolic processes in all organs and systems of the body is diagnosed.

Moreover, the first suffering is the nervous system itself. As a rule, nerve fibers to liven up blood-bearing judges.

We are trivial in pouring in carbohydrates because it is called the destruction of nerves. As a result of which stench falls into the camp of hypoxia, as a legacy, the primary symptoms of illness appear.

With a slight interruption and frequent decompensation, it is significant to accelerate the apparent problems with the nervous system, which step by step inflate a nonvolatile chronic character.

Diabetic polyneuropathy of lower symptoms according to ICD-10

The same diagnosis most often smells the children who are suffering from diabetes.

Denmark of ailment is hostile to the organism of todi, if the peripheral system and fibers are destroyed. There can be provocations by the very different factors.

As a rule, people of the middle age were strong before, in the first place. Most of the time, some people get sick more often. It is also obvious that polyneuropathy is not common in children of preschool and adulthood.

Diabetic polyneuropathy, code for MKH-10, which is E10-E14, invoke enemies of the very top and bottom of people. As a result, responsiveness, praiseworthiness decreases, the quality becomes asymmetric, and blood circulation also decreases. It seems to me that the head particularity of the whole ailment is that those who are guilty are widening in every way, hostile to the very same nerve fibers. It is not marvelous for those who are calling, for those who suffer from their feet.

signs

Diabet is afraid of the whole cat, yak will burn!

It is necessary for all to have it.

Sickness, manifested overwhelmingly on the lower symptoms, volodya great number of symptoms:

feeling a strong oniminnya in the legs;
swelling of the feet and nig;
unbearable pain and prickly vision;
weakness in meat;
increase or decrease in sensitivity of pictures.

The cutaneous form of neuropathy leads to the following symptoms:

diabetic at the first stages. Vaughn is characterized by some of the lower cues, a lot of pokryuvannya and strong writing in them. The presence of ice is smudged in the feet, gomilkovy soblobnyh slopes, as well as in litkovye ointments. As a rule, at night the symptoms become more severe and swelling;
diabetic at lower stages. With the appearance of such troubling symptoms: unbearable beating in the lower symptoms, as it can also appear in the country of calm, weakness, atrophy of the muscles and the symptoms of the pigmentation of the school. We will proceed with the development of the sickness, the stink will burn, as a result of which the stench will become more delicate, or will atrophy. Also, in a sick person, a diabetic foot is called so called: it means to grow in size, there is flatness, ankle deformity and neuropathic bulges develop;
diabetic encephalopolyneuropathy. For some of the following signs are characteristic: how not to go through severe headaches, instantaneous and increased stomachache;
toxic and alcoholic. Їy characteristic symptoms such as severe swelling of the symptoms: sudomy, oniminnya nig, not impaired sensitivity of the feet, weakening of the tendon and reflexes of the muscles, change to the bluishness of the scalp, I will curl on the bluishness of the hair of the hair, change As a heritage, the trophies take off and the swelling of the nig.

diagnostics

Oskilka one type of dosage cannot show again the picture, then diagnostics of diabetic polyneuropathy is carried out using the ICD-10 code for additional decals of popular methods:

As a rule, the first method to follow-up is to take a detailed look at a number of people: a neurologist, surgeon and endocrinologist.

The first doctor to deal with the development of specific symptoms, such as: blood pressure in the lower symptoms and sensitivity, the presence of all the necessary reflexes, conversion to the increase in the size of the machine.

As far as laboratory dosages are concerned, they include: analysis of blood plasma, glucose concentration in blood plasma, cholesterol, as well as the level of toxic speech, which can be found in the body when it is suspected of having toxic neuropathy.

And the axis is instrumental diagnostics of the presence of diabetic polyneuropathy in the organism of a patient according to ICD-10 May on the basis of MRI, as well as electroneuromyography and biopsies of nerves.

lykuvannya

It is important to memorize, but lіkuvannya is guilty of being complex іmіshanim. Vono, it is not uncommon to include in itself perennial drugs, which are direct on the entire process of development.

Even more importantly, the treatment included the intake of these drugs:

vitamini. Smells of guilt come into the body at once with food products. The workers use the transport of impulses along the nerves, and also block the negative effects of glucose on the nerves;
alpha-lipoic acid. Won the purchased zukru in the nerve tissue, activating the singing groups of enzymes in the cells and changing the nerve damage;
antibiotic preparations;
іngіbіtory aldose reductase. The stench to stand at the plant is one of the number of transformations of zukru in the blood, which change by itself and infuse on the nerves of the end;
actovegin. Winning glucose vikorizannya, will dye microcirculation of blood in arteries, veins and capillaries, which nudge nerves, as well as transferring nerve cells;
Calcium and Calcium. At the same time, the power of change of judgment and oniminnya in the pictures of the people may cause the power of change;
antibiotics. You can only get it right, if there is a risk of gangrene development.

In addition, as the very form of diabetic polyneuropathy ICD-10 is revealed, the eligible doctor recognizes a professional treatment, as I increase the symptoms of the disease. At the same time, it is possible to help on the outside of the vil_kuvannya.

Competent fachіvets signifies both medication and non-medication treatment.

Even more importantly, it is important to reduce the amount of blood in the blood, and only then to start testing for diabetic polyneuropathy according to the ICD. If you do not kill, then all efforts will be absolutely ineffective.

It is even more important in the case of toxic forms of increasing alcoholic drinks and after being able to take advantage of the suvorian children. A liquid drug is obviously guilty of special medications that cause microcirculation of blood and overload blood clots. Even more importantly, get out of the mess.

Video by topic

Candidate of Medical Sciences about polyneuropathies in diabetics:

You can be intelligent with the help of information, you can see it in the statistic, diabetic neuropathy can be done well. Naygolovnishe - not starting the process. The ailment can be very swirling of symptoms, as it is important not to mention it, so with a reasonable approach to it, you can end up quickly getting confused. For the first symptoms of anxiety, it is important to go through medical procedures, to confirm the transfer of diagnosis. As soon as it goes, you can go to the treatment of ailment.

Stabilizu rivn tsukru nadovgo
Introduce the revolving to the insulin in the slurry plant

Inshi polyneuropathies (G62)

The Russian International Classification of ailments of the 10th glance (ICD-10) has adopted a single normative document for the incidence of illness, the reasons for the infestation of the population to the medical establishments, the causes of death.

ICD-10 was introduced into the practice of protecting health in the entire territory of the Russian Federation in 1999 by the order of the Ministry of Health of Ukraine dated 27.05.97. No. 170

A new look (ICD-11) is planned by WHO in 2017 2018 roci.

Іf changes and additions of the VOOZ rr.

Processing and transfer zmin © mkb-10.com

What is the value of the treatment of polyneuropathy according to ICD-10?

The polyneuropathy code according to ICD-10 will be different for fallowness, depending on the type of disease. Given the uncomfortable mind of a pathological camp, with any hostilities, a nerve in the body of a man. It also manifests itself in the form of parallels, paresis, problems with trophic tissue and vegetative type growths.

Axonal polyneuropathy of the lower symptoms or of the lower parts of the body develops when the communication processes are broken. For example, an affliction can be manifested when mish, mercury, lead and other words get into the body. In addition, the alcoholic form can be included until the end. For the interruption of polyneuropathy, there is a hostility, pidgostroy, chronic, recurrent.

See the onset of the axonal polyneuropathy:

1. Gostra form. To develop with a stretch of decilkoh dib. The nerve cut is tied with a strong intoxicating organism through the infusion of methyl alcohol, mish'yak, mercury, lead, foul gas and other spoluk. This form of pathology can be no more than 10 dB. Therapy is carried out under the control of a doctor.
2. Subacute. Vaughn grows out with a stretch of decіlkokh tizhnіv. It is typical for toxic and metabolic species. Oduzhati viyde only through the clump of miscellaneous.
3. Chronic. It grows in a stretch of a trivial advance for an hour, for more than 6 months. Such a type of pathology is progressing, as there is a lack of vitamin B12 or B1 in the body, and also lymphoid, cancer, pukhlina, and diabetic diabetes develop.
4. Recurrent. There can be a lot of sick people more than once, and it can be manifested by a stretch of rockets, albeit periodically, and not permanently. It is often possible to achieve this in case of alcoholic forms of polyneuropathy. Qia ailment vvazhaє to be even more insecure. Growing up, only when Lyudin lived on a lot of alcoholic beverages. At the same time, it is not only the amount of alcohol that plays a great role, but also its quality. Tse is disgustingly pouring into the zalny camp of the healthy people. During the period of therapy, it is categorically to abstain from living alcohol. Due to the alcoholic content, it may be necessary to use it as a matter of course.

The demiєlіnіzuyucha form is characteristic of the Bari-Gin syndrome. Tse pathology of the ignition type. Її provoke ailments, infections. With a lot of people, there is an operative type of pain in the legs and weakness in the muscles. The price of the characteristic features of the ailment. After the weak health, symptoms of the sensory form of the ailment appear in an hour. The development of the whole ailment can be carried out in months.

If the patient has diphtheria-type polyneuropathy, then in a couple of days there will be enemies of the cranial nerves. Through the tse of awesome mova, people are important to grow, kovtati їzhu. The integrity of the phrenic nerve will also deteriorate, so it is important for people to dichati. Parallich of kintsivok insisted only through the month, and the whole hour the sensitiveness of the hands would be ruined step by step.

Also, there is a classification of polyneuropathy for provocative officials:

1. Toxic. The qia form is manifested through the detachment of the organism by the chimneys of the chimneys. It may not be just a mish'yak, mercury, lead, ale and a pobutova chemistry. In addition, the toxic form manifests itself with trivial alcoholic deposits in chronic forms, as it is badly infused into the camp of the nervous system and cause malnutrition in the robotic organs of children. Another type of toxic polyneuropathy is diphtheria. Vaughn manifest itself as an accelerated pislya diphtheria. Zazvychay to grow up to do the trick at the grown-ups. The pathology is characterized by small changes, which are linked to the functions of the nervous system. For example, it’s easy to lose weight with the cleanliness of fabrics, and it’s awesome for rukhov’s function. Lіkuvati similar polyneuropathy is guilty of only lіkar.
2. Ignite. Tsey razvidovy zvoryuvannya develop only for the development of ignition processes in the nervous system. At the same time, there is an inappropriate vision, it is in the legs and hands. Maybe the building is ruined and talked about. If any of these symptoms appear, it is necessary to immediately return to the hospital.
3. Allergic. The qi form is developed on aphids of toxicity with methyl alcohol, mish'yak, foul gas and phosphorus-organic fluids. A great role is played by the chronic form of intoxication with the help of others. Unfriendly є prognosis for diabetics, diphtheria and avitaminoses. To achieve the often allergic form of getting sick grows through the trivial implantation of any medication.
4. Traumatic. Tsey rizvid z'yavlyatsya through the removal of serious injuries. Symptoms will only be shown by the onset of the onset of deciduous movements. Name the head symptom є deterioration of the rukhovaya function. Even more important before the hour of exercise є exercise and exercise therapy.

Vidіlyayut and inshi, less widening of the form of polyneuropathy.

Diabetic polyneuropathy and disease

Diabetic polyneuropathy (code for MKH-10 - G63.2 * or E10-E14 p.4) is called a sign of damage to the nervous system in patients with diabetes, which are the reasons for the pathology of the disease. Diagnosis can be established when there is a scarg from the side of the patient, if the cut is indicated for the hour of the cleaning.

Diabetic polyneuropathy is not confirmed on the basis of one key sign. The current recommendation of the WHO to speak about those, that the diagnosis is guilty because of the obviousness of the two manifestations of the problem in order to confirm the pathology of the nervous system on the aphids of "malt ailment".

As the processes are seen in the vicinity of nerve fibers, then we can read about neuropathies. Polyneuropathy develops in different numerical stripes. Ailments for type 1 diabetes mellitus are accelerated in 15-55% of cases, type 2 - 17-45%.

Classification

Posed polyneuropathies to finish in a folding manner, some of them are one in a number of syndromes. One author is vazhayut for a more beautiful classification in terms of the amount due to the fact that the nervous system is seen before the process: peripheral (spinal nerves) and autonomous (autonomic) form.

Another widely used classification is:

Polyneuropathy is bistro-reversible (timchasova, scho vinikla on the smallest growths in the blood).
The polyneuropathy is symmetrical: the striation of the nerve fibers (distal somatic); lesion of fine fibers; training of autonomous type.
Focal / multifocal polyneuropathy: cranial type; compressor type; proximal type; thoracoabdominal type; neuropathy of children.

cause

A high level of zukru in the blood, characteristic of diabetics, a zdatny pathological rank injected into the camp of the sudin of an ancient caliber, the development of microangiopathy, and the great arteries, provoking macroangiopathy. Zmini, which occur in great vessels, are similar in the mechanism of the formation of atherosclerosis.

Angiopathy - head lanka in the development of nerve damage in case of diabetes mellitus

Admittedly, arteriol and capillaries, everything is displayed here. Hyperglycemia activates the enzyme protein kinase-C, which increases the tone of the urine stinks, pushes the membrane, and stimulates the processes of blood larynx. At the internal station, arterioles and capillaries are used to repair glucogen, mucoproteins and other words of carbohydrate nature.

Toxicity of glucose can be but and not. You will have to come to the big, shy ones, glittered, as you can shit the vessel membranes and damage the communication, transport and vital life processes in the body. The most common glucose block is hemoglobin HbA1c. Chim more and more indicators, less soreness to get rid of the cells' organisms, develop tissue hypoxia.

Diabetic polyneuropathy of winy through the lesion of endoneural (which is found in a completely tissue prodrug along with nerve fibers in the nerve stovbur)) sudins. The process is supported by the interconnection between the thickness of the vessel membranes and the thickness of the fibers in the nerve. The process of triggering neurons and sprouts, which leads to metabolic breakdowns in the organisms of diabetics.

provocative factors

The development of polyneuropathy in case of diabetic diabetis is taken by the following officials:

failure of self-control over indicators of blood sugar;
trivial period of the main disease;
high arterial vise;
high spr_st;
abduction of vіk;
the appearance of shkidlivyh calls (tyutyunopalinnya, implantation of alcoholic beverages);
dislіpіdemiya;
genetic strength.

Features of the pathological process with multiple lesions of nerve fibers

stages

Regardless of the severity of the development of the onset of the stage of battle, at the present time, there is a need for polyneuropathy:

0 - visual data on the day;
1 - asymptomatic overloading;
1a - scargs from the side of the patient on the day, ale pathological changes can also be made for additional diagnostic tests;
1b - scars are visible, changes can be started not only by specific tests, but by neurological examination;
2 - stage of clinical manifestations;
2a - symptoms of urazhennya are manifested at once with positive diagnostic tests;
2b - stage 2a + weakness of tilted legs;
3 - polyneuropathy, accelerated by the failure of preceding.

symptoms

Symptoms of diabetic polyneuropathy are in direct presence of the stage and form of development, as well as vicious therapy.

sensitive ruin

Characteristic manifest sensory pathology. The stench can start with diagnostic tests (subclinical form), or become scargs of patients (clinical form). Ailments suffer from pain syndrome. Bіl can be baking, how to move, how to shoot, pulsating. It can be caused by these factors, which do not suffer from unacceptable impressions in healthy people.

Sickness can be on the same, seeming, or giving goosebumps, sorrow, sensitiveness to the inflow of cold, warmth, vibrations. Physiological reflexes are taken into account, and pathological reflexes can be seen on the day.

As a rule, sensitive and symmetrical. When an asymmetric pathology appears, the pain syndrome should be repaired from the pelvic area and descend down the stitch. The price of supervising changes in the overall proportions of the picture, the loss of proportions in terms of maturity to the other parts of the house.

