ICD 10 dismetabolic polyneuropathy. Toxic polyneuropathy of the lower extremities: causes, symptoms and treatment

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. No. 170

The release of a new revision (ICD-11) is planned by WHO in 2017-2018.

With changes and additions from WHO.

Processing and translation of changes © mkb-10.com

Polyneuropathy of the lower extremities: code according to ICD-10

Axonal and demyelinating neuropathy

Classification by causes of illness

Conclusion on the topic

Diabetic polyneuropathy code according to ICD-10

Polyneuropathy is a complex of diseases that includes multiple lesions of peripheral nerves. The disease most often progresses to chronic stage and has an ascending distribution path, that is, the process initially affects small fibers and gradually covers increasingly larger branches.

The classification of polyneuropathy according to ICD 10 is officially recognized, but does not take into account the individual characteristics of the course and does not describe treatment tactics.

Symptoms and diagnosis

The clinical picture is primarily based on disorders of the musculoskeletal system and the cardiovascular system. The patient complains of muscle pain, weakness, cramps and lack of ability to move normally (paresis lower limbs). An increase in frequency is added to the general symptoms heart rate(tachycardia), jumps in blood pressure, dizziness and headaches due to changes in vascular tone and improper blood supply to the organs of the central nervous system.

When the patient’s health deteriorates, the muscles completely atrophy, the person mostly lies down, which negatively affects the nutrition of the soft tissues. Sometimes necrosis develops.

Initially, the doctor is obliged to listen to all the patient’s complaints, conduct a general examination, check tendon reflexes and skin sensitivity using special instruments.

Laboratory blood diagnostics are effective in determining concomitant pathologies and the causes of the development of the underlying disease. An increase in glucose concentration or toxic compounds, heavy metal salts may be observed.

Of the modern instrumental methods, electroneuromyography and nerve biopsy are preferable.

Treatment

The international committee has developed a whole system for the treatment of polyneuropathy. First of all, the influence of the main causative factor is excluded - organisms are destroyed with the help of antibiotics, diseases of the endocrine system are compensated for by hormonal therapy, the place of work is changed, alcohol intake is completely eliminated, surgical intervention neoplasms are removed.

In order to avoid the development of complications, a high-calorie diet is prescribed (in the absence of contraindications), a complex of vitamins and minerals that restore function immune system and cell trophism.

To relieve symptoms, painkillers, antihypertensive drugs, and muscle stimulants are used.

Definition and treatment of polyneuropathy according to ICD-10?

The ICD-10 code for polyneuropathy will vary depending on the type of disease. This disease is understood as a pathological condition in which a nerve in the human body is damaged. This disease manifests itself in the form of paralysis, paresis, problems with tissue trophism and vegetative disorders.

ICD-10 contains codes for various pathologies in the human body. There are several sections for polyneuropathy:

Axonal polyneuropathy of the lower extremities or other parts of the body develops due to metabolic disorders. For example, the disease can manifest itself when arsenic, mercury, lead and other substances enter the body. In addition, the alcoholic form is also included in this list. According to the course, polyneuropathy can be acute, subacute, chronic, or recurrent.

Highlight the following types axonal polyneuropapia:

1. Acute form. Develops over several days. Nerve damage is associated with severe intoxication of the body due to exposure to methyl alcohol, arsenic, mercury, lead, carbon monoxide and other compounds. This form of pathology can last no more than 10 days. Therapy is carried out under the supervision of a doctor.
2. Subacute. It develops over several weeks. This is characteristic of the toxic and metabolic variety. You will be able to recover only in a few months.
3. Chronic. Develops over a long period of time, sometimes more than 6 months. This type of pathology progresses if the body does not have enough vitamin B12 or B1, as well as if lymphoma, cancer, tumor, or diabetes develop.
4. Recurrent. It can bother the patient repeatedly and appears over many years, but periodically and not constantly. Quite often found in the alcoholic form of polyneuropathy. This disease is considered very dangerous. It develops only if a person has consumed too much alcohol. In this case, not only the quantity of alcohol plays a big role, but also its quality. This has a bad effect on a person's overall health. During therapy it is strictly forbidden to drink alcohol. Alcohol addiction also needs to be treated.

