Zapalenie nerwów obwodowych: etiologia, diagnostyka i leczenie

• Autorzy: Oskar Puk

Warianty tytułu

EN

Peripheral neuritis: etiology, diagnosis and treatment

Abstrakty

EN

Peripheral neuropathy is a common condition, with diabetes, alcoholism, and Guillain-Barre syndrome accounting for approximately 90% of all cases. The heterogeneous mechanism of nerve damage, e.g. trauma, infection, metabolic disease, etc., and the heterogeneous nature of the affected nerve fibres result in a broad and complex spectrum of symptoms of neuropathy. However, most common symptom is pain, most often constant, strong sensations as burning, stinging, etc. In addition, paraesthesia, loss of superficial sensation, weakness of reflexes and muscle weakness may occur. Diagnostics is based primarily on the clinical evaluation of patients and a thorough history. Importantly, therapy must include causal treatment, e.g. antibiotic therapy, surgery for pressure / trauma, etc., and adequate pain management with coanalgesics such as opioids, tricyclic antidepressants, antiepileptic drugs, etc. Supplementation of vitamin B complex as a coanalgesic is of great benefit. B vitamins reduce pain in more than 75% of patients and have neuroprotective effects through decrease of inflammation. It should be remembered that good therapeutic effects are obtained by using combination drugs, e.g. tramadol with paracetamol, diclofenac with B vitamins or other pharmaceutics with vitamins B1, B6 and B12. The therapy should follow the "analgesic ladder". Treatment of neuropathic pain should be supervised by an appropriate specialist, e.g. a neurologist.

PL

Neuropatia nerwów obwodowych jest dolegliwością powszechnie występującą, a cukrzyca, alkoholizm i zespół Guillain-Barre odpowiadają za ok. 90% jej przypadków. Różnorodny mechanizm uszkodzenia nerwów, tj. uraz, infekcja, choroba metaboliczna itp. oraz różnorodny charakter dotkniętych włókien nerwowych są przyczyną szerokiego spektrum objawów neuropatii. Jednakże najczęściej dolegliwości bólowe są stałe, silne, odczuwane jako pieczenie, szczypanie, itp. Ponadto mogą wystąpić parestezje, zniesienie czucia powierzchownego, osłabienie odruchów oraz osłabienie siły mięśniowej.

Słowa kluczowe

PL

ból neuropatyczny; leczenie; zapalenie nerwów obwodowych; witaminy B; witamina B1; witamina B6; witamina B12; NLPZ; diklofenak

EN

neuropathic pain; treatment; peripheral neuritis; vitamins B; vitamin B1; vitamin B6; vitamin B12; NSAIDs; diclofenac

• Wydawca: Wydawnictwo Naukowe Medyk sp. z o.o.
• Czasopismo: Gabinet Prywatny
• Rocznik: 2022
• Tom: 29 (280)
• Numer: 01
• Strony: 19-29

Daty

wydano

2022

Twórcy

autor

Oskar Puk

• Szpital Uniwersytecki nr 2 im. Jana Bizela w Bydgoszczy

Bibliografia

• Greenberg, M. S. (2020). Handbook of Neurosurgery. Thieme.
• Vinik, A. I., Nevoret, M. L., Casellini, C., & Parson, H. (2013). Diabetic neuropathy. Endocrinology and metabolism clinics of North America, 42(4), 747–787. https://doi.org/10.1016/j. ecl.2013.06.001Art. Z cukrzycy (advanced)
• TheADVANCECollaborative Group. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med 2008;358:2560–72.
• Julian, T., Glascow, N., Syeed, R., & Zis, P. (2019). Alcohol-related peripheral neuropathy: a systematic review and meta-analysis. Journal of neurology, 266(12), 2907–2919. https://doi.org/10.1007/s00415-018-9123-1
• Baron, R., Binder, A., & Wasner, G. (2010). Neuropathic pain:diagnosis, pathophysiological mechanisms, and treatment. The Lancet. Neurology, 9(8), 807–819. https://doi.org/10.1016/S1474-4422(10)70143-5
• Xu, L., Zhang, Y., & Huang, Y. (2016). Advances in the Treatment of Neuropathic Pain. Advances in experimental medicine and biology, 904, 117–129. https://doi.org/10.1007/978-94-017-7537-3_9
• Mutschler E. Farmakologia i toksykologia – podręcznik. Wydanie IV polskie Redakcja naukowa: Marek Droździk, Iwan Kocić, Dariusz Pawlak. MedPharm-Polska 2018.
• Tamaddonfard, E., Samadi, F., & Egdami, K. (2013). The effects of vitamin B12 and diclofenac and their combination on cold and mechanical allodynia in a neuropathic pain model in rats. Veterinary research forum : an international quarterly journal, 4(1), 19–24.
• Ponce-Monter, H. A., Ortiz, M. I., Garza-Hernández, A. F., Monroy-Maya, R., Soto-Ríos, M., Carrillo-Alarcón, L., Reyes-García, G., & Fernández-Martínez, E. (2012). Effect of diclofenac with B vitamins on the treatment of acute pain originated by lower--limb fracture and surgery. Pain research and treatment, 2012, 104782. https://doi.org/10.1155/2012/104782
• Altun, I., & Kurutaş, E. B. (2016). Vitamin B complex and vitamin B12 levels after peripheral nerve injury. Neural regeneration research, 11(5), 842–845. https://doi.org/10.4103/1673-5374.177150
• Julian, T., Syeed, R., Glascow, N., Angelopoulou, E., & Zis, P.(2020). B12 as a Treatment for Peripheral Neuropathic Pain: A Systematic Review. Nutrients, 12(8), 2221. https://doi.org/10.3390/nu12082221
• Ang, C. D., Alviar, M. J., Dans, A. L., Bautista-Velez, G. G., Villaruz-Sulit, M. V., Tan, J. J., Co, H. U., Bautista, M. R., & Roxas, A. A. (2008). Vitamin B for treating peripheral neuropathy. The Cochrane database of systematic reviews, (3), CD004573. https:// doi.org/10.1002/14651858.CD004573.pub3
• Wang, J. Y., Wu, Y. H., Liu, S. J., Lin, Y. S., & Lu, P. H. (2018). Vitamin B12 for herpetic neuralgia: A meta-analysis of randomised controlled trials. Complementary therapies in medicine, 41, 277–282. https://doi.org/10.1016/j.ctim.2018.10.014
• Buesing, S., Costa, M., Schilling, J. M., & Moeller-Bertram, T. (2019). Vitamin B12 as a Treatment for Pain. Pain physician, 22(1), E45–E52.
• Ehmedah, A., Nedeljkovic, P., Dacic, S., Repac, J., Draskovic Pavlovic, B., Vucevic, D., Pekovic, S., & Bozic Nedeljkovic, B.(2019). Vitamin B Complex Treatment Attenuates Local Inflammation after Peripheral Nerve Injury. Molecules (Basel, Switzerland), 24(24), 4615. https://doi.org/10.3390/molecules24244615

Identyfikatory

Biblioteka Nauki

2037379