Loss of pain sensitivity is one of the most important symptoms of polyneuropathy

pathology detected

The development of sensorimotor polyneuropathy in a large number of cases during a long period of time. For diabetics, use the following:

vidchuttya oniminnya;
great character;
loss of sensitivity right up to the day;
myazova weakness;
visibility of physiological and pathological reflexes;
no judgments of the lower and upper cuts;
the visibility of the stiffness when walking.

To the most frequent accelerated chronic processes in the case of mechanical children, the old diabetic foot is a pathological stun, with any damage I will swallow all the structures, including cartilage and cyst elements. The result is deformation and damage to the walk.

off-line

The nerves of cells, which are localized in the internal organs, can also be affected. The symptomatology is due to the fact that an organ or the system is damaged. The pathology of the heart and the heart is manifested by orthostatic hypertension, a lot of legends, impaired sensitivity to physical pressure. Patsinti skarzhaya on broken heart rhythm, pidvischennya arterial vise, backwardness, cough. The appearance of a free-for-all treatment can lead to a lethal result.

Disruption of the heart rhythm is a possible symptom of the pathology of the autonomous type

Lesion of the intestinal tract is manifested by paresis, decreased tone of its appearance, damage to normal microfloria, reflux ailment. The ailment to torment the attacks of blues, stoves, carrying, lowering vagi, pain syndrome.

Polyneuropathy of the sectarian system and supervises the atony of the slaughter, the zealous injury of the slaughter, the impairment of sexual functions, and the possibility of secondary infections. There is a bile across and above the pubis, more frequent, it becomes more frequent, it becomes painful for palynia, the temperature rises, there is a pathological appearance of the urethra.

damage to the processes of visualization (it is possible to do it or it is drastically reduced right up to the whole daytime of the robot on the ground);
pathology of the healthy analyzer (the period of time changes in diameter, the rate of growth decreases sharply, especially in the days);
polyneuropathy of nadnirnikov not having symptomatic manifestations.

diagnostics

First, not to recognize the diagnosis of diabetic polyneuropathy of the lower symptoms, the patient is not only on the nutrition of neurology, but as an endocrinologist, to clarify the level of compensation for the main disease.

Specialist will clarify the level of different types of sensitivity (temperature, vibrational, tactile, painful). For a lot of vikoristoyutsya cotton wool, Monofilament, hammers with a penzlik and a hollow on the tip, a tuning fork. In special cases, carry out the collection of material for additional biopsies for further histology. Neurological advances also include advanced methods:

Victory potentials - nerve fibers are stimulated, as a result of which they are fixed by a special apparatus.
Electroneurography is a method of diagnostics, with the help of which it begins to expand the nerve impulses from the forms of the central nervous system to the receptors.
Electromyography is a refinement, specifying the transmission of impulses from nerve cells to the meat apparatus.

Significant transmission of impulses is an important diagnostic method

Obligatory laboratory methods of diagnostics: clarification of the level of glucose, biochemical analysis, indicators of C-peptide and glycated hemoglobin. In case of suspicion of autonomy, the ailment should be diagnosed with EKG, EchoKG, ultrasound of the heart, dopplerography of sudin, ultrasound of the intestinal tract, EGDS, X-ray.

The standard of the sechid system can be based on the additional analysis of the sech, analysis of Zimnitskiy and Nechiporenko, as well as during ultrasound examination, cystography, cystoscopy and electromyography.

specialties of lіkuvannya

For the treatment of diabetic polyneuropathy by the obovasculature of the mind є the correction of indications of the blood in the blood. An endocrinologist is involved in the process of looking at the diagrams of insulin therapy and the storage of juvenile medications. If necessary, you should be more effective, or additional medications should be used.

Carry out a correction of the process of eating, pick up the necessary mode of physical activity. Likar yes, please, as pidtrimuvati the level of the arterial vise and mass in the allowable boundaries.

The following groups of medicines are meant:

Pochіdnі alpha-lipoic acid - preparations of a vibor. The smell of high cholesterol surpluses, eliminates the toxic effect of new officials on the stove and judgment. Representatives - berlitionu, Lipova acid, Tiogamma. Likuvannya course - not less than 2 months.
Vitamin groups B - rotate the robot of the central and peripheral view of the nervous system, receive normalization of transmission of nerve-muscle impulses (Pyridoxin, Cyanocobalamin, Timin).
Antidepressant - vicorisation for the reduction of sickly manifestations (Amitriptyline, Nortriptyline). It is used in small doses, step by step reaching the necessary therapeutic effect.
Ingibitories of aldose reductases are positive moments in therapy with the help of a group of bullets, but the stench did not justify all the hopes that were laid on them. Vikoristovuyutsya on the investigation of a lykuyu lykar (Olrestatin, Izodibut, Tolrestat).
Miscellaneous anesthetics are used for stopping ailments in patients with complaints. The effect is to appear in a minute.
Protisudomnі - Carbamazepin, fiinitoin. Qia group of vimagazatelny pіdboru dozuvannya. Repair with small doses, increase the amount of decalcifications.

Descending alpha-lipoic (tioctic) acids - preparations for the normalization of the stun of the brain and the reduction of inappropriate suspicions in diabetic disorders of the nervous system

People zasobi

Lіkuvati diabetic polyneuropathy is possible not only with traditional medicine, but also with different methods and infusions prepared in home minds.

recipe number 1

Vikladaut zzdalegіd harvested sprinkling stems. Ailments are guilty of stomping on them at least 7-10 quills a day.

recipe number 2

Reduce the fineness of burdock root and blackberry leaves. 3 tbsp Otrimannoy sumіshі pour a liter of sprinkle and insist not less than 8 years. Dal to put on the fire and soften for more than 3 years. In addition, since it is a good idea, it is necessary to process it. Vipiti otrimane a bit of rіdini with a stretch to finish.

Recipe number 3

Pour 1 liter of sprinkle into a glass of vivsa. Napolyagayut stretching for 10 years, then it is necessary to boil sums not less than 40 chilins. Know from the plate and drive in a warm place. Pislya filter and take a glass for six months to a skin dye.

It is necessary to remember how to get used to polyneuropathy by folk methods without traditional medicine and control over indicators of zukru in blood is ill-advised. And the axis can be brought down to a pathology that is friendly to the result.

Also alcoholic polyneuropathy

One of the inheritances of chronic alcoholism is polyneuropathy. Dane ailment, according to the International Classification of ailments, code G62.1 and is characterized by impaired functions of the peripheral nervous system. There is an alcoholic polyneuropathy of the lower symptoms at the lower stages of the formation of fallowness due to the implantation of alcoholic beverages and a poor prognosis. The development of an impairment of waste alcohol and other toxins on the structural elements, the storage base of the peripheral nervous system, and the breakdown of the communication processes in them.

Pathological changes occur not only in the cranial and spinal nerves, but also in the brain and spinal cord. It is worth noting that medical statistics show that another skin patient with alcoholism is susceptible to symptoms of polyneuropathy, moreover, women are more likely to get sick, less people.

cause

Alcoholic polyneuropathy develops into a link with a dental infusion of ethyl alcohol.

Regular alcoholic malignancies are known to cause nerve impulses to the point of failure. Surrounded by the price of reliance on exchange processes and outbreaks in the transport of lively conversations. In addition, acetaldehyde, which is ruined and peripheral, and the central nervous system, makes its contribution to the development of ailments.

There is not a lack of vitamins in group B, and the deficiency is established through the deterioration of the process of getting lively words in the small intestine in patients with chronic alcoholism. Chronic alcoholism is susceptible to a disease in the immune system, such as the formation of antibodies, which degrades the nerve tissue. To complement the picture of liver dysfunction symptoms. As a result, the poisonous infusion of alcohol has a number of overwhelmed diseases, which cause the development of alcoholic polyneuropathy.

symptoms

Alcoholic polyneuropathy is diagnosed, as in a sick person's presence such signs of an ailment:

baking pains in homosexuals and feet;
myazovi spasms;
seeing "goose bumps";
weakness in the lower pictures;
a decrease in sensitivity in the hands and feet of nig, to accommodate at night;
"Shlyopati" course;
blіdі shkіrnі pokrivi;
ruinous ravnovagi;
colder gomіlok i feet with normal blood flow;
empowerment;
parts of sechovipuskannya;
one of the hands;
blue for marmurism of shkiri nig;
weak tendon reflexes, no more or less visibility;
parallel or paresis nig;
change of hairline of homilok;
trophіchnі virazki;
hyperpigmentation of shkiri.

diagnostics of illness

The general picture of an affliction, described in ICD 10, does not allow polyneuropathy to be diagnosed at once, some of the symptoms presented may indicate the manifestation of these health problems. With a kind of classy picture, Mayut:

diabetic polyneuropathy (ICD code 10 - G63.2);
chronic ignition polyneuropathy (ICD code 10 - G61);
Hyun-Barre syndrome (code of the International Classification of ailments - G61.0);
recession of the peripheral nervous system.

When staging a diagnosis, it is necessary to exclude the manifestation of recessive pathologies, inheritance of intoxications (including lykarska), whose symptoms may be similar to the picture. I especially respect the food that comes, not the presence of diabetic or uremic polyneuropathy. For the whole, MRI, nerve biopsy, computer tomography, electro-neuromography and a secondary neurological examination are prescribed.

Diabetic abnormal uremic form can be diagnosed only behind additional biopsies of the nerve. Before the hour of obstezhennya, it is necessary to establish the reasons, which led to the development of the ailment.

Lіkuvannya alcoholic polyneuropathy

When a sign of ailment appears, it is necessary to see it as an alcoholic drink, to see children and to eat a lot of vitamins. At the same time, if the ailment is to continue the disease, then there is no way to find the most effective drugs, not to stop the development of the disease. Therapy includes medication and non-medication treatment.

Medication therapy on the basis of internalization or internal administration of drugs. Preparations include:

vitamini group B;
antihypoxanths;
pentoxifyline, liquids for microcirculation;
neuromedin for accelerated nerve conduction.

Dodatkovo can be used drugs for zenyatty zapalennya (diclofenac, nimesulid), antidepressants, non-narcotic analgesics, hepatoprotectors. For patients with severe pain syndrome, use carbamazepin or amitriptyline.

In case of non-drug treatment, complex rehabilitation is stagnant, in order to rely on the importance of carrying out physiotherapeutic procedures:

electrostimulation of the spinal cord;
magnetotherapy;
massage;
electrostimulation of nerve fibers;
lykuvalnoy physical culture;
holcoreflexotherapy.

forecast

It is worth noting that medical statistics become ill, there is an uncomfortable prognosis: a greater number of ailments spend on patronage and disability (group II). In the wild, with the speedy beefing up to the factions and the demise of all attributions to the countries, it can be reduced. In medical practice є diseases, if the disability in such ailments was known through the sign of the improvement of health. At the same time, drinking alcoholic polyneuropathy is a process of triviality and vimag of a sickly significant volovych zusil.

prophylaxis

Prevention of alcoholic polyneuropathy of transmission of vicious factors, health impairments of the nervous system. First for everything, the price is put before the implantation of alcoholic beverages. Only if the alcohol is taken into account, there is a 100% guarantee not to fall ill with alcoholic polyneuropathy.

ICD-10 was introduced into the practice of protecting health in the entire territory of the Russian Federation in 1999 by the order of the Ministry of Health of Ukraine dated 27.05.97. No. 170

A new look (ICD-11) is planned by WHO in 2017 2018 roci.

Іf changes and additions of the VOOZ rr.

Processing and transfer zmin © mkb-10.com

Diabetic polyneuropathy code according to ICD-10

Classification of polyneuropathy according to ICD 10 є officially known, but not for individual specific features, and does not describe the tactics of treatment.

Symptoms and diagnostics

When the health of the ailing ointment is gone, I will atrophy, the lyudin basically lie, but it is negatively signified on the grating of the soft tissues. In some cases, necrosis develops.

A handful of remedies for goiters to listen to all of the patient's skargi, to take a look around, to reconsider the tendon reflexes and the sensitivity of the pupils for the help of special tools.

І of the modern instrumental methods for the reduction of electrical neuromography and biopsies of the nerve.

lykuvannya

For the knowledge of symptoms, there are no painful drugs, antihypertensive drugs, as well as muscle stimulants.

For an ailment such diabetic polyneuropathy: code for MKH-10, clinical picture and methods of treatment

Polyneuropathy is a complex of ailments, which includes the so-called multiple lesions of peripheral nerves.

So tse take?

Polyneuropathy is the so-called acceleration of the diabetic diabetes, the whole essence of the polyagus is in the generalized accelerated nervous system.

Nerve reduction in polyneuropathy

Causes of the blame

As a rule, in case of a trivial interruption of the disease and the frequent consumption of the tsukru, the breakdown of the metabolic processes in all organs and systems of the body is diagnosed.

Moreover, the first suffering is the nervous system itself. As a rule, nerve fibers to liven up blood-bearing judges.

With a slight interruption and frequent decompensation, it is significant to accelerate the apparent problems with the nervous system, which step by step inflate a nonvolatile chronic character.

Diabetic polyneuropathy of lower symptoms according to ICD-10

The same diagnosis most often smells the children who are suffering from diabetes.

Denmark of ailment is hostile to the organism of todi, if the peripheral system and fibers are destroyed. There can be provocations by the very different factors.

signs

Sickness, manifested overwhelmingly on the lower symptoms, volodya great number of symptoms:

feeling a strong oniminnya in the legs;
swelling of the feet and nig;
unbearable pain and prickly vision;
weakness in meat;
increase or decrease in sensitivity of pictures.

The cutaneous form of neuropathy leads to the following symptoms:

diabetic at the first stages. Vaughn is characterized by some of the lower cues, a lot of pokryuvannya and strong writing in them. The presence of ice is smudged in the feet, gomilkovy soblobnyh slopes, as well as in litkovye ointments. As a rule, at night the symptoms become more severe and swelling;
diabetic at lower stages. With the appearance of such troubling symptoms: unbearable beating in the lower symptoms, as it can also appear in the country of calm, weakness, atrophy of the muscles and the symptoms of the pigmentation of the school. We will proceed with the development of the sickness, the stink will burn, as a result of which the stench will become more delicate, or will atrophy. Also, in a sick person, a diabetic foot is called so called: it means to grow in size, there is flatness, ankle deformity and neuropathic bulges develop;
diabetic encephalopolyneuropathy. For some of the following signs are characteristic: how not to go through severe headaches, instantaneous and increased stomachache;
toxic and alcoholic. Їy characteristic symptoms such as severe swelling of the symptoms: sudomy, oniminnya nig, not impaired sensitivity of the feet, weakening of the tendon and reflexes of the muscles, change to the bluishness of the scalp, I will curl on the bluishness of the hair of the hair, change As a heritage, the trophies take off and the swelling of the nig.

diagnostics

Oskilka one type of dosage cannot show again the picture, then diagnostics of diabetic polyneuropathy is carried out using the ICD-10 code for additional decals of popular methods:

As a rule, the first method to follow-up is to take a detailed look at a number of people: a neurologist, surgeon and endocrinologist.

lykuvannya

Even more importantly, the treatment included the intake of these drugs:

vitamini. Smells of guilt come into the body at once with food products. The workers use the transport of impulses along the nerves, and also block the negative effects of glucose on the nerves;
alpha-lipoic acid. Won the purchased zukru in the nerve tissue, activating the singing groups of enzymes in the cells and changing the nerve damage;
antibiotic preparations;
іngіbіtory aldose reductase. The stench to stand at the plant is one of the number of transformations of zukru in the blood, which change by itself and infuse on the nerves of the end;
actovegin. Winning glucose vikorizannya, will dye microcirculation of blood in arteries, veins and capillaries, which nudge nerves, as well as transferring nerve cells;
Calcium and Calcium. At the same time, the power of change of judgment and oniminnya in the pictures of the people may cause the power of change;
antibiotics. You can only get it right, if there is a risk of gangrene development.

