Plexitis

Plexitis - disease of the nerve plexus. Localization of the defeat distinguish plexitis neck, shoulder and lumbar-sacral.
Cervical plexitis. Cervical plexus formed from the upper cervical spinal nerves (I-IV), Innervate the skin and muscles of the neck, part of the head, and the diaphragm. The cause of cervical plexitis can be a tumor, enlarged neck glands, infections (influenza, tuberculosis, syphilis), gout. Pain in the neck (often on the front and side surfaces), and also in the area of the ear; there may come a paralysis of the neck muscles, irritation or phrenic nerve palsy, at last comes the respiratory distress, impaired movement of the diaphragm, are not doing enough stomach, the patient cannot speak, cough, appears hiccups.
Shoulder plexitis. Brachial plexus is formed of the lower cervical spinal nerves (V, VI, VII, VIII) and breast (I and II), Innervate the skin and the muscles of the shoulder girdle, top the shoulder and chest, upper limb joints and ligaments of the shoulder girdle and upper extremities. The reasons are: a dislocated shoulder, a broken collarbone, gunshot wounds, birth trauma, anaesthesia and "spike" paralysis that occur in the long traumatizarii nerve fibers, cervical ribs, tumors of the spine or the top of the lung, subclavian artery aneurysms and infectious diseases (flu, influenza, tuberculosis, brucellosis) and metabolic disorders (diabetes, gout). When the disease only plexus affects the muscles of the shoulder girdle and upper extremities, pain in above - and subclavian areas with irradiation in hand, there paresthesia or gipestesia in his hand, may come flaccid paralysis hands with atrophy of the muscles of the shoulder girdle and hands with the reaction of rebirth, tendon reflexes are reduced or absent.
The defeat of the sympathetic fibers in the plexus trunks causes vegetative-trophic disorders- cyanosis or pale hands, swelling of her and sweating, disruption of trophic nails. Most often affected not all plexus, and the top or bottom part. The clinical picture at last - see Degerin-Klumpke paralysis, Duchenne - ERB's palsy.
Neck and shoulder plexitis often start acute severe pain. Most plexitis runs favorably, reduce pain, restore the reflexes, the sensitivity. In severe (traumatic) cases, the pain will disappear, remain flaccid paralysis of the arms, muscle atrophy, reflexes and sensitivity are not restored. Forecast when "spike" and anaesthesia paralysis more favorable, paralysis, neonatal less favorable. At long paralyses and paresises, followed by contractures the prognosis is poor. Cm. also Paralysis, paresis.
Lumbosacral plexitis. Lumbosacral plexus formed from the lumbar and sacral spinal nerves (I-IV lumbar and part XII of the breast, V lumbar and I-V sacral), Innervate the muscles and the skin side and front wall of the abdomen, groinand pubic area, perineum, external genital organs, and gluteal muscles and the muscles of the lower extremities. The cause of the lumbosacral plexitis can be diseases of the sacrum, the pelvic bones (tumors, trauma), muscles, organs of small pelvis (gynaecological diseases, psot), pregnancy and difficult childbirth (compression plexus head of the fetus), spinal injuries and intoxication, infection and diabetes.
For lumbosacral plexitis characterized by pain in the lower back, which can be spread on the area of the hips, buttocks, legs. In these areas may be discomfort, there are sometimes paresis of the legs, hips and legs. Tendon reflexes decreased, sometimes the weight of the muscles of the thighs, legs and feet, swelling lower limbs, increased sweating, a breach of trophic nails. The course and prognosis of the lumbosacral plexitis depend on the underlying causes.
To differentiate plexitis followed with a disease of the joints, sciatica (see), neuritis (see).
Treatment at the infectious plexitis. In the acute period is anti-inflammatory therapy (antibiotics penicillin 6 million IU per course), pain relievers - analgin inside (0.5 g 3 times a day) and intramuscularly (50% solution of 1 ml, 10 injections), amidopyrine , 0.5 g, thermal procedures, iontophoresis with novocaine procaine blockade, Bernard currents, UHF. If the exchange plexitis - Uragan (1 tsp 1 / 2 Cup water), Tofan (0.5 g 3 times a day), potassium iodide (3% solution 3 times a day on 1 table. L. after a meal), an appropriate diet. Gynecological diseases - treatment of these diseases, in addition, novocaine blockade, pain relievers. When all plexitis apply intramuscular injections of vitamins: thiamine bromide (6% solution of 2 ml daily, at the rate of 20 injections) and of cyanocobalamin (200 mcg daily, in the course of 15 injections). After the acute period - ozocerite, paraffin, radon baths, remedial gymnastics. Chronic, long-term recurrent plexitis - and-Spa treatment (mud baths, hydrogen-sulphidous baths). Treatment should be started early, with the first manifestations of the disease and in those cases when plexitis flows easily and is of a transient nature.
When aneurysms subclavian artery, cancer, cervical ribs, traumatic plexitis - surgical treatment. When plexitis avoid physical strain, cooling and work with toxic substances. For prophylaxis recommended hardening of the organism, therapeutic gymnastics, careful treatment of acute disease, the limitation of heavy physical activity.