The demyelinating form is characteristic of Baret-Guillain syndrome. This is an inflammatory type pathology. It is provoked by diseases caused by infections. In this case, the person complains of shingles-type pain in the legs and muscle weakness. These are characteristic features of the disease. Then health weakens, and after a while symptoms of the sensory form of the disease appear. The development of this disease can last for months.

If a patient has diphtheria-type polyneuropathy, then within a couple of weeks the cranial nerves will be affected. Because of this, the tongue suffers, it is difficult for a person to talk and swallow food. The integrity of the phrenic nerve is also compromised, making it difficult for the person to breathe. Paralysis of the limbs occurs only after a month, but all this time the sensitivity of the legs and arms is gradually impaired.

There is also a classification of polyneuropathy according to provoking factors:

1. Toxic. This form manifests itself due to poisoning of the body with various chemical compounds. This can be not only arsenic, mercury, lead, but also household chemicals. In addition, the toxic form manifests itself with long-term alcohol dependence in a chronic form, since this also has a bad effect on the state of the nervous system and leads to malfunctions of various organs. Another type of toxic polyneuropathy is diphtheria. It manifests itself as a complication after diphtheria. Usually develops quite quickly in adult patients. This pathology is characterized by various disorders that are associated with the functioning of the nervous system. For example, tissue susceptibility sharply deteriorates and motor function suffers. Only a doctor should treat such polyneuropathy.
2. Inflammatory. This type of disease develops only after the development inflammatory processes V nervous system. At the same time there appear discomfort, numbness in the legs and arms. The ability to speak and swallow food may be impaired. If such symptoms appear, you should immediately go to the hospital.
3. Allergic. This form develops against the background of acute intoxication with methyl alcohol, arsenic, carbon monoxide or organophosphorus substances. The chronic form of intoxication with other compounds plays an important role. The prognosis for diabetes mellitus, diphtheria and vitamin deficiency is poor. Quite often, an allergic form of the disease develops due to prolonged use of any medication.
4. Traumatic. This variety appears due to serious injuries. Symptoms will only appear for the next few weeks after this. Usually the main symptom is impaired motor function. Exercise and exercise therapy are very important during treatment.

There are other, less common forms of polyneuropathy.

The International Health Organization has established its own code for each pathology; there are also several sections for polyneuropathy. Numbers are assigned depending on the type of disease, since polyneuropathy can be inflammatory, toxic, traumatic, or allergic.

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Code 10 μb - diabetic polyneuropathy

Diabetes is dangerous due to possible complications, one of which is polyneuropathy. Diabetic polyneuropathy has a code according to ICD-10, so the disease can be found under the label E10-E14.

Why is it dangerous?

This pathology is characterized by damage to a group of nerves. In diabetic patients, polyneuropathy is a complication in its acute course.

Prerequisites for the development of polyneuropathy:

older age;
excess weight;
lack of physical activity;
permanently increased concentration of glucose in the blood.

Neuropathy develops because the body triggers the carbohydrate elimination mechanism due to constantly high glucose concentrations. As a result of this process, structural changes in neurons occur, and the speed of impulses slows down.

Diabetic polyneuropathy is classified by ICD-10 as E10-E14. This code is entered into the patient’s disease progress report.

Symptoms of pathology

Most often, diabetic polyneuropathy affects the lower extremities. Symptoms can be divided into two groups - initial symptoms and late signs. The onset of the disease is characterized by:

a slight tingling feeling in the limbs;
numbness in the legs, especially during sleep;
loss of sensation in the affected limbs.

Often patients do not pay attention to the initial symptoms and go to the doctor only after later signs appear:

constant leg pain;
weakening of the foot muscles;
change in nail thickness;
foot deformity.