It is even more important in the case of toxic forms of increasing alcoholic drinks and after being able to take advantage of the suvorian children. A liquid drug is obviously guilty of special medications that cause microcirculation of blood and overload blood clots. Even more importantly, get out of the mess.

Video by topic

Candidate of Medical Sciences about polyneuropathies in diabetics:

Stabilizu rivn tsukru nadovgo
Introduce the revolving to the insulin in the slurry plant

Treatment of diabetic polyneuropathy

Succinic diabetes є we will broaden illnesses in the whole world. Most often, it is most common to develop chronic diseases. One of the accelerated disease is diabetic polyneuropathy.

Chronic diabetic (sensorimotor) polyneuropathy - the form of neuropathy is broadened, as it is super-susceptible to sensitive, vegetative and ruffled disorders.

E 10.42 diabetic polyneuropathy in type 1 diabetes,

E11.42 diabetic polyneuropathy in DM 2,

G 63.2 Diabetic distal polyneuropathy.

Diabetic polyneuropathy is associated with pain syndrome and often decreases the level of life of patients.

The development of a sickness can lead to more serious acceleration. Such, yak: ataxia, Charcot's angle, diabetic foot syndrome, diabetic osteoarthropathy.

Diabetic polyneuropathy of children can be brought to gangrene and other amputations.

To that, it is important to remember the development, and it is more effective to pick it up even with the first signs of a child with a baby with diabetes.

cause development

The main ethiological factors that provoke the development of diabetic polyneuropathy are taken into account:

Courinnya and alcohol;
Failure to control blood glucose;
vik;
Arterial vise;
Destruction of spіvvіdnoshennya lіpіdіv (fatty words) blood;
Decreases against insulin in blood;
Trivial overbig of a diabetic.

The number of up-to-date ones should be taken into account for those who constantly control the level of glucose and the arterial grip, but rather reduce the development of pathology. And the time spent on insulin therapy will reduce the risk of development by a factor of two.

symptoms

Symptoms of diabetic polyneuropathy appear as more symptoms in the lower symptoms. Pekucha, stupid or sverblyachі bіl, rіdsche gostry, prickly і pierced. The most frequent winners are in the foot and to feast on the evening hour. Nadal, more can be manifested in the lower third of the woman's hands.

Patients skarzhitsya on the part of the m'yaziv, pain in the slopes, the ruined walk. Tse is tied with a rosette in the nervous system. Temperamental sensitivity is involved, trophism may appear.

Hvory vidchuv discomfort comes from doty ogyagu. Pain syndrome in such vipadas is of a permanent character and sutta pogirshuє in the back of the self-esteem of the sick person.

Yak viyaviti and clarify the diagnosis?

Diagnosis of polyneuropathy is to be repaired from a doctor's account, which can help you collect anamnesis and a sign of the need for a diagnosis.

Electroneuromyography appears in the capacity of the main preliminaries. In addition, there can be stasosovuvati doslіdzhennya VKSP (vegetative shkіrnyh sympathetic potential).

lіkuvannya pathology

To set the diagnosis for diabetic polyneuropathy, use ethiotropic therapy. It is important to normalize glucose instead of blood glucose. For continuous control, in 70% of cases, more responses change. In some cases, insulinotherapy is indicated.

In the scheme of treatment for oxidative stress, for renewal of edema, it is necessary to use medicinal preparations with an antioxidant effect. By taking the drug, take courses to finish a trivial hour. At tsei period ide control and caution for the patient.

For pain relief, analgesics and protivopalny drugs are used. Ale, as I mean fakhivtsi, I will increase the stink of the odd odor from most of the seen, that trivially, you can get the correct robot into the slurry.

For symptoms of chronic neuropathic pain, anesthetics, antidepressants and antiepileptic drugs are prescribed. In addition to preparations, it is recommended to use vikoristovuvati plasters with lidocaine, gels, ointments and cream.

As a consolidation of a complex treatment of diabetic polyneuropathy, in the presence of a patient, I mean:

fizio likuvannya,
magneto and phototherapy,
electropharesis i strumi,
electrostimulation of myaziv,
golkovkolyuvannya,
hyperbaric oxygenation,
monochromatic information optimization.

Likuvannya by folk zasoba is allowed to be deprived of a likuyuchiy lykar for the season. As an addition to the traditional methods of treatment, you can use phytherapy and treatment of ointments.

Effective treatment of diabetic polyneuropathy takes into account the individual's condition to the skin patient with a complex of conservative methods of treatment.

What is the value of the treatment of polyneuropathy according to ICD-10?

See the onset of the axonal polyneuropathy:

1. Gostra form. To develop with a stretch of decilkoh dib. The nerve cut is tied with a strong intoxicating organism through the infusion of methyl alcohol, mish'yak, mercury, lead, foul gas and other spoluk. This form of pathology can be no more than 10 dB. Therapy is carried out under the control of a doctor.
2. Subacute. Vaughn grows out with a stretch of decіlkokh tizhnіv. It is typical for toxic and metabolic species. Oduzhati viyde only through the clump of miscellaneous.
3. Chronic. It grows in a stretch of a trivial advance for an hour, for more than 6 months. Such a type of pathology is progressing, as there is a lack of vitamin B12 or B1 in the body, and also lymphoid, cancer, pukhlina, and diabetic diabetes develop.
4. Recurrent. There can be a lot of sick people more than once, and it can be manifested by a stretch of rockets, albeit periodically, and not permanently. It is often possible to achieve this in case of alcoholic forms of polyneuropathy. Qia ailment vvazhaє to be even more insecure. Growing up, only when Lyudin lived on a lot of alcoholic beverages. At the same time, it is not only the amount of alcohol that plays a great role, but also its quality. Tse is disgustingly pouring into the zalny camp of the healthy people. During the period of therapy, it is categorically to abstain from living alcohol. Due to the alcoholic content, it may be necessary to use it as a matter of course.

Also, there is a classification of polyneuropathy for provocative officials:

1. Toxic. The qia form is manifested through the detachment of the organism by the chimneys of the chimneys. It may not be just a mish'yak, mercury, lead, ale and a pobutova chemistry. In addition, the toxic form manifests itself with trivial alcoholic deposits in chronic forms, as it is badly infused into the camp of the nervous system and cause malnutrition in the robotic organs of children. Another type of toxic polyneuropathy is diphtheria. Vaughn manifest itself as an accelerated pislya diphtheria. Zazvychay to grow up to do the trick at the grown-ups. The pathology is characterized by small changes, which are linked to the functions of the nervous system. For example, it’s easy to lose weight with the cleanliness of fabrics, and it’s awesome for rukhov’s function. Lіkuvati similar polyneuropathy is guilty of only lіkar.
2. Ignite. Tsey razvidovy zvoryuvannya develop only for the development of ignition processes in the nervous system. At the same time, there is an inappropriate vision, it is in the legs and hands. Maybe the building is ruined and talked about. If any of these symptoms appear, it is necessary to immediately return to the hospital.
3. Allergic. The qi form is developed on aphids of toxicity with methyl alcohol, mish'yak, foul gas and phosphorus-organic fluids. A great role is played by the chronic form of intoxication with the help of others. Unfriendly є prognosis for diabetics, diphtheria and avitaminoses. To achieve the often allergic form of getting sick grows through the trivial implantation of any medication.
4. Traumatic. Tsey rizvid z'yavlyatsya through the removal of serious injuries. Symptoms will only be shown by the onset of the onset of deciduous movements. Name the head symptom є deterioration of the rukhovaya function. Even more important before the hour of exercise є exercise and exercise therapy.

Vidіlyayut and inshi, less widening of the form of polyneuropathy.

Neuropathy nig: diabetic, alcoholic, peripheral, sensory, toxic

Whether it’s a neurological illness, it’s like a neuropathy of the lower symptoms, connected with nerves, so that it’s not possible to get rid of the nerves and sensory nerves. This can lead to a weakening or a loss of sensitivity, and also to the loss of the health of the muscular fibers, it starts to tighten up, so that the locomotion of the musculoskeletal apparatus is improved.

Code for MKH-10

Epidemiology

In patients with diabetes, the frequency of neuropathy of the lower symptoms is 60%. І CDC statistics indicate the presence of peripheral neuropathy in 41.5 million Americans, which is higher in 14% of the US population. Such numbers may seem unrealistic, but the National Institute of Diabetes doesn’t mean that almost half of the patients now don’t know if they have a pathology, which is why the development of ailments is at an early stage of discomfort. lykarya.

According to the assessments of experts, peripheral neuropathy appears in 20-50% of HIV-infected patients and in 30% of oncological patients in chemotherapy.

Spadkov neuropathy Sharko-Mari-Tuta won 2.8 million people in the whole world, and the frequency of Guin-Barré syndrome is 40 times lower, as many malomas are diagnosed.

The incidence of alcoholic neuropathies (sensory and motor) varies from 10% to 50% alcoholics. Ale, if the electrodiagnostic methods are victorious, then neurological problems with the legs can be found in 90% of patients with trivial alcoholic deposits.

Causes of neuropathy of lower symptoms

In modern neurology, there are some of the most common causes of neuropathy of lower symptoms, such as:

injuries, in case of any malice of the hand, or of the malleable fixation (with splints, tires), they can fix the vice without the need for the hand on the nerves;
stenosis (zvuzhennya) of the spinal canal, in which there is a stovbur of the spinal nerve, as well as the compression of the ventral nerves, or the heating of the nerve roots;
craniocerebral trauma, stroke, swelling of the brain (in the first place in the zones of the extrapiracytic system, the cornsus and the pedicle nuclei);
іnfektsії, vklyuchayuchi viklikaєtsya vіrusom Varicella zoster gerpetichny mієlіt, Gієna-Barre syndrome (rozvivaєtsya at urazhennі vіrusom herpes IV type pіdrodini Gammaherpesvirinae), difterіyu, hepatitis C, hvoroba Lyme (klіschovy borelіoz) SNІD, leprosy (sprichinyuєtsya bakterієyu Mycobacterium leprae), menіngoentsefalіt rіznoї ethology;
metabolic and endocrine discomfort - diabetes of both types, porphyria, amyloidosis, hypothyroidism (lack of hormones in the thyroid gland), acromegaly (excess of hormone growth);
autoimmune ailments: rheumatoid arthritis, systemic cervonium vovchak, rosy sclerosis (with ruptured myelin nerves), hospitality roscience encephalomyulitis;
recessionary illness: neuropathy of Sharko-Mari-Tooth, neurodegenerative ataxia of Friedreich, recessive sphingolipidosis or Fabri ailment; another type of glucogenesis (Pompe's ailment, which is a defect in the lysosomal gene for the enzyme maltasi);
ailments of motor (rukhovyh) neurons - amyotrophic bichny sclerosis;
subcortical atherosclerotic encephalopathy with atrophic serpentine speech in the brain (Binswanger's ailment);
multiple maloma or multiplex plasma cell miloma (in case of malignant degeneration of plasmatic B-lymphocytes);
Lambert-Iton syndrome (for example, in case of malignant cancer of the leg), neuroblastoma. In some types of neuropathies, it is called Paraneoplastic;
systemic vasculitis (inflamed blood-bearing vasculature), which can provoke the development of a vascular periarthritis from the deterioration of the innervations of the lower symptoms;
exchange and chemotherapy;
toxic infusion of ethyl alcohol, dioxin, trichlorethylene, acrylamide, herbicides and insecticides, mis'yak and mercury, important metals (lead, taliyu and in.);
In addition, anti-tuberculosis drugs in izonicotinic acid, proto-dominal drugs in the group of hydantoin, fluoroquinolone antibiotics, hypolipinoxydemic statics
lack of levels in the organisms of cyanocobalamin and folic acid (vitamins B9 and B12), which leads to the development of funicular myelosis.

Riziku factories

Physicians unanimously consider the factors of development of neuropathy of lower symptoms of weakening of immunity to the factors of development of the neuropathy, which infuses on the basis of the organism of bacterial and foreign infections, as well as the decline (the disease).

In addition, the development of adipose diabetes with obesity and metabolic syndrome; rosy sclerosis - diabetes, intestinal problems and pathology of the thyroid gland.

The factors of risk of systemic vasculitis of HIV infection, virus of hepatitis and herpes, sensitization of the organism of the developmental ethology. And the plasma cell mієloma grows easier in the quiet, who will lose their vagu or alcoholic stagnation.

In a large number of cases of blood loss to the brain, necrosis of his tissue, if the myelin sheath of nerve fibers is inadequate, leads to degradation. The first such camp can be spared in patients with cerebrovascular problems.

In principle, all overwhelmed disease can be brought down to factors that cause a neurological breakdown of ruddy functions.

pathogenesis

The pathogenesis of neurological problems with the legs is one of the reasons for this. Physical injuries can be superficially compressed by the compression of nerve fibers, which transforms their health, stretching, through which their integrity is destroyed.

The pathological effect of glucose on the nervous system is not understood, however, with trivial transposition of glucose in the blood, the failure of the conduction of nerve signals along the nerve nerves is an unsettled fact. And with an insulin-dependent diabetes mellitus, it is not just a breakdown in carbohydrate metabolism, but the functional lack of bagatose endocrine valleys, which is poured into the backward exchange of speeches.

Pathophysiological neuropathy in case of Lyme ailments is in two versions: Borrelia bacteria can provoke an immune-mediated attack on the nerve or even without a middle ear of the cell with its toxins.

In the development of amyotrophic lateral sclerosis, the main pathogenetic role of the substitution of dead nerve neurons from the brain structures by the nodes of the glial cells is the main pathogenetic role.

In the pathogenesis of demilinating neuropathies (in the middle of the most common diseases, peroneal amyotrophy of the disease occurs, or Sharko-Mari-Tooth ailment), genetic impairment of the synthesis of Schwann cells of the speech fibers - the sheaths of the nerves in 75% Extend on the nerve along all the way (behind the blame of small, non-localized universities), the myelin sheath of the cell's nerves. Without it - through the degenerative changes of axons - the transmission of nerve signals will break down or be pulled back. In the case of Sharko-Mary-Tooth ailments (due to the lesions of the small nerve, which transmits the impulses to the peroneal muscles of the lower muscles, the spine of the foot), mutations appear on the short arm of chromosome 17 (MFNP222 geni).

Bagatorazova mієloma hostile to the germinal center of the lymph node B-lymphocytes, destroying the proliferation. This is the result of chromosomal translocation between the important lancer genome and immunoglobulin (in 50% of specimens - on chromosome 14, at the q32 locus) and an oncogene (11q13, 4p16.3, 6p21). Mutations lead to dysregulation of the oncogene, and a chubby clone grows and produces abnormal immunoglobulin (paraproteine). And how to vyroblyayutsya with a lot of antibodies to produce up to the development of amyloidosis of peripheral nerves and polyneuropathy in viglyadi paraplegia nig.

Mechanism of detachment with mish'yak, lead, mercury, tricresyl phosphate polyagi in addition to pyrovic acid in the blood, impairing the balance of thiamin (Vitamin B1) and reduced enzyme activity of cholmeninesterase (nerve loss) Toxins provoke a cob drop in the muscle, which triggers an autoimmune reaction, which manifests itself in the swollen muscle fibers and glial cells with further destruction.