Plexitis (from lat. plexus - plexus) - diseases of the nervous plexuses of different etiology. There are P. neck, shoulder and lumbar-sacral.
The clinical picture and over. Cervical plexitis (plexitis cervicalis). Education cervical plexus and the area of innervation - see the Cervical plexus. Cervical P. may be caused by a tumor, tuberculosis, syphilis cervical vertebrae, enlarged neck glands. With the defeat of the cervical plexus injuries may occur paralysis deep cervical muscles, pain in the distribution occipital, auricular nerves, as well as irritation or phrenic nerve palsy; at last there comes a respiratory distress, violation of the movement of the diaphragm, are not doing enough stomach, the patient cannot speak, cough, stimulation of the diaphragm comes hiccups. During acute.
Shoulder plexitis (plexitis brachialis). Education of the brachial plexus and the area of innervation - see Brachial plexus. Shoulder P. occurs when injuries (dislocations head shoulder, broken collar bones, gunshot wounds, birth injuries, anaesthesia paralysis, spike paralysis), cervical ribs, tumors of the spine, tops light (swelling of Pancost), with acute and chronic infections and intoxication, metabolic disorders (gout, diabetes). When the disease only plexus affects the muscles of the shoulder girdle and upper limb (not always equal), the pain in above - and subclavian areas with irradiation in the upper limb, come paresthesia, gipestesia and flaccid paralysis, some time later appear muscular atrophy as the shoulder girdle and upper limbs (Fig) the reaction of rebirth; tendon and periosteal reflexes are reduced or absent. The presence of a sympathetic fibers in the plexus trunks causes vegetative-trophic disorders (cyanosis or pale hands, swelling of her, sweating, disruption of trophic nails). The defeat plexus is rare, most often affected the upper or lower part of it. Clinical picture of destruction of the upper and lower part plexus - see Dusana-ERB's palsy, Degerin-Klumpke paralysis. For more acute, severe pain. Most plexitis runs favorably: decrease pain, restored reflexes, sensitivity. In severe cases (traumatic) remain flaccid paralysis hands atrophy; reflexes and sensitivity are not restored. The duration of P. - W-2 months, and more.
The prognosis for spike and anaesthesia paralysis more favorable, paralysis, neonatal less favourable in the long paralyses and paresises, followed by contractures the prognosis is poor.
Lumbosacral plexitis (plexitis lumbosacralis). Education lumbosacral plexus and the area of innervation - see Lumbosacral plexus. Lumbosacral P. arises in connection with the disease of the sacrum, pelvic bones, muscles and organs of the small pelvis (gynecological diseases, psoty), pregnancy and difficult labour (compression plexus head of the fetus), tumors of the pelvis or abdomen, fractures of the spine, pelvis, intoksikatziah, diabetes. The clinical picture of the lumbosacral P. characterized by pain in the lumbar region; they can spread on the area of innervation locking, femoral and sciatic nerve. In the parts of the hand of these nerves can be discomfort. There are a paralysis of foot muscles of the thigh and lower leg tendon reflexes are reduced. Sometimes there comes a weight loss of muscles of the thighs, legs, feet, are observed and vegetative-trophic disorders (swelling, rash, disruption of trophic nails). In the study symptom Wasserman there is pain in the buttocks, sometimes in the groin area, the rapid lowering of the legs painfully, with straining m. ileopsoas, which compresses plexus, and it may causes pain. For lumbosacral plexitis and the prognosis depends on their cause.


Diagnosis of plexitis is made on the basis of the pain syndrome, corresponding localization disorders of sensitivity of movement disorders and reflexes, vegetative-trophic disorders. Diagnosis of cervical P. facilitates the presence of cervical ribs, shoulder P. - aneurysm above - and subclavian arteries. Shoulder P. must be differentiated from disease shoulder; when the latter is limited to motion at the shoulder joint with the abduction of the shoulder, there is swelling and crunch in the area of the shoulder joint and the corresponding radiological changes in it.
Lumbosacral plexitis should be differentiated from sciatica (see), sacroileitis and paycom. When sacroileitis pain when pressure on the sacroiliac joint, pain worsens the torso the affected side, there are x-ray changes in the sacroiliac joint. When Paice characteristic bent in the hip joint, the leg, its hard to get out of this state in connection with strengthening of pain.
Treatment plexitis is defined etiology. When infectious P. conduct anti-inflammatory therapy, used pain relievers, thermal procedures, iontophoresis with novocaine procaine paravertebral blockades and Astvatsaturova intradermally. After the acute period - therapeutic physical culture. When the exchange P. - Uragan, Tofan, potassium iodide, an appropriate diet. Gynecological diseases - treatment of these diseases, in addition, pain relievers, novocaine blockade. When all P. apply vitamins B1 and B12, the motor disorders apply neostigmine and Dibazol. Of physiotherapeutic procedures - UHF, Bernard currents, ozokerite, radon baths, therapeutic physical culture. If there is no effect of physical therapy, it is recommended radiotherapy. Chronic long-term current P. - and-Spa treatment: mud baths, hydrogen sulphide and radon baths. When subclavian artery aneurysm, cancer, cervical ribs, traumatic P. recommended surgical treatment. Treatment plexitis should begin early, with the first manifestations of the disease and in those cases when they are mild, transient nature. When P. avoid physical strain, cooling and work with toxic substances.

Traumatic left shoulder pleksit: 1 movement of the proximal left hand sharply limited; atrophy of the muscles of the shoulder girdle, shoulder and forearm; 2 - atrophy adaptaciyn of muscles and the muscles of the shoulder.