Ganglionevrit - causes, symptoms, diagnosis and treatment
Ganglionevrit - Inflammation of the ganglion (ganglion) with involvement in the inflammatory process associated nerve trunks. The clinical picture consists of ganglionevrita expressed pain, sensitivity disorders, vasomotor, neurotrophic and vegetative-visceral disorders. It is different depending on the localization ganglionevrita. Diagnosed ganglionevrit mainly on the basis of characteristic clinical changes. Additional tests (X-ray, MRI, CT, MDCT, US) are used for the purpose of differential diagnosis ganglionevrita. Treated ganglionevrit mostly conservative ways. If they are ineffective, and expressed pain syndrome shows the surgical removal of the affected ganglion (sympathectomy).
Ganglionevrit
Neurology is called gangliitis. If the pathological process affects neighboring node sympathetic peripheral nerves, such a condition is called ganglionevrit. When combined with the defeat of sympathetic ganglia and spinal nerve disorder is verified as a ganglioradikulit. In addition, isolated poliganglionit (truntsit) - inflammation of several sympathetic ganglia. About ganglionevrite say also against inflammation ganglia, which contain nerve fibers of different types: sympathetic, parasympathetic, sensory. Of these, the most frequent ganglionevrit crankshaft assembly and gangliitis pterygopalatine node.
measles, diphtheria, influenza, erysipelas, dysentery, tonsillitis, scarlet fever, sepsis) and chronic infectious diseases (rheumatism, syphilis, tuberculosis, brucellosis). Ganglionevrit often develops on the background of chronic inflammatory diseases. For example, the reason ganglionevrita pterygopalatine node can be complicated by dental caries, and cause sacral ganglionitis - adnexitis, salpingitis, oophoritis, men - prostatitis. In more rare cases ganglionevrit is toxic nature or caused by tumors (metastatic or secondary ganglioneuroma process). To promote the emergence of ganglionevrita can: hypothermia, fatigue, stress, alcohol abuse, surgery in the near ganglia anatomical areas, etc.
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sleep disorders; may develop fatigue, hypochondriac syndrome, neurasthenia.
ptosis, miosis and enophthalmos. During stimulation of the ganglion develops Purfyur du Petit syndrome (extension of the optic fissure, mydriasis and exophthalmos), there is a stimulating effect on the thyroid gland, leading to the emergence of hyperthyroidism. The secretory and vasomotor disturbances verhnesheynogo ganglionevrita manifested by redness and hyperhidrosis corresponding half of the face, decrease in intraocular pressure. sensitivity changes with cervical ganglionevrite noted above 2nd rib. Chance of paresis of the larynx, accompanied by hoarseness. In cases where ganglionevrit superior cervical ganglion is accompanied by a pronounced pain syndrome affecting the area of the teeth, patients often unsuccessfully treated by a dentist and even pass through the erroneous extractions.
Ganglionevrit lower cervical ganglion is accompanied by the proliferation of disorders of sensitivity to the 6th rib. These disorders and hand grip, leaving intact only the inner surface thereof. In his hand there is a decrease in muscle tone, cyanotic skin coloration (diffuse or only the tips of the fingers). Reduced corneal, conjunctival, mandibular, pharyngeal and Carpio radial reflexes. At the lower cervical ganglionevrite possible omission of the ear on the affected side of the unit.
Ganglionevrit stellate ganglion manifested by pain in the side of the chest on the affected side. pain and sensitivity disorders area looks "polukurtki". Often, the pain radiates to the upper limb, and the pain resembles angina and requires differential diagnosis with coronary heart disease. There dysmotility V finger on the hand.
Gangleonevrit upper thoracic sympathetic ganglia is manifested not only sensory symptoms and pain, and visceral and vegetative disorders. There may be pain in the heart, shortness of breath, tachycardia. Ganglionevrit lower thoracic and lumbar sympathetic ganglia characterized by pain, sensory disorders, vascular and trophic disorders of the lower trunk and lower limbs. With involvement in inflammation of the sciatic nerve pain radiating to the thigh corresponding to the characteristic clinic neuropathy of the sciatic nerve. Vegetative-visceral disorders are manifested by the organs of the abdominal cavity.
Krestsovogo ganglionevrit may be accompanied by itching of the external genitalia and dysuric disorders. Women are possible menstrual irregularities, acyclic uterine bleeding. Ganglionevrit pterygopalatine node accompanied clinic trigeminal nerve in the orbit, nose, and upper jaw (II branch innervation area) hyperemia half face, lacrimation from the eye on the affected side and abundant nasal discharge on the same side. Ganglionevrit crank assembly is characterized by paroxysmal pain in the ear, which often radiates to the back of the head, face and neck. On the affected side may develop neuritis of the facial nerve paresis of mimic muscles.
cardiologist about cardialgia, a gastroenterologist in connection with the violation of the secretory and motor function of the stomach or intestines, a gynecologist about the persistent pelvic pain. In such cases, especially pain, its chronic and persistent character should be a reason for patient consultation with a neurologist.
The differential diagnosis is carried out with ganglionevrita funicular myelosis, spinal cord tumors, syringomyelia, neuroses, violation of the spinal circulation. In order to avoid these diseases in the diagnosis can be carried out ganglionevrita spine X-ray, CT and MRI of the spine, electromyography. To identify related ganglionevritu inflammatory changes in the physical bodies appointed by MSCT or ultrasound of the abdomen, gynecological ultrasound, prostate ultrasound, etc. Test.
paravertebral blocks with novocaine at the level of the lesion. Depending on the etiology ganglionevrita prescribed therapy directed against the infectious process. When the viral nature ganglionevrita used antiviral drugs and gamma globulin for bacterial - antibiotics.
If ganglionevrit accompanied by increased activity of the sympathetic nervous system, in its treatment according to indications include ganglioplegic, anticholinergics, antispasmodics and antipsychotics. Perhaps the appointment of antihistamines, because they also have anticholinergic effects. If ganglionevrit flows down the activity of the sympathetic system, its complement treatment nicotinic drugs gluconate and calcium chloride.
In the treatment of ganglionevrita actively apply physiotherapy: erythematous dose UFO, electrophoresis ganglefena, amidopirina, novocaine, potassium iodide in the area of inflamed ganglia, diadynamic (DDT), common radon baths, mud applications.
Ganglionevrit with persistent pain, not cropped complex conservative treatment, an indication for sympathectomy - surgical removal of the affected sympathetic ganglion. Depending on the type of ganglionevrita carried cervical and thoracic sympathectomy, lumbar sympathectomy. When breast ganglionevrite thoracoscopic sympathectomy may conduct at the lumbar ganglionevrite - laparoscopic. The use of such methods of endoscopic sympathectomy is the least invasive method of surgical treatment ganglionevrita.