In case of alcoholic neuropathy of lower levels of acetaldehyde, there is a decrease in intestinal absorption of vitamin B1 and a fast rate of tiaminpyrophosphate coenzyme, so that the process is reduced to breakdown. So, there is a growing rin of lactic, pyrovine and d-ketoglutaric acids; to go down the glucose uptake and decrease the amount of ATP needed for the training of neurons. In addition, alcoholics have experienced a systemic nervous system at the level of segmental demyelination of axons and loss of muscle at the distal ends of the nerves. They play a significant role in metabolic efficiency of liver failure, associated with alcoholism, spine, lack of lipid acid.

Also alcoholic polyneuropathy

cause

Alcoholic polyneuropathy develops into a link with a dental infusion of ethyl alcohol.

symptoms

Alcoholic polyneuropathy is diagnosed, as in a sick person's presence such signs of an ailment:

baking pains in homosexuals and feet;
myazovi spasms;
seeing "goose bumps";
weakness in the lower pictures;
a decrease in sensitivity in the hands and feet of nig, to accommodate at night;
"Shlyopati" course;
blіdі shkіrnі pokrivi;
ruinous ravnovagi;
colder gomіlok i feet with normal blood flow;
empowerment;
parts of sechovipuskannya;
one of the hands;
blue for marmurism of shkiri nig;
weak tendon reflexes, no more or less visibility;
parallel or paresis nig;
change of hairline of homilok;
trophіchnі virazki;
hyperpigmentation of shkiri.

diagnostics of illness

diabetic polyneuropathy (ICD code 10 - G63.2);
chronic ignition polyneuropathy (ICD code 10 - G61);
Hyun-Barre syndrome (code of the International Classification of ailments - G61.0);
recession of the peripheral nervous system.

When staging a diagnosis, it is necessary to exclude the manifestation of recessive pathologies, inheritance of intoxications (including lykarska), whose symptoms may be similar to the picture. I especially respect the food that comes, not the presence of diabetic or uremic polyneuropathy. For the whole, MRI, nerve biopsy, computer tomography, electro-neuromography and a secondary neurological examination are prescribed.

Lіkuvannya alcoholic polyneuropathy

Medication therapy on the basis of internalization or internal administration of drugs. Preparations include:

vitamini group B;
antihypoxanths;
pentoxifyline, liquids for microcirculation;
neuromedin for accelerated nerve conduction.

In case of non-drug treatment, complex rehabilitation is stagnant, in order to rely on the importance of carrying out physiotherapeutic procedures:

electrostimulation of the spinal cord;
magnetotherapy;
massage;
electrostimulation of nerve fibers;
lykuvalnoy physical culture;
holcoreflexotherapy.

forecast

prophylaxis

ICD code 10 - diabetic polyneuropathy

Diabetes is not safe due to rapid acceleration, one of which is polyneuropathy. Diabetic polyneuropathy is code according to ICD-10, therefore, it is possible to get sick from marks E10-E14.

chim is not safe

The pathology is characterized by lesions of the group of nerves. Patients with diabetics have polyneuropathy є accelerated when they are interrupted.

Change your mind about the development of polyneuropathy:

senior clerk;
bobbing a wag;
lack of physical activity;
permanently adjusted glucose concentration in blood.

Neuropathy develops through those that trigger organism, the mechanism of vivennya in carbohydrates, in conjunction with a consistently high concentration of glucose. As a result of the process, structural changes in neurons are observed, and the speed of the impulses is improved.

Diabetic polyneuropathy is classified by ICD-10 yak E10-E14. The whole code is entered into the protocol when the patient gets sick.

symptoms of pathology

Most often diabetic polyneuropathy is hostile to the lower children. Symptoms can be divided into two groups - cob symptoms and signs. It is characteristic of the ear of the ear:

almost a light pokolyuvannya in pictures;
onіміння ніг, especially when I go to sleep;
the loss of sensitivity of expressions.

Often, patients do not pay respect to the symptoms on the cob and go to see if they see more signs:

post_yni more nig;
weakening of the muscles of the foot;
change of tovshchini nigtiv;
deformation of the foot.

Diabetic polyneuropathy, which is assigned the code E10-E14 according to the ICD, brings a lot of discomfort to the sick and is fraught with serious acceleration. The pain syndrome does not change at night, so the disease is often supervised by sleeplessness and chronic self.

diagnostics

Diagnosis is put on the display of the last picture of the patient's skarg. Necessary additional manpulations:

perevirka vise;
reversal of the heart rhythm;
arterial grip of kintzivok;
analysis for cholesterol level.

It is also necessary to recalculate the concentration of glucose in the blood, hemoglobin and insulin. For all the analyzes, a patient needs to undergo a complex examination by a neurologist, which is to assess the steps of improving the nerves of a child.

The ICD code E10-E14 in the protocol of the patient's illness means the diagnosis of diabetic polyneuropathy.

lіkuvannya pathology

Lіkuvannya polyneuropathy in a complex approach. For addiction to stagnate:

drug therapy;
normalization of glucose concentration in blood;
progrіvannya nіg;
physical culture.

The drug therapy is aimed at the improvement of the walls of the nerves, the improvement of the performance and the reduction of the nerve fibers. In case of the establishment of a pathology, it is also necessary to have a miscellaneous therapy, which is aimed at processing the disease and minimizing the risk of introducing infection into the wound.

In the office of exercise therapy, the patients show the right way, as it is necessary to show the day.

An important stage in the treatment of diabetic polyneuropathy is the reduction of glucose concentration in the blood. Gradually adjustments to the tsukru stimulate the rapid development of the improvement of the education, so it is necessary to continue the correction of the sick person.

may riziki

Polyneuropathy (code for MKH-10 - E10-E14) is not without serious acceleration. Deterioration of sensitiveness can lead to the appearance of a great number of trophic virazoks, contaminated with blood. It’s not possible to get sick all the time, you can amputate urazhenoї kіntsіvka.

forecast

With an important mind of a successful result є a quick beast to a licar. Itself on its own the diabet becomes a serious rizik for a sick person's life, for that to listen to the vlasny organ_ism - the most important zavdannya skin patient.

Nowadays it is possible to allow the development of polyneuropathy to the polyneuropathy of children. It is even more important to continuously control the concentration of sugar in the blood to detect a relapse.

Diabetic polyneuropathy of lower symptoms (signs, like likuvati)

The middle of the acceleration of diabetic diabetes is one of the most disliked and very important to bear - diabetic polyneuropathy. Through the struggle of the nerves of the ailments, the blasphemy of the mouths, the feet bother about the jgut, you can see it, the strong sverbinnya, the trivial gostra. Tsі vіdchuttya disgustingly known by antihistamіnnye zasob that simple zealous. As a rule, symptoms will occur at night, ailments can practically be relieved of normal sleep, so depression, panic attacks, mental breakdown can be achieved before polyneuropathy.

On a part of diabetic polyneuropathy, a third of all neuropathies are seized. Immovability of a diagnosis of an accelerated rate of being overwhelmed by diabetes: with a 5-year experience, neuropathy is diagnosed in a skin patient, life with a diabetic is 30 years of age for 90% of children.

Also diabetic polyneuropathy

The destruction of carbohydrate and other types of metabolism in case of sugar diabetes is negatively infused into the entire nervous system, repairing it from the brain and ending with it. The education of the central nervous system was called diabetic encephalopathy, peripheral - diabetic neuropathy.

sensory - for impaired sensitivity;
motor - for the worries of nerves, such as service staff;
I am vegetative, if I get nervous, as a service to the organ of the people.

Sensorimotor neuropathy is the most common type, it is most often to be repaired on the most recent types of the central nervous system and on the links, as a rule, on the lower pictures. This is called distal, from the Latin disto - like. Zvychay snakes are repaired at once on both legs, the stench is also progressed symmetrically. The distal symmetric sensorimotor neuropathy is called "diabetic polyneuropathy", due to the widening of the middle of neuropathies, in the first place, up to 70% of the peripheral nerves are affected.

In such a rank, diabetic polyneuropathy, it is assumed that the damage to the motor fibers of skeletal muscles, mechanoreceptors of the skeletal muscles, tendons, pain receptors, and in the case of diabetic diabetics on the back of the child is taken.

Polyneuropathy is one of the main factors in the development of diabetic foot syndrome, in case of nerve damage, infection is achieved and, as a result, the symptoms appear to be glib, nasty jerks.

Type of diabetic polyneuropathy

See 3 types of diabetic polyneuropathies:

Sensory type. Reworking sensitive peripheral nerves, which are nerve fibers of varying diameter, which collect information about our perceptions and transmit them to the brain.
Motor type. Stronger ruining of ruffian nerves, which are required for the transmission of information to the messages about the need for speed and relaxation.
Zm_shaniy type. In the body, all the nerves work smartly: they are sensitive, they start to feel hot, and they carry the command to pull back their hand, to remove the senses. Rush nerves can be most often complex, for that sensor-motor polyneuropathy - nayposhirenish.

cause sickness

The development of polyneuropathy is without a mediocrity in the form of a sick person's blood glucose for diabetics. It has been clinically reported that more often in the blood of a diabetics a high tsukor is spared, and that more and more people will progress all the acceleration, including polyneuropathy. Even though blood glucose is stably in the norm, after 15 years of illness, signs of polyneuropathy reestablish only in 15% of patients, and all of them are in a mild form.

The reasons for the reduction of nerve cells in the minds of hyperglycemia:

Disruption of metabolism.

Chronic hyperglycemia of the organism of vikoristovuvati is the best way to utilize glucose, when accumulated sorbitol and fructose are accumulated, including in the nerve cells and around them. From the end of the guard, the sheath of the nerve, yak takes care of the fate without the middle in the transmission of impulses;
glycation of nerve cells;
ruinuvannya їх shells by violent radicals;
shortage of muscle in the nerve through blocking the transport of myoinositol.

Poshkojennya sudin. Through the diabetic microangiopathies, the judges are guarded to live the peripheral nerves.
Slump. The instability to diabetic polyneuropathy is revealed. There is a tribute, that some people have the nerve to go through a few rockets for diagnostics of diabetes, and without such acceleration to live ten years, unimpressed on a high tsukor.
Destruction in immunity is the very low-latency reason. In the version, polyneuropathy can be provoked by antibodies to factors in the growth of nerves, such as the organism of the sick person itself.

Symptoms and signs

In case of polyneuropathy, perish, bend over to the sensitive fibers, then to fix the fight of the ruffs. Most of the first symptoms occur on the feet, and then step by step widen on all the lower symptoms, the hands are thirsty in front of them, and in important cases, they live and the breasts.

Strengthening sensitiveness, inability to see from ancient dotypes or odyagu. Goosebumps, onіміння, surface bіl in the camp calm without reason. It is uncharacteristic for the reaction of an organism to a mock, for example, itching when touching.

Weakened sensitivity. Ailment with diabetic polyneuropathy ceases to perceive earlier speech: shortness of the surface when walking barefoot, more when standing on other objects. The water temperature will collapse because the water temperature is too hot, the ice is hot to build up.

Diabetic distal polyneuropathy

Find nerves fibers in the body of people and rots in the legs. Shkokojennya їх on whether dіlyantsі means loss of functions of a nerve, that polyneuropathy is most often є distal, so it is localized in lower images. The most sensible changes are promoted in the so-called "zone of shkarpets" - on the feet and hands. In the first place, tactile, temperamental, more painful sensitivity will break down here.

It is necessary to fix the changes in the sounds, as a result of which the call of the foot changes - to go out and know one on one toe, to restrain the stars. Shkira, relieved by her sensitivity, is becoming a vidminous task for young children, as through the other problems the food and products in the metabolism gradually cease to be hungry; Permanently locally fired ruinu cistkovy fabrics. As a result, the distal polyneuropathy can turn into gangrene and osteomyelitis with the second state of self-sufficiency.

Dіabetichna polіneyropatіya nizhnіh kіntsіvok on pochatkovіy stadії Got takі symptoms yak onіmіnnya, pokolyuvannya, tyazhkіst the feet Vnochi, nemozhlivіst vіdchuti easy dotik, postіyne vіdchuttya cold in his fingers nіg, znizhennya potovidіlennya the feet abo, navpaki, postіyno vologa shkіra, shelled i pochervonіnnya in mіstsyah rubbing.

Yak likuvati polyneuropathy in diabetics

Treatment of diabetic polyneuropathy of lower symptoms at the first stage є reaching a permanently normal blood flow. It has been brought that good control over glucose is brought to regression of the recently diagnosed neuropathy and the generalized mind of the effective treatment of important forms of discomfort.

For the normalization of glucose level in the blood, it is necessary to consult a competent endocrinologist, who can identify a new therapy regimen, in order to obtain more effective symptoms. Because of the sick person at the whole stage, it is necessary to follow the recommendations of the fakhivts, which were formed independently from the licars' preparations, to include the occupation of physical culture and the environment in the harvesting - you will see the result

Likuvannya without drugs

Polyshiti blood circulation, and hence, і harchuvannya tissue in the feet, it is possible with the help of simple non-drug methods. A few times a day it is necessary to work out a light self-massage of the feet. Yakshcho shkira is overdried, with a massage, it is viscous to vikoristovuvati a liquid cream. Grylki and hot baths are fenced off through security, as a diabetic with polyneuropathy may not be aware of, so as a receptor on the surface of the screen.

In any case, it is impossible to interconnect the activity. Obov'yazkovo pidlyagaє walks and skinny day, even with a lot of stitching, but the legs are not overstretched.

For the improvement of blood circulation, the brown awkward complex will be right:

Sit down on the glass.
Bend - bend your fingers.
Viconize the feet of the circles of the hands in the small sides.
Pull the socks towards yourself - up to yourself.
Roll your feet on round objects - bags, pipes, rocking chair.

In physiotherapy rooms, for pain relief, there are signs of electrophoresis, paraffin therapy, ultratonotherapy, radon and water baths.

The understanding of polyneutropathy includes a group of illnesses, the reasons for which may be different. Rice, which combined ailments in one row, is an abnormal function of the peripheral nervous system and abnormal nerve bundles.

Typical rice polyneutropathy є symmetrically destructed robots in the upper and lower links. At the same time, there is a need for confidence in blood flow and loss of sensitivity of hands and nig. Importantly, the price of the enmity of the enemy is lower kintsivka.

Polyneuropathy of toxic genesis according to ICD10

One of the most common types of ailments is toxic polyneuropathy. Name the ailments a hundred zerosumilo, but you won’t pour in a lot on the nervous system of the old otruynykh speeches. Toxins can penetrate into the body of a zzvnі or be a lot of sickness.

In order to treat the type of ailment, it is projected to look at the cause, which is toxic polyneuropathy. ICD 10, or the International Classification of ailments of the 10th glance, I propose a twofold form for ailment. The essence of a polyag is in assigning a code to that type of ailment, which is due to the reasons for its diagnosis. Thus, toxic neuropathies are known to be transformed into ICD 10 by the G62 code. Further to be guided more clarified the classification:

G62.0 - designated for lykarskoy polyneuropathy with the possibility of specifying the medication;
G62.1 - cim code to name the alcoholic form of an affliction;
G62.2 - code for polyneuropathy, viclikan and other toxic speech (you can put a code to the toxin);
G62.8 - designation for other specified polyneuropathies, up to which change the form of a disease;
G62.9 - Code for unspecified form of neuropathy (NOS).

Yak bulo was designated earlier, toxic polyneuropathy can be caused by viclican in two types of reasons:

Mati exogenous changes of mind (to this type of diphtheria, it is herpetic, it is accumulated by VIL-infection, lead, arsenov, alcoholic, viclikana with FOS, medication, neuropathy exchange).
They are a lot of endogenous factors (for example, diabetic, paraproteinemia or disproteinimia, diffuse lesions from the resulting tissue).

Toxic neuropathy will last an hour and grow sickly through more and more contact with people with toxins of a healthy lifestyle. It is not safe to talk about us everywhere: the stench є in the food products, in the living goods, in the medicines and in the midst of the day. Infectious disease is also often the cause of this disease. Microorganisms see toxins that are injected onto the body of people, and hostile to the nervous system.

Exogenous toxic polyneutropathy

As it has been designated earlier, it is possible to get sick when a specific factor is infused into the human body: toxins of viruses and bacteria, important metals, chemical words, and lykarsky traits. Yak and іnshy type of polyneutropathy, and ailments can be mother's chronic or hospitable character.

diphtheria polyneuropathy

Name the zhvoryuvannya zrozumilo, as a result of the important form of diphtheria, which is supervised by the injection of exotoxin. Most often it is also a phenomenon of vinikє among grown-up children. At the same time, it is spared the infusion on the sheaths of the nerves of the skull and їх ruinuvannya. Symptoms of illness are manifested for the first time (especially not without a heart and pneumonia), for the 4th time at the time of infection.

The stench swirls around the curved functions of the eyes, moving, kovtannya, can win the difficulty of the dichotomy and tachycardia. It is practical to find out the symptoms and fix them in 2-4 times, or through a few months.

herpetic polyneutropathy

The Danish type of convalescence is through the activity of the Epstein-Barr viruses to herpes simplex I and II types, the virus to the cytomegalovirus. Infection with cymus infections is seen in a child's life, and after a transferred illness, it is a child's immunity. As soon as the body loses its strength, then polyneuropathy can develop with characteristic viscera in its entirety.

Polyneuropathy on aphids VIL

In two of three patients, in ailments with VIL -infectious diseases, neurological acceleration appears, and most often the stench occurs at the last stages of illness.

It is toxic to viruses, autoimmune reactions, secondarily infirmities, development of pooches and the inheritance of the implantation of drugs in the complex, to cause damage to the normal functioning of the body. As a result, encephalopathy, changes and polyneutropathy of the cranial nerves are detected. The remaining ailment often swings in decreased sensitivity of the feet, pain in the transverse-crisp viddil. The stench poddajutsya lykuvannyu, protects fraught with lethal acceleration.

lead polyneuropathy

The Danish view of the zhvoryuvannya vinikє through the detachment with lead, which can penetrate into the organism of the people behind the help of the dikhannya, or through the intestinal tract. Wines are deposited in boxes and ovens. Lead toxic polyneuropathy (code for MKH 10 - G62.2) rotates in a patient with viglyadia mlyavost, high stomachache, "dull" headache, decreased memory and respect, encephalopathy, anemia, pain in the hands This ailment is characterized by a loss of exchange and small nerves. This is often diagnosed with the syndrome of "hanging brush" and "walking". In cich vipadkah contact with lead is more common. The forecast of amelioration of ailments is friendly.

Mish'yakova polyneuropathy

Mish'yak can penetrate into the body of people at once with insecticides, leaks, farbs. Dane fell ill є professional at the smelters. If the inflow of the spouting speech is one-time, then it will develop a hypothesis of hypotension, boring and bloating. After 2-3 times, polyneuropathy manifests itself, rotates in the weakness of the muscles. If you see it again, you find symmetrical distal sensorimotor ailments. At times of chronic poisonous speech, hypersalivation, trophies and sunspots (hyperkeratosis of shkiri on children and lobes, hanging, smut on nigments) Mish'yakova polyneuropathy is diagnosed by way of carrying out an analysis of the warehouse of hair, hair and nigtiv. Renovation of a sick painting of a transferred illness in three months.

alcoholic neuropathy

In medical science, polyneuropathy is toxic to aphids in the absence of alcohol, the mechanism of development to the point of no intelligence.

The main reason is the lack of food in the body and gastroduodenitis, which is caused by the malignancy of alcoholic beverages. Until then, the alcohol itself will be sprinkled on the nervous system.

Toxic can be poodostroy, hospitality, however, the subclinical form is most often developed, which appears when a patient is obstinate. Vona rotate in an insignificant deterioration of the sensitivity of the feet, degradation or in the presence of reflexes of the ailment of lithic mucus during palpation. Often toxic polyneuropathy swirls in symmetrical paresis, swelling of the feet and fingers, decreased sensitivity of the mittens and scars, pain in the feet and homilies of continuous or widespread type, palpitations One of the ailments can be associated with dementia, degeneration of the corns, a symptom of epileptoform. Oduzhuj paciєnt altogether. Success in the habit of storing up all kinds of alcoholic beverages. ICD code toxic polyneuropathy on aphids for alcoholism G62.1.

Polyneuropathy and removal of FOS

FOS, or organophosphorus spoluks, can be consumed in the human body at once with insecticides, masticators and plasticizers. In case of severe disruption of the intestinal tract, the following symptoms are detected: fatigue, hypersalivation, myosis, dislocation of the intestinal tract, bronchospasm, non-limiting slaughter, fusculating, sudden death, a potentially fatal result. Through a few days, polyneuropathy develops with ruff defects. Parallel to finish is foldable.

medication polyneuropathy

The Danish type of neurological damage is affected by the use of advanced drugs:

Drug toxic polyneuropathy ICD 10 designated by the code G62.0.

Endogenous toxic polyneutropathy

The Danish type of congestion in a large number of diseases through dysfunction of the internal secretions, as a result of the deficiency of the necessary hormones, for the impaired functions of the internal organs of humans. You can see the following:

you can work on the gostro, progress in general, or to finish it shydko. There is a small collection of pains and a loss of sensitivity in pictures.
Polyneuropathy, associated with paraproteinemia and dysproteinemia, is mainly associated with kidney disease in people, such as macroglobulinemia. Clinical manifestations are manifested in pains and paresis of the lower and upper symptoms.
Polyneuropathy also develops in cases of congestion with a diffuse type of tissue: rheumatoid arthritis, systemic cervonia, scleroderma.
Pechinkova polyneuropathy є inherited diabetes and alcoholism and very similar clinical manifestations.
Neurological damage in case of sickness of the intestinal tract is tied to pathological organs of poisoning, which leads to avitaminoza. Celiac disease can provoke polyneuropathy, as it rotates in psychomotor breakdowns, epilepsy, good health, ataxia.

Polyneuropathy in chemotherapy

Toxic polyneuropathy from chemotherapy has been seen in the surrounding group, as it can be a fatal manifestation from the reception of the patient, or by a slight drop of plump clitins. There is no need for a vicious systemic firing, for the nerves of the family and the way. This phenomenon may not have accelerated the appearance of diabetes, alcoholism, liver dysfunction and nirok. Ailments flare up in the ruined sensitiveness and ruddiness, the decreased tone of the muses of the children. Polyneuropathy in chemotherapy, symptoms of what is described as food, may also cause motor dysfunctions. Damage to the autonomic and central nervous systems and develop more.

Lіkuvannya given to the type of discomfort is brought up to symptomatic therapy. Patients can be signs of anti-fatigue, anti-inflammatory, immunodepressant, hormonal drugs, vitamins "Neuromultivit" and "Timin".

diagnostics of illness

Toxic polyneuropathy of the lower symptoms is diagnosed for additional advances in the following:

Ultrasound and X-ray of internal organs;
analysis of cerebrospinal origin;
advanced reflexes and performance of the nerve fibers;
biopsia.

Due to the accuracy and timeliness of diagnostics, the success of the treatment of polyneuropathy can be found.

Features of the disease

Toxic polyneuropathy, lіkuvannya like persh for everything is raised to the conclusion of the reasons її ї ї ї ї ї ї ї ї ї ї ї і ї ї ї ї ї ї ї ї ї ї ї ї ї ї ї ї ї ї ї ї ї ї ї ї ї ї ї і ї ї ї вінінення;

Regardless of the type of illness and the severity of the break, the onset of medication is recognized:

"Tramadol" and "analgin" - for severe pain.
"Metilprednizalon" - in case of a particularly difficult interruption of ailments.
"Pentoksifylin", "Vazonit", "Trental" - for strengthening the blood flow of the nerve fibers.
Vitamini group V.
"Piracetam" and "Mildronat" - to improve the absorption of fabrics of lively words.

Yak physiotherapeutic methods can be stagnated:

electrostimulation of the nervous system;
lykuvalny massage;
magnetic stimulation of the nervous system;
injections into the organisation;
hemodialysis, blood purification.

Those, in which the way of solving polyneuropathy is most acceptable in a particular way, is guilty of the lykar. Ignoring the symptoms of getting sick is categorically impossible. Gostra polyneuropathy can go into chronicity, which clutters up with the second sensitivity of the pictures, atrophies and general immobility.

Features of the class of diabetic neuropathy.
Find the new form of neuropathy in the case of diabetes mellitus. When diabetic suffers, in the first place, the other children themselves, including those who supply blood to the nerve fibers. The main type of rice is the formation of neuropathy є a decrease in sensitivity in the areas of shock. In the past, the risk of traumatization and information on the incidence of severe problems in the area of discomfort is growing. In case of diabetic, such a picture is found for the lower pictures.
There is a great part of patients with diagnoses of diabetes mellitus that they may have this form of neuropathy:
Peripheral: in general, in case of severe nerves, when they see for the innervations of the upper or lower symptoms, the visualization of those on the sides of the affected nerve; ailments mean a deterioration in the sensitivity of the fingers of both hands, as well as seeing them.
Proximal: the deterioration of sensitivity in the area of homily, stegon and child is meant.
Autonomous: the activity of the organs of etching, the secular vision of any other organs will be destroyed.
The abnormal weakness in meat is also often a supernumerary form of diabetic neuropathy. When a lot of m'yazi stepwise atrophy, destructive curves develop.
Clinic of toxic neuropathies.
The reason for the given form of becoming ill is of the kind of intoxication. Nerve dissection can be prevented in case of infectious diseases (diphtheria, VIL, herpetic infection), as well as in case of disfigured speech (alcohol, lead, mischief), as well as in case of wrong
Alcoholic neuropathy is important for the development of the peripheral nervous system, as well as for the most frequent acceleration of non-alcoholic implantation of alcohol and surrogates. Symptomatic forms of alcoholic neuropathy appear practically in everyone to be ill with alcohol.
At the present moment, it seems that the infusion of the most outworn speech on the nerve fiber, and the destruction of the communication processes in the way of disabling the organisms, take the development of neuropathy.
More often the nerves of the pictures are suffering. Necessarily from the causes of rejection, neuropathy manifests itself in a deterioration of sensitivity in the feet and hands, the appearance of a feeling of feeling and poking on the skirts, hyperemic schools of children. Likewise, at larger stages of incapacitation, there may be a thickening of fabrics in the lower cues. Tsia Khvoroba is a protracted trip, the need for prophylactic visits, zokrem, sanatorium-and-spa treatment.
Clinic of post-traumatic neuropathy.
The reason for the post-traumatic lesion of nerve fibers is the delay in the result of fractures, tissue filling, improper coverage of post-traumatic scars, and new diseases. More frequent forms of this disease are lesions of the lytic, sinus and exchange nerve. At the same time, atrophy of muscular tissue develops, the destruction of fast-feeling health and a decrease in reflexes. It also implies a decrease in sensitivity to more podraznikiv.

RCHRH (Republican Center for Development of Health Protection of the Ministry of Health of the Republic of Kazakhstan)
Version: Clinical protocols of the Ministry of Health of the Republic of Kazakhstan - 2016

Ignition polyneuropathy, unspecified (G61.9), other igneous polyneuropathy (G61.8)

Neurology

General information

Short description

caught
Unified committee for the quality of medical services
Ministry of Health Protection and Social Development of the Republic of Kazakhstan
from "29" falling leaves 2016 to rock
Protocol No. 16

For chronic heat dementia polyneuropathy (CIDP) In the Danish hour, all the drops of firing demilinizing polyneuropathies, which may be larger than the ear and chronically (after 2 months), are extended, which are characterized in some cases by flaring and warning signs.

Specialized codes ICD-10 and ICD-9

Date of launch / revision of the protocol: 2016 rik.

to the protocol: GP, therapists, neuropathologists (adults, children).

Evidence scale:

A	A high-quality meta-analysis, a systematic survey of PCI, for example, a greater PCI with an even low efficiency (++) systematic reduction of the results, which may be broadened to the general population.
V	Visokoyakisny (++) systematic survey of cohorts, or even later vipad-control, or Visokoyakisne (++) cohorts, or even low-rises, systematic control of even low rhizics, systematic grazing, or PCI with low (+) versatility of systematic grazing, the results of populations ...
Z	A cohort of either the dosage of the vipad-control or the control of the dosage without randomization with an inexpensive risk of systematic pardon (+). The results, which can be broadened to the general population or PCI with an even low or low risk of systematic gratification (++ chi +), the results which cannot be without an average broadening to the general population.
D	A description of a series of vipadkiv or uncontrolled until recently, or a thought of experts.

Classification

Classification
The clinical classification of the CVDP (Working group for the CVDP EFNS / EPNS 2010) with the views of the typical and atypical options is presented below.

klinichna classification CIDP

options	characteristic
type HVDP	Symmetrical proximal and distal weakness and sensitive nerve damage in most cases, which developed for more than 2 msec. Perebig chronically progressive, stepwise progressive, recurrent-remitting. May on the basis of the vision of one of the lower options, these characteristics (the period of the increase in symptomatology, prolonged) appear to be such a type of CIDP (tendon reflexes in non-abnormal symptoms can be normal): distant localities the distal sidewall is symmetrical demiєlіnіyucha polyneuropathy)
Atipova KVDP	· Asymmetric option: sensory and muscle damage asymmetric or localized in the area of innervations of nerves (multifocal dribbling of sensory and motor neuropathy, Lewis-Sumner syndrome); Focal option: sensory and ruptured damage is localized in the area of innervation of the brachial or transverse-crooked gossip, or one or more peripheral nerves in one upper or lower brain); · Isolation of rukhovy option: viklyuchno rukhovy ruin; · Isolation of sensory variant (including chronic immune sensory polyradiulopathy): sensitively sensitive.

HVDP makchotiri basic options perebigu:
· Chronic monophasic - the symptoms step by step reach the maximum variability, and then they tend to regress again, and do not progress or recur;
Chronic relapsing-remitting - clearly improving the symptoms of the onset of rapid development - relapses, changing periods of stabilization, before the hour of getting sick - not progressing;
· Step-progressive - progressive step-like growth of symptoms;
· Steadily progressive - more and more without interruption of the growth of symptoms.

Diagnostics (outpatient)

DIAGNOSTICS ON THE AMBULATOR RIVNI

diagnostic criteria
skargi:
· On the weakness in the distal or proximal views nig, inodi asymmetric;
· Oniminnya and paresthesia in the hands and feet;
· On instability when walking;
The first to be inviting to urazhayutsya lower prints - they couldn’t walk, walk along the gatherings, walk from the crystal, win the fall; when the top ideas are obtained, it is difficult to get difficult when the kitchen stuffings are corroded, laces are tied up, and objects are buried.

anamnesis: The neurological symptomatology of the build-up is more often, often with a prolonged period of time, perhaps even for some time, because of a symmetrical weakness in the picture and at the loss of sensitivity. Nadal nabuvay has a progressive, recurrent or chronically monophasic character.
In a large number of cases, neurological symptoms do not occur, if there is an infection, it is necessary to clarify the relapsing history, especially the manifestation in relatives of stomatomy and weakness of the feet
z'yasuyut:
· Symptoms of polyneuropathy have long appeared (oniminnya shkiri, myazova weakness, etc.);
· Chi is not a ominous patient with alcohol;
· Chi tied yo professional efficiency with any kind of chemical words (gasoline, salts of important metals);
· Chi maє patsієnt cukrovy diabet (sickness, which is characterized by periodic or persistent glucose levels in the blood, which is toxicly infused on all organs and tissues);
· There were no similar symptoms in any of the closest relatives.
Zakvoryuvannya vinikє in any vіtsі, including a child. The HVDP is able to move the ear with the movers and the gradual development of symmetric weakness in the proximal and distal sides of the lower edges and paresis, with an extension of 8 types.

physical condition:
State-of-the-art status: foreign camp and severity, temperature of the body, vimiruvannya of the patient's vagi, inspecting the pupils' curves, behavior, pulse, AT, camp of internal organs (legends, heart, furnace, nirki and inn.
Neurological status: level of svidomosty, general cerebral symptoms, meningeal signs, cranial nerves, rukovo-reflex sphere, sensitive sphere, coordinator function, pelvic organ function, cognitive function of the nervous system, autonomic.
Paresis is usually overwhelmed in the legs, which is difficult to manifest when walking on gatherings, when standing up and down and falling. Weakness can be promoted in the proximal as well as in the distal muscles. The swelling of paresis is not supervised by an increase in atrophy; Characteristic of diffuse hypotonia of myaziv. Variations of the bolovy syndrome occur infrequently. Early and characteristic of CIDP є lowering of tendon reflexes in later visualizations. Naybіlsh permanently transmits the Achilles reflex.
Some of the ailments suffer from cranial nerves (call face and bulbar, older than okorukhs). Cranial neuropathy depends on the activity of CIDP. M'yazova weakness in supernatant sensory impairment in patients with hyperesthesia or anesthesia. Sensitive impairment (paresthesia, hyperesthesia, hyperpathy, hyperalgesia of the type "shkarpetok", "mitten") can also be tolerated in case of acute illness, and even if it does not appear in the clientele on the first plan.
If the brain is missing, it is possible to develop clinical signs of the central nervous system - the Babinsky reflex or the development of tendon reflexes. Vegetative impairment (overgrowth and acrophysihydrosis, passing of heart arrhythmia with development of obscurity, progressively decreasing the weight of the body by 10-20 kg in length at normal temperatures, during the duration of the cerebral and intestinal dysfunction) Dichally lack of development in CIDP is very rare.

In the classroom practice for assessing the degree of rotation of ruddy rosters, the scale of the strength of the varieties of colors (A. Szobor, 1976).

... 0 points - to ruku in myazuvidsutnі.

... 1 point - minimal ruku in music, the patient will not let go of the picture.

... 2 bali - the patient will utrim the vagu of the kintsevki, ale the opir, which is to be repaired to the glimpse, is minimal.

... 3 bali - patsієnt to repair the opіr to the Zusillians, the camp of the kinsіvki, albeit insignificant.

... 4 bali - patsієnt to kindly repair the Zusillas for the improvement of the camp of the kintzivka, ale and deyake of the decrease in strength.

5 points - the strength of the sound of the change and constitutional norms of the situation.

Prior to the announcement of the key marks of the KVDP, the following shall be applied:

· More importantly, distal or changes (distal and proximal) nature of paresis of the teeth;
· Myazova hypotonia and hypotrophy of hands and nig are swirled;
· More parts and styles of sensitive and vegetative breakdown in pictures;
· Vkray rydko - bringing in spontaneous and pelvic dislocations.

The KhVDP is diagnosed with the presence of two regional key signs:
-progressive or recurrent weakness in the triviality of 6 months;
-hypo- abo areflexia in all chotiroh kintzivkah.

Diagnostic criteria of CIDP (A.Ropper, E . Wijdicks, V.Truax, 1991)
... bilaterally symmetrical weakness of the colors.
... paresthesia in the fingers of the fingers and nig.
... Progression from 6 days to 6 months, from 6 days to 6 months from 6 months to
... tendinous hyporeflexia in kintsivkah, denote the muscular weakness; visibility of the achilles reflexes.

Laboratory Doslidzhennya:
UAC - for the prevention of ignition of internal organs, for the prevention of polyneuropathic syndrome;
· Prescribed blood for tsukor, creatinin, sechovina, AST, ALT, bilirubin, on elektrolity - biochemistry of pretreatment of blood in addition to assisting in the inclusion of metabolic polyneuropathies;
· ОАМ - for vyklyuchennya zakvoryuvannya internal organs, for supervising polyneuropathic syndrome;
· Pre-treatment of blood for thyroid hormone - і thyrotoxicosis, і hypothyroidism may suffer from weakness, polyneuropathic syndrome;
· Pre-treatment of blood on VKV (value of antinuclear antibodies) - the KVDP clique has been pummeled with systemic ailments;
· PLR of blood for hepatitis virus - for the development of polyneuropathic syndrome in hepatitis;
· Pre-treatment of blood for VIL-infection - for the prevention of polyneuropathy, associated with VIL-infection;
· Immunelectrophoresis of blood cells - pretreatment of blood for blood cells, blood cells, for monoclonal proteins - for the prevention of disproteinemic polyneuropathy;
· Immunelectrophoresis of monoclonal proteins, BensJones' blocks allows the inclusion of monoclonal gammapathy and malignant ailments.

Instrumental doslіgennya:
· Oglyadova R-graph of the organs of the breast cancer - for the prevention of adolescent tuberculous infections, oncological diseases of the legends, in case of any possible development of polyneuropathic syndrome;
· Ultrasonic examination of organs of the worm-empty - the incidence of internal organs (liver, nirok and іn) can be supervised by polyneuropathy, similar to HVDP;
· MRI - to the brain - for the activation of the demilinization process in the central nervous system (detection of the demilinization in the cerebral stovbur, periventricular, subcortical);
· Ultrasound scan - thyroid zone - for carrying out differential diagnosis of CIDP with metabolic polyneuropathy;
X-ray of flat cysts - to carry out when paraproteinemia is detected for malaria disease
· Electroneuromyography (ENMG) * - allowing signs of destruction of muscle and axonal degeneration to appear.
· Holly elektromyografiya ** - by means of such є to reveal signs of a flow denervation-reinnervational process in polyneuropathy.

NB!* In case of systemic lesions of peripheral nerves, it is necessary to clarify the type of pathological process (axonal or demilinizing).
The main criteria for the axonal process:
· Decreased amplitude M - vidpovidі;
· Normal or slightly decreased performance of stimulation along motor and sensory axons of peripheral nerves;
· Detection of blocks, about how to lead a breakdown;
· Increasing the amplitude of the F-hwil, the appearance of the great F-hwils with the amplitude, scho changing 5% of the M-hwil amplitudes.
The main criteria for the demyelinizing process:
· Reducing the performance of stimulation on motor and sensory axons of peripheral nerves (on the hands less than 50 m / s, on the legs less than 40 m / s);
· Increase of triviality and polyphase M - changes;
· Increased residual latency (more than 2.5-3 m / s);
· Necessity of blocks of carrying out zbudzhennya;
· Expanded to the latency range of F-hvil.

During HVDP on the EMG, there are changes in the potentials of ruddy ones, which are characteristic of denervation, and a rapid stage of the development of fibrillation, so that it can be caused by triviality and severity of damage. The speed of carrying out on the loose and sensory fibers on the upper and lower edges will help to increase the decrease by 20% (as the demolition process is not surrounded by only the roots of the spinal nerves). There can be a change in the degree of rotation, blocks of carrying out and the time dispersion of the total muscular potential for the potential of the nerve fibers. Distal latencies in the case of a widespread ill health.

NB!** Until the most frequent distal joints of the upper and lower joints (for example, the anterior tibial joint, the back of the fingers), and, if necessary, the proximal joints (for example, the chotirigol). It is necessary to remember that the first signs of denervation to the process do not appear earlier than after 2-3 days after a cob of illness, but signs of the renewed process - not earlier than after 4-6 days. The appearance of the flow denervation-reinnervational process of additional assistance in the differential diagnostics of the HVDP and MGB in the spinal vypadki.

Diagnostic algorithm:

Diagnostic panel, proponed OK. Koski (L.C. Koski, 2009) including clinical and neurophysiological diagnostic criteria for CIDP.
Key criteria include:
- a symmetrical ear or a symmetry of an exercise in case of an active reading,
- the manifestation of weakness in some pictures and the manifestation of proximal weakness is not less, not in one picture.

Neurophysiological criterion includes the fact that there is a desire to be one of the signs of demilinization (in the reduction of the distal latency, for the decrease in the SRV, or the increase in the latency of the F-sickness) not less than in the 50% for the reduction of the nerves nerves). Assigned diagnostic criteria can be quite sensible and specific (more than 85%) and handy for practical storage.

Diagnostics (stationary)

DIAGNOSTICS at the stationary РІВНІ

Diagnostic criteria at the stationary level:
The classical CVDP is characterized by a symmetric weakness of the proximal and distal joints of the joints, progressing more than 2 months. Vona also associates with sensitive injuries, weakened or deficiencies of tendon reflexes, changes in the size of a child in spinal cord disease (SMR), changes, typical for demineralization of diseases This current can be recurrent or uninterruptedly progressive, and the remaining is more typical for young patients.

Diagnostic Criteria of the CIDP Working Group on the CIDP of the European Federation of Neurological Associations/ European Partnership for Implantation of Peripheral Nervous System (EFNS / EPNS) 2010 р include three blocks:
· Clinical criteria;
· Neurophysiological criteria;
· View signs.

The block of key criteria for transferring the conversion to the type of the key characteristics of the CIDP, which is considered to be one of the variants

Criteria for determining the diagnosis of CIDP

Infectious diseases, how to endure Borrelia burgdorferi (Lyme ailments), diphtheria, lykarski and toxic infusion, health problems of development of polyneuropathies

Spadkova demilinizucha neuropathy

Spinning damage

Multifocal motor neuropathy with blocks

Monoclonal IgM gammapathy with high titer of antibodies to MAG

Evidence of the other reasons for the development of demilinating neuropathies, including the POEMS syndrome (polyneuropathy, organomegalia, endocrinopathy, M-protein and shkirnіy diseases), osteosclerotic myeloma; diabetic and non-diabetic transverse-kryzhovy radiculoplexopathy; lymphoma of PNS and amyloidosis

The block of neurophysiological criteria can be used to reconsider the results of stimulation EMG as reliable (definite), probable or possible (possible) EMG as signs of a demiєlinizable shock.

Neurophysiological criteria of the CIDP

(1) Adequate	At least 1 of the criteria below: (A) an increase in the distal motor latency of two nerves by ≥50% of the upper inter-norm (in patients with carpal tunnel syndrome); (B) decrease in SRV in motor fibers in the two nerves by ≥30% of the lower normal range; (B) an increase in the latency of F-type in two nerves by ≥30% of the upper inter-norm (by ≥50%, if the amplitude of the distal M-wave is less than 80% of the lower inter-norm); (D) the visibility of the F-type in the two nerves with the presence of the distal M-type, the amplitude of the transition to the lower between the norms by ≥20% + ≥1 is the sign of demyelination in ≥1 nerves; (E) partial block of conduction along the root fibers: a change in the amplitude of the proximal M-form by ≥50% in the case of the amplitude of the distal M-form, which is the amplitude of the distal M-form of the nerve by ≥20% + ≥1 signs of demyelination in ≥1 nerves; * (E) abnormal tim-hour dispersion (an increase in the triviality of the negative peak of M-appearance with proximal and distal stimulation of 30%) in ≥2 nerves; (G) an increase in the triviality of the distal M-waveform (the interval between the ear of the first negative peak and the point overflow of the second negative peak) in ≥1 nerves (the middle nerve is ≥6.7 ms, the lactic nerve is ≥6 6 ms, great muscle nerve ≥8.8 ms) + ≥1 sign of demyelination in ≥1 nerve
(2) Ymovirniy	a decrease in the amplitude of the proximal M-type by ≥30% in the case of the distal M-type by ≥20% in the case of the distal M-type by ≥20% in ≥1 nerve.
(3) Mozhlivy	be it a sign that has been re-insured in criterion 1, if only in 1 nerve

* The block of conduction along the motor fibers of the lactic nerve in the area of the lactic slope cannot be trapped; for the determination of the imoving block, the decrease in the amplitude of the M-vidpovidi during the stimulation of the nerve at the Erba point and the wrist is guilty to fold not less than 50%.

Signs that can be used to diagnose CIDP

Adjustment of concentration of blood in liquor with cytosis less than 10 leukocytes in μl

Accumulation of contrast і / аbo hіpertrophy of the Chinese tail, transverse-crooked or brachial gossip, root and transverse-crooked spinal nerves according to MRI data

Pathological symptoms with advanced sensory fiber conductivity not less than in 1 nerve:
a) a decrease in the amplitude of the sensory potential of the action in the presence of the pre-median (in case of the affected carpal tunnel syndrome) or of the exchange nerve, and the normal amplitude of the sensory potential of the action in the presence of the presence of the lithic nerve, or:
b) a decrease in SRV less than 80% of the lower inter-norm (less than 70%, if the amplitude of the sensory potential is less than 80% of the lower inter-norm), or: an increase in the latency of SSEP without pathology of the central nervous system

Objectively clinical training in immunomodulatory therapy

Unambiguous signs of demilinization and / or remyelination in the biopsy of the nerve (pre-splitting fibers or electronic microscopy)

Diagnostic criteria of CIDP bouly were proponed immediately by the decilcoma by expert groups (Table 5).

Diagnostic criteria of the HVDP

signs	Criteria ААN *	Saperstein criteria	INCAT criteria **
key overrun	Rukhovy and sensitive deficiency from the study of more than one cinema	Great: symmetric weakness of proximal and distal types of images. Small: only weakness or sensitive deficiency in distal vesicles	Progressive or recurrent motosensory deficiency in patients with more than one disease
Triviality (mіsyatsі)	2 and more months	2 and more months	More than 2 months
reflex	Decrease abo vіdsutnі	Decrease abo vіdsutnі	Decrease abo vіdsutnі
Results of electrophysiological studies	Detection of 3 out of 4 onset criteria: partial blockage of conductivity in 1 or more muscle nerves, decreased speed of impulse in 2 or more muscle nerves, prolonged distal latency of 2 or more muscle nerves hwil	2 of 4 AAN Electrophysiological Criteria	Particular blockade of conductivity in 2 or more nerves and pathological speed of the pulse, or distal latency or latency of F-type in 1 nerve of the localization; abo, for the duration of the partial blockage of conductivity, pathological speed of the impulse, distal latency or latency of F-jets in 3 nerves; for the electrophysiological data, which is indicative of demyelination in 2 nerves, plus the histological confirmation of the rest
CSF	The number of leukocytes is more than 10 cells / mm; negative results of venereal diseases; adjustment rivn bіlka (additional criterion)	Rіven bіlka ponad 45 mg / dl; number of leukocytes in excess of 10 cells / mm (additional criterion)	An analysis of the spinal cord is recommended, but not obovasovy
results of biopsies	Prove for cinnamon demilinization and remyelination	As a rule, the signs of demilinization are not necessarily	The procedure for binding only in the case of electrophysiological damage in all 2 nerves
* American Academy of Neurology. ** Group of reasons for and treatment of ignition neuropathies.

Diagnostic criteria of the CIDP (Hughes R., 2000)

criteria	diagnostic signs
Клінічні	Progressively or with a reworking of myazov weakness with a stretch of 8 or more
	Symmetric proximal and distal weakness of the upper and / or lower values
	Decrease in the visibility of reflexes in exercises
laboratory	Reducing the performance of the impulse less than 70% of the lower limit of the norms not less than 2 rukhovy nerves
	Rivn bottle in liquor is more than 0.45 g / l, a warehouse is less than 10 cells in 1 mm ³
	With biopsies of the lithic nerve, the picture of demyelination and remyelination, including the loss of myelin fibers and perivascular infiltration
viklyuchayut	Detection of systemic ailments і toxic official
	family vipads
	Wrinkles with biopsies of the nerve, inappropriate for the diagnosis of CIDP

The diagnosis of CIDP is reliable if all diagnostic criteria are present.
Ymovirnim diagnosis of CVDP is recognized for all clinical and clinical tests, as well as 2nd and 3rd laboratory signs.

Regardless of the recent emerging clinical, neurophysiological criteria, and there is a sign of the diagnosis of CIDP, it can be reliable, accurate and possible.
In addition, the vision of the KVDP (be it a level of value) was transmitted with fellow disabilities.

Diagnostic gradations of the KhVDP

diagnostic category	necessary criteria
reliable HVDP	Klinichno type abo atypical HVDP, visibility of criteria for inclusion + EMG criterion 1; abo: ymovirna HVDP + not less than 1 pіdtrimu signs; Abo: Mozhliva KVDP + not less than 2
ymovirna KVDP	Klinicno type abo atypical HVDP, visibility of criteria for inclusion + EMG criterion 2; Abo: mozhliva KVDP + not less than 1 pіdtrimu signs
Moss HVDP	Clinically typical abo atypical HVDP, visibility of criteria for inclusion + EMG criterion 3
HVDP, associated with a pathology	Dostovirna, ymovirna, for the mobility of the KVDP + supportive discomfort

Skargi and anamnesis: see outpatient r_ven.

Physical details: see outpatient r_ven.

Сlініchnі options HVDP
· Viklyuchno rukhova polyneuropathy. Weakness in symptoms (wrinkle in distal parts) without sensory symptoms.
· Asymmetric neuropathy. Asymmetric rukhovi (can be nagaduvati like in case of sick amiotrophic sclerosis) or sensitively rukhovi razladi; transient form between CIDP and multifocal motor or sensorimotor neuropathy.
· Viklyuchno sensory polyneuropathy. Sensitive symptoms of mingling and visualization in distal forms of symptoms without myazoi weakness.
· Forms with minimal symptomatology. Mild sensitive symptoms of mismatching with minimally increased stomachache of mucous membranes in the distal shapes of the teeth; as a rule, in general it is transformed into more classically manifest forms of the HVDP.
· The distal form of Rukhov and sensitive damage in the distal forms of the pictures, without the formation of the proximal ones.
· Sensory polyradiculoneuropathy is an atactic form of CIDP, which appears as a result of impaired sensitivity with sensitive ataxia.
· The form for lesions of the central nervous system The data of clinical and paraclinical signs of lesions of the central and peripheral nervous systems.

Laboratory Doslidzhennya: see outpatient rіven (dodatkovo to new)
· Analysis of the spinal cord - with the appearance of typical signs of CVDP: change in the place of a bile (the level of a bile spit up 0.6 g / l) і normal or slightly swollen cytosis;
· Analysis of liquor on immunogram - Local synthesis of IgG can be modified. You can also adjust the level of Q-albumin, as well as inform about the development of hematoneural or hematoencephalic barriers;
· Immunelectrophoresis of monoclonal proteins, BensJones' blocks allows the inclusion of monoclonal gammapathy and malignant ailments;
· Biopsy of the lithic nerve - it can be more diagnostically significant; Biopsy is especially recommended in case of adolescence on CVDP, in patients, neural conductivity in those who do not indicate demyelination, for example, in case of viral vasculitis.

instrumental doslіgennya: See outpatient treatment.

Diagnostic algorithm of HVDP:

Switching of the main diagnostic entries:

· Analysis of the spinal cord;
· Electroneuromyography.

Change of additional diagnostic entries:
· Analysis of liquor for immunoglobulin;
· Holchasta elektromyografiya;
· MRI of nerve gossip;
· Biopsy of the lithic nerve.

Differential diagnosis

diagnosis	Gruntuvannya for differential diagnostics	rigidity	criteria for victories diagnosis
Guine-Barre Syndrome (Gostra igniting demilinizucha polyneuropathy)	Polyneuropathic syndrome	ENMG, equipped with ENMG, consultation of a therapist, infectious disease specialist.	· Zahvoryuvannya State Security Service to obey the state security; · Myazova weakness of progress is close to 1 month; · Detection of anterior infection with GBS; · For GBS, there is a greater characteristic pain syndrome: it is more localized in the area across, wide, great slopes, in stegon, homillocks, before and when it comes to collapse; With GBS, positive symptoms of radicular tension appear (Lasega, Kerniga), palpation of nerve stubs on symptoms; · SGB often supervises vegetative damage: damage to the heart rhythm, instability of the arterial vise, hyperhidrosis, or dryness of the shkiri tuluba or kintzivok; · Training of cranial nerves: most often VII, IX and X nerves are involved in the process; · Carrying out an additional help in the differential diagnostics of the HVDP and MGB in the spinal vipads;
recession polyneuropathy put on: (Motosensory polyneuropathies of NMSP; recessionary polyneuropathy from schizophrenia to fresh paresis Autosomal recessive recessions of polyneuropathies)	Polyneuropathic syndrome	ENMG, cons. therapist, cons. lykarya-genetics	· Repair at 10-35 years; · Сlіd retally take a family anamnesis: in case of circumstantial relatives, it is possible to develop subclinical contractions of the HMCH form; · The clinical picture of decay polyneuropathy is characterized by weakness of the rosin of the joints of the feet, steppage, the visibility of the achilles tendon reflexes; · In the case of the NMSP Big World, the brace and abductor of the feet are raised by the higher crypt of the feet or the deformity of the type "kinskoy"; · Tendon reflexes quickly extinguish; · Myazova atrophy symmetric; · Destruction of the surface sensitivity of the stiyki; · Vyavlennya at stimulation EMG of a rapidly increased threshold of vicious M-Vidpovisti, a swirling decrease in the speed of conduction along the nerves; · Diagnosis of decay polyneuropathy is supported by additional molecular genetic methods; Polyneuropathic syndrome
Polyneuropathy, associated with monoclonal gammapathy put on: Polyneuropathy in osteosclerotic myeloma, monoclonal gammapathy and Vandelstrom's macroglobulinemia	Polyneuropathic syndrome	ENMG, cons. therapist, cons. hematologist	· Clinically manifested as isolated sensory impairment in children; · Diagnostics of zhvoryuvannya primerutsya viklyuchno on immunoenzymatic analyzes; Slide z'yasuvati of the primary cause
infectious polyneuropathies put on: SNID leprosy Boreliasis (including Lyme ailment) diphtheria	Polyneuropathic syndrome	ENMG, cons. therapist, cons. іnfektsіonіsta	With leprosy polyneurolpathy, as a rule, to fix a sensitive deficiency, it is easy to develop weakness at different stages · Differential polyneuropathy develops after 2-4 days of diphtheria pharyngitis. After 8-12 days, the generalization of the process of defeating the language of the ideas will be taken into account, then the sick people will quickly change, and through a number of tasks, or even more, the function has become more (one day new). In case of diphtheria, the necessary bacterial inoculation for the emergence of the pupil
Polyneuropathies, tied with systemic ignition and immune disabilities put on: sarcoidosis; amiloidosis; vasculature, including vascular periarthritis, Churg-Strauss syndrome, rheumatoid arthritis, Sjögren's syndrome, Wegener's granulomatosis, systemic cervonia vovchak, systemic sclerosis, giant cell arteryitis, Behcet's syndrome, hemoglobulinemia	Polyneuropathic syndrome	ENMG, cons. therapist, cons. rheumatologist	· Necessary indications of laboratory preliminaries, as well as biopsies of muscular tissue and lithic nerve (as shown); · Behind the witnesses - biopsies of the muscularis and the lithic nerve; For systemic vasculitis and collagenoses, the development of mononeuropathy is characteristic with the development of pain syndrome in an ailing patient with signs of a systemic process (lesions, intestinal tract, cardiovascular system, retinal weakness, constipation). therapist
toxic polyneuropathies put on: Alcohol, industrial spoluces (for example, acrylamide), metals (for example, lead), drugs (for example, platinum mixtures, amiodarone, perhexiline, tacrolim, chloroquin and suramin)	Polyneuropathic syndrome	ENMG, cons. therapist, cons. toxicologist	Overlapping axonal striae, not demyelination · Suggestions for changes in laboratory and clinical data
nutritional polyneuropathy put on: Lack of vitamins B1, B6, B12 or E	Polyneuropathic syndrome	ENMG, cons. therapist, if necessary - cons. endocrinologist	Required laboratory information
metabolic polyneuropathies put on: Diabetic polyneuropathy and polyneuropathy with impaired glucose tolerance; uremic, pechinkova and acromegalic polyneuropathy; hypothyroid polyneuropathy	Polyneuropathic syndrome	ENMG, cons. therapist, if necessary - cons. endocrinologist, abo nephrologist, abo rheumatologist, abo infectious	Required laboratory information · Diabetic polyneuropathy is characterized by progressively progressive hypesthesia of the lower symptoms in some cases with some painful manifestations in the feet; · Uremichna polyneuropathy invoke vinnikє on the chronical illnesses of nirok, which will supervise nirk deficiency; · Amiloid polyneuropathies are characterized by the development of sensory-vegetative polyneuropathies, which are characterized by palynia, dysesthesia, on a small change in mass;
Paraneoplastic polyneuropathy put on: Polyneuropathy in lymphoma and cancer	Polyneuropathic syndrome	ENMG, cons. therapist, R-gr. organs of the breast, ultrasound of organs of the black empty and organs of the small pelvis, FGDS and іn., cons. oncologist	Slid z'yasuvati primary reasons: to conduct an oncopoysk
Polyneuropathy of Critical Stations put on: Polyneuropathy, obtained with sepsis, polyorganic deficiency or trivial intubation	Polyneuropathic syndrome	ENMG, cons. therapist, cons. doctor-reanimatologist

Likuvannya beyond the cordon

Pass a lykuvannya in Korea, Izrail, Nimechchin, USA

Otrimati the consultation on medturism

lykuvannya

Preparations (such as speech), which can become stagnant during treatment

A group of drugs in the absence of ATC, which can become stagnant during drug use

Likuvannya (outpatient clinic)

LIKUVANNYA ON AMBULATORNY RIVNI

Likuvannya tactics: go in, which is carried out with HVDP, on specific (pathogenetic) and nonspecific (symptomatic).
The plan for the treatment of the HVDP at the outpatient hospital has three main directions:
· Zupiniti autoimmune firing and ruining nerves;
· Renewal of nerve conductivity, force of communication and sensitivity (remієlіnіzatsії);
· Unique repetition of HVDP attacks.

non-druglykuvannya:
· Prevention of the regime of practice and correction (physical and psychological treatment can be provoked);
· Prototype proofs of the insolation, let it be a kind of infectious disease, cut it off, rob it, be it chippings and a test of Mantoux.

Drug treatment:
· In a given hour, there are three main pathogenetic diseases of CIDP-corticosteroids, plasmapheresis, immunoglobulin.
· Posindromic therapy.
Symptomatic therapy for CIDP includes:
· Preparations for the relief of neuropathic pain (gabapentin 1200-1800 mg / day, amitriptylin 75 mg / dobu);
· Anticholinesterase drugs (neostigmin 0.5 mg / dobu).

Algorithm for non-emergency situations:
· Symptomatic therapy

Інші vidi lіkuvannya:
· Plasmapheresis;
· Golkoreflexotherapy;
· Physiotherapeutic treatment;
· Physical culture;
· Hyperbaric oxygenation;
· Orthopedic come in with peripheral paresis.

Consultation of an infectious disease specialist - establishment of any chronic infection (brucellosis, boreliasis, etc.)
Consultation of a therapist - establishment of abnormal therapeutic incapacitation (fiery incapacitation of internal organs: legends, nirki, pechinka, etc.)
Consultation of an oncologist - if necessary, oncology
Consultation of an endocrinologist, nephrologist, rheumatologist - if necessary, the inclusion of somatic pathology

Prophylactic come in:
Primary prophylaxis: it is aimed at prophylaxis of zagostren.
· Post-treatment and regular examination by a neurologist є obovasovy for ailing CIDP.
deposited:
· Control immunograms once a day.
Not recommended:
· Ailments with infectious diseases, illnesses, which are transmitted by a state road;
· Zalishati without respect zagostrennya chronic ailments (tonsillitis, pharyngitis, sinusitis, pyelonephritis, gastritis, etc.).
· It is easy to put up to odyagu in cold weather, get cold;
· Piddavatisya be-any kind of bran (great doses of alcohol, contact with toxic farbs and varnishes, etc.);
· Launch the empty company (karієs, stomatitis and іn);
· Robiti be-like chips and Mantoux test;
· Visnazhuvatisya and overturned physically and psychologically;
Perebuvati pіd dієu active sleepy exchanges

Secondary prevention is focused on accelerated prevention:
With CIDP, spontaneous remissions are not susceptible, but for the prevention of recurrences, it takes a trivial hour to take immunosuppressive ones.
It is trivial to use glucocorticoids to produce side effects, such as Cushing's syndrome, osteoporosis, steroid diabetes, arterial hypertension, tendency to the growth of vagi, superficial gastritis.
· The tendency to the growth of vagi vimagає systematic vikorystannya otmezheniya kalorіnostі vіzhivanoї їzhі, especially in carbohydrates.
· The trend towards a decrease in tolerance to carbohydrates and a periodical increase of sugar in the blood, in the form of drugs prescribed, to increase the tolerance to carbohydrates, normalization of peroxidation before oxidation
· For the prevention of gastritis vikoristovuyu change the course of treatment with the proton pump with the ingibitor (omeprazole 20 mg 1 time for 10 days).
In case of sympathicotonia (adduction of an arterial vise, tachycardia, and even to prednisone psychosis), it is necessary to prescribe vegetotropic drugs (anaprilin 20-40 mg 2-3 times as needed). Most often it occurs during pulse therapy with methylprednizolone.

Monitoring the patient's stance- on this stage, according to the rules for maintaining medical documentation, establish (PMSD, medical centers, etc.), in which the following are re-instituted:
· Assessment of the ailing camp with a description of the camp of shkirnykh pokriviv; vagi of the sick;
· Indicators of hemodynamics: the number of spontaneous rucks, A / D, HR, Pulse;
· Assessment of neurological status.

· The visibility of the ignition of the ignition demilinizing polyneuropathy.

Likuvannya (shvidka dopoga)

DIAGNOSTICS І LIKUVANNIA AT STAPI SHVIDKOЇ NEVIDKLADNOЇ HELP

Diagnostics come in: depending on the state of the art, there is no need to help.

Drug treatment:
Ethiopathogenetic treatment is not carried out.
On this stage, symptomatic therapy is carried out.

Likuvannya (stationary)

LIKUVANNYA at the stationary РІВНІ

tactics of addiction
Non-drug treatment:
· Dyeta Nizkosolova with a high vm_lka, ale low vm_ fat;
· Zabezpechennya adequate to look for ailments with the method of prevention of bedsores and contractures.

Drug treatment:
Lіkuvannya CIDP is composed of pathogenetic and symptomatic therapy. Pathogenetic therapy is based on the development of immunomodulatory diseases, as in this day it was taken on the basis of the first and other lines.
In yakosti therapy of the first line vikoristovuyu:
Glucocorticoids (GC),
Human normal immunoglobulin for internal introduction (VVIG)
· Plasmapheresis.

HA (methylprednizolone or prednizolone)... For all ailments, it is recommended to take prenizolone in a dose of 1.5 mg / kg a day for 2-4 days, when polishing, I will step by step to take a dose of prenizolone every other day. In case of a significant excess of the period, the dose of prednisolone can be changed step by step (by 5 mg of skin 2). After 3-4 months, switch to an additional dose (20 mg every other day), and take more for 2 months. In such a rank, the course of treatment is trivial in the middle of 6 months. The prenizolone is skewed in case of repeated renewal of the potency of the principles and the pre-requisite indicators of the electro-neuromographic (ENMG) for the last time.
Alternative treatment schemes: methylprednizolone intravenously 1 g / day 5 days, sometimes 1 g / add 1 time per day for 4 or 8 days, use 1 time per month; or 500 mg of methylprednizolone orally 1 time per week 3 m / s, then the dose should be reduced by 50 mg of skin 3 m / s.

plasmapheresis
In the given hour, plasmapheresis as monotherapy is stagnant in CIDP in vinyatka vines: resistance is either contraindicated to the persistence of corticosteroids and / or immunoglobulin in class G.
Then call up plasmapheresis with CIDP to go to hormone therapy (Div. Vishche). In a wide range of operations, up to 200-220 ml of plasmas / kg are carried out per course for 5-7 sessions with two lengths. As a substitute component in plasmapheresis, it becomes 5% of albumin levels, so as the drug, on the basis of fresh frozen plasmas, gives a lesser number of accelerated and replenishment of the rhizik of the transferred hepatitis B and CHIDy.
In quiet patients, if plasmapheresis is carried out with CVDP as monotherapy, it is recommended that it be taken 2 to 3 times per week before the appearance of a stable clinical course with further changes in the frequency of operations with a stretch of deciduous months.

In the last few days, it was shown before plasmapheresis with CIDP, they knew a lot of evolu- for some reason, it is not a matter of consuming immunoglobulin in class G).
Plasmapheresis without oven for vaginal women and children, who are suffering from the HVDP. It is not recommended to use plasmapheresis with corticosteroids, as it will reduce its therapeutic efficacy. Approximately 5-10% of the ailments who suffer from plasmapheresis are susceptible to relapse and relapse, which, as a rule, quickly regress to the smallest morbidity patterns.
An alternative to plasmapheresis is intravenous immunoglobulin (IVIG).
VVIG zazvichayut in a nasal dose of 2 g / kg (stretching 2-5 dB.), Poten 1 g / kg skin 3 tension. stretching 6 ms. or 0.5 g / kg for a stretch of 4 days for leather months for a stretch of 6 ms.

The therapeutic effect of immunoglobulin is based on anti-firing, neutralization of anti-virus, antibacterial antibodies and autoantitils, anti-inflammatory and neutralization of active complement. For the effectiveness of immunoglobulin before plasmapheresis, ale less acceleration (head bile, shkirnі reactions, bіl across, chills, aseptic menіngіt). Immunoglobulin of contraindications We are sick with lack of immunoglobulin A, as they have a risk of development of anaphylactic shock.
If there is a lack of efficiency in the first line, the reserve drugs are stored - pick up another line- azathioprine, cyclophosphamide, cyclosporine, mycophenolate mofetil, methotrexate.

Azatioprin (imuran) prescribe orally at a dose of 50 mg / cyt with increased doses of up to 150-200 mg / cyt.

cyclophosphamide vicorisation during the daytime as a result of the other immunodepressants as in monotherapy, as well as in conjunction with azathioprine. The drug is administered internally at a dose of 200 mg or every other day at a dose of 400 mg. Therapy can be repaired in the minds of the hospital, and only after having passed into the tolerance of the drug, it is possible to transfer the ailments to the outpatient clinic. cyclosporine it is prescribed orally at a dose of 3 mg / kg. When there are toxic reactions, the dose can be increased up to 5 mg / kg 2 times a day. To achieve a stable therapeutic effect, the dose of cyclosporine can be reduced to a minimum

mycophenolate mofetil prescribe a supplement to glucocorticoids in vipads, if a lower dose is required. Mycophenolate mofetil should be administered orally at a dose of 2 g / cyt with a similar correct dose, depending on the efficiency of treatment.

tіamіn- priznachayut 25-50mg 2-4 times for doba. Course 3-4 days.

The change of the main lykarsky zoobіv:

preparations	single dose	multiplicity of input
prednisolone Methylprednizoon	1.5mg / kg orally 1 g / day	X 1 time a day against 2-4 times with the onset of lowering up to 20 mg / add every other day for more than 2 months. but: internally 5 days, sometimes 1 g / add 1 time per day for 4 or 8 days, sometimes 1 time per month; for vseredin 500mg 1 time per week 3 m / s, then the dose should be reduced by 50 mg of skin 3 m / s.
internal mmunoglobulin	2 g / kg	stretching 2-5 dB., at least 1 g / kg skin 3 ton. stretching 6 ms. or 0.5 g / kg for 4 days leather month for 6 months

Transfer of pre-daddish licars:

preparations	single dose	multiplicity of input
Azatioprin (imuran)	50mg / cyt orally	1 time a day, daily with increased doses up to 150-200 mg / cy.
cyclophosphamide	200 mg i / m	1 time per day, every other day at a dose of 400 mg.
Trental (pentoxifyline)	0.6 g (0.1 і 0.4); 2% solution 5-10 ml (0.3 g / 0.9 g).	in the middle 2-3 times for doba internally 1-2 times and for extra
tіamіn,	25-50 mg / day	in the middle 2-4 times for doba

Hirurgical involvement, due to the indicated indications for operational involvement: Nemaє.

Інші vidi lіkuvannya:
Be aware of the memory of the importance of the complex of rehabilitation visits, and for the prevention of quickening of the ill health and for the development of the functional state of the mind before the presence of a sufficient commitment of self.
A sick person needs:
Likuvalna fizkultura
Massage is beneficially infused into the exchange of speech, which will also accelerate the growth of nerves and renewal
· Physiotherapy for preventing the formation of contractures (electrostimulation, heat treatment, lykarsky electrophoresis, etc.).
· Hyperbaric oxygenation.

Shown for consulting fahivts:
· Consultation of an infectious disease specialist if necessary (at times of an agent for a pre-hospital emergency) - the establishment of any chronic infection (bruceliosis, borelitis, etc.), and so
Consultation of a therapist if necessary (at every day of the day at a pre-hospital period) - the establishment of a therapeutic incapacitation (an ignition of internal organs: therapy, therapy, liver disease)
· Consultation of an endocrinologist, nephrologist, rheumatologist - if necessary, the inclusion of somatic pathology or correction of the disease.

Indicated for transfer to the form of intensive therapy and reanimation:
· Important and extremely important steps of neurological disorders;
· Instability of hemodynamics;
· Destruction of dikhannya function;

Indicators of efficiency of treatment:
· Stabilization of immunological status (short and high storage of IgG blood and blood);
· Regression in cognitive neurological symptoms.

Farther away.

The dispensary is kept in check in the clinic for the place of residence.
Call your patients to continue using corticosteroids until they are quiet, as long as there is no maximum therapeutic effect (give 4-6 months). Likar is guilty of negotiating with the patient about the failure of steroids and living calls for them. The following recommendations will be nice:
· With a prophylactic method of gastritis vicoristovuyu to redistribute the rate of treatment by the proton pump with the ingibitor, for example, omeprazole (20 mg in the middle at low).
· Hypocalypse can be provided by taking calories at a dose of 30 mEq / add, or even 1-2 bananas per day.
· Violation of glucose tolerance can be developed in patients with a latent diabetes or a family history of diabetes. In general, it is necessary to change the day, or else it can be known and the supply of hypoglycemic drugs.
Arterial hypertension. Obov'yazkova dієta with a low volume of sodium.
· Zbіlshennya masi tila. Patients are guilty of having a low calorie diet with a low amount of carbohydrates and salts and a high amount of energy.
· Cataract and glaucoma. It is necessary 1 time per month to be examined by an ophthalmologist.
Myopathy. Steroid myopathy is suspected in case of increased muscle weakness, as the activity of enzymes in the blood and EMG is lost without changes. Women are more advanced to steroid myopathy. Likuvannya polyagaє in reduced doses of steroids; as long as it is polyphenia, it is possible to vvazaty, so mischievous weakness has developed due to the consumption of the hormone. In case of biopsies, atrophy of fibers of type 11 appears. The development of steroid myopathy is often found in the dose and triviality of the steroid intake; Prote іnividual sensitivity is meaningfully varіyє, in connection with which the symptoms can be manifested already through a few words, and not mіsyatsіv.
It is important to remember that in the period of remission it is an indispensable component of treatment є additional therapy and complex rehabilitation.
It is shown the early sign of occupational therapy for ailments with damaged functions of the upper children.

medical rehabilitation

carried out according to the Standard of Organizational Assurance of Medical Rehabilitation to the Population of the Republic of Kazakhstan, approved by the order of the Ministry of Health Protection of the Republic of Kazakhstan dated 27.12.2013, Rock No. 759.

palliative assistance

On this stage, the psychological education of the sick and relatives, legal and social nutrition is carried out on the basis of the improvement of the quality of the life of the sick and the motherland.

Falling down to the type and severity slowed down, but ailments have come to a head, you can also know more about it, like:
For those who are sick, we have to admit heparin for children in a dose of 5,000 OD for skin 12 years and an hourly compression of lithic mucous membranes to prevent glib vein thrombosis
· Massage is beneficially infused into the exchange of speech, which will also accelerate the growth of nerves and renewal.
Kinesiotherapy brought stimulation to renewal and renewal of myazovy volume
· Physiotherapy for polishing strength, for preventing the formation of contractures (electrostimulation, heat treatment, lykarsky electrophoresis).
· Reabilitation for the development of common tips and adaptive products that add to everyday life.
A person who is sick can know orthopedic as well as additional additional methods of oversupply
Psychotherapy

hospitalization

Indicated for planned hospitalization:
· Zagostrennya KVDP;
· Increase in sedentary neurological symptoms in patients with chronic igneous demilinizing polyneuropathy.

Indicated for the emergency hospital:
· Patients with previous diagnoses of HVDP.

information

Dzherela and Literature

Protocols of the United Committee for the quality of medical services of the Ministry of Health and Social Development of the Republic of Kazakhstan, 2016
1. 1. Bikova O. V., Boyko A. M., Maslova O. I. Internal stasis of immunoglobulins in neurology (Review of literary and vlast sparing) // Nevrol. zhurn. - 2000, 5.P.32-39. 2. Gekht BM, Merkulova DM Practical aspects of the clinical course and treatment of polyneuropathies // Nevrol. zhurn.-1997 No. 2.-P.4-9. 3. Mozolevsky Yu. V., Dubanova E. A., Ivanov M. І. Klinika and likuvannya of chronic ignition demilinizing polyradiculoneuropathy // Zhurn. neurol. і psychiatr. - 1992, No. 3. P.106-110. 4. Latov N. Advances in the diagnosis and treatment of CIDP and related immune-mediated neuropathies // Neurology. - 2002. - Vol. 59 (Suppl 6). - S. 1. 5. Akhmedova G.M., Averyanova L.A., Devlikamova F.I. that in. Complex dosage of chronic dizimmune neuropathies for lesions of the central nervous system // Practical medicine. - 2013. - T. 68, No. 1 (1). - S. 83-86. 6. Vallat J.M., Sommer C., Magy L. Chronic inflammatory demyelinating polyradiculoneuropathy: diagnostic and therapeutic challenges for a treatable condition // Lancet Neurol. - 2010. - Vol. 9. - P. 402-412. 7. Dyck P. J., Lais A. C., Ohta M. et al. Chronic inflammatory polyradiculoneuropathy // Mayo Clin Proc. - 1975. - Vol. 50. - P. 621-637. 8. Gorson K.C., Katz J. Chronic Inflammatory Demyelinating Polyneuropathy // Neurol Clin. - 2013. - Vol. 31. - P. 511-532. 9. Misra U.K., Kalita J., Yadav R.K. A Comparison of Clinically Atypical with Typical Chronic Inflammatory Demyelinating Polyradiculoneuropathy // Eur Neurol. - 2007. - V. 58. - P. 100-105. 10. Koller H., Kieseier B. C., Jander S. et al. Chronic Inflammatory Demyelinating Polyneuropathy // NEJM - 2005. - Vol. 352 (13). - P. 1343-1357. 11. De Sousa E.A. Chronic inflammatory demyelinating polyneuropathy: diagnosis and management // Expert Rev. Clin. Immunol. - 2010. - Vol. 6 (3). - P. 373-380. 12. Busby M., Donaghy M. Chronic dysimmune neuropathy: a subclassification based upon the clinical features of 102 patients // J Neurol. - 2003. - Vol. 250. - P. 714-724. 13. Van den Bergh P.Y.K., Hadden R. D. M., Bouche P. et al. EFNS / PNS Guideline on management of chronic inflammatory demyelinating polyradiculoneuropathy: Report of a joint task force of the EFNS and the PNS - First Revision // Eur J Neurol. - 2010. - Vol. 17. - P. 356-363. 14. Koski C.L., Baumgarten M., Magder L.S. et al. Derivation and validation of diagnostic criteria for chronic inflammatory demyelinating polyneuropathy // J Neurol Sci. - 2009. - Vol. 277. - P. 1-8. 15. Brannagan T.H. Intravenous gammaglobulin (IVIg) for treatment of CIDP and related immunemediated neuropathies // Neurology. - 2002. - Vol. 59 (Suppl 6). - S. 33-40.27. Koski C.L. Therapy of CIDP and related immunemediated neuropathies // Neurology. - 2002. - Vol. 59 (Suppl 6). - S. 22-27. 16. Rajabally Y. A., Narasimhan M., Chavada G. Electrophysiological predictors of steroid-responsiveness in CIDP // J Neurol. - 2008. - Vol. 255. - P. 936-938.

information

SHORT, SCHO VICORIST IN PROTOCOLS

OVDP	gostra ignition demilinizucha polyradiculoneuropathy
CIDP	chronic ignition demilinizucha polyradiculoneuropathy
Tnp	polyneuropathy
NMSP	spadkov motor-sensory polyneuropathy
SGB	Guine-Barré syndrome
A / D	arterial hypertension
PNS	peripheral nervous system
CNS	Central nervous system
MRI	Magnetic resonance tomography
PLR	polymerase lantsyugov reaction
CSF	spinal cord ridina
SHOE	the rate of accumulation of erythrocytes
Ig	immunoglobulin
Heart rate	the number of hearts is very fast
SNID	syndrome of packed immune deficiency
EMG	electromyography
ENMG	electroneuromyography
VVIG	human normal immunoglobulin for internal introduction
GK	glucocorticoids

List of list of protocols in the protocol based on the qualifications of the qualifications:
-Kayshibaeva Gulnaz Smagulovna - candidate of medical sciences, AT "Kazakh medical university of uninterrupted education", head of the department of neurology, certificate "neuropathologist of grown-ups".
-Zhumagulova Kulparam Gabibulovna - candidate of medical sciences, AT "Kazakh medical university of uninterrupted education", associate professor of the department of neurology.

Ordering for the presence of a conflict of interest: dumb.

List of reviewers:
Dushanova G.A. - Doctor of Medical Sciences, Professor, Head of the Department of Neurology, Psychiatry and Psychology of the Pivdenno - Kazakhstan State Pharmaceutical Academy.

Letting the minds look at the protocol: Revision of the protocol through 3 years of writing and publishing and from the date of joining the diya, or if new methods are evident with sufficient proof.

Attached files

Uwaga!

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