Diabetic polyneuropathy, which is assigned code E10-E14 according to the ICD, brings a lot of discomfort to the patient and is fraught with serious complications. The pain does not decrease even at night, so this disease is often accompanied by insomnia and chronic fatigue.

Diagnostics

The diagnosis is made based on an external examination of the limbs and a study of the patient’s complaints. Additional manipulations required:

pressure check;
heart rate check;
blood pressure of extremities;
cholesterol tests.

Checking blood glucose, hemoglobin and insulin concentrations is also required. After all the tests, the patient must undergo a comprehensive examination by a neurologist, who will assess the degree of damage to the nerves of the limb.

ICD code E10-E14 in the patient’s disease report means the diagnosis of diabetic polyneuropathy.

Treatment of pathology

Treatment of polyneuropathy requires an integrated approach. For treatment it is used:

drug therapy;
normalization of blood glucose concentration;
warming up the feet;
physiotherapy.

Drug therapy is aimed at strengthening the walls of blood vessels, improving their conductivity and strengthening nerve fibers. In case of ulcer formation, local therapy is also necessary, aimed at treating the damage and minimizing the risk of infection in the wound.

In the exercise therapy room the patient will be shown therapeutic exercises which must be performed daily.

An important step in the treatment of diabetic polyneuropathy is to lower the concentration of glucose in the blood. Constantly increased level sugar stimulates the rapid development of damage to the limbs, so constant adjustment of the patient’s condition is necessary.

Possible risks

Polyneuropathy (ICD-10 code – E10-E14) is dangerous due to serious complications. Impaired sensitivity can lead to the appearance of a large number of trophic ulcers and blood poisoning. If the disease is not cured in time, amputation of the affected limb is possible.

Forecast

An important condition for a favorable outcome is timely consultation with a doctor. Diabetes itself poses a serious risk to the patient’s life, so listening to your own body is the primary task of every patient.

Timely treatment will completely cure polyneuropathy of the extremities. To avoid relapse, it is very important to constantly monitor blood sugar levels.

The information on the site is provided solely for popular informational purposes, does not claim to be reference or medical accuracy, and is not a guide to action. Do not self-medicate. Consult your healthcare provider.

Polyneuropathy

Polyneuropathy (polyradiculoneuropathy) is multiple damage to the peripheral nerves, manifested by peripheral flaccid paralysis, sensory disturbances, trophic and vegetative-vascular disorders, mainly in the distal limbs. This is a common symmetrical pathological process, usually of distal localization, gradually spreading proximally.

Classification

By etiology

Inflammatory
Toxic
Allergic
Traumatic

According to the pathomorphology of the injury

Axonal
Demyelinating

According to the nature of the flow

Acute
Subacute
Chronic

Axonal polyneuropathies (axonopathies)

Acute axonal polyneuropathies

Most often they are associated with suicidal or criminal poisoning and occur against the background of a picture of severe intoxication with arsenic, organophosphorus compounds, methyl alcohol, carbon monoxide, etc.

Subacute axonal polyneuropathies

They develop over several weeks, which is typical for many cases of toxic and metabolic neuropathies, but even more of the latter last for months.

Chronic axonal polyneuropathies

Progress over a long time: from 6 months or more. It develops most often with chronic alcohol intoxication (alcoholic polyneuropathy), vitamin deficiencies (group B) and systemic diseases such as diabetes mellitus, uremia, biliary cirrhosis, amyloidosis, cancer, lymphoma, blood diseases, collagenosis. Of the drugs, special attention should be paid to metronidazole, amiodarone, furadonin, isoniazid and apressin, which have a neurotropic effect.

Demyelinating polyneuropathies (myelinopathies)

Acute inflammatory dimyelinating polyradiculoneuropathy (Guillain-Barré syndrome)

Described by French neurologists G. Guillen and J. Barre in 1916. The cause of the disease remains insufficiently clear. It often develops after a previous acute infection. It is possible that the disease is caused by a filterable virus, but since it has not yet been isolated, most researchers consider the nature of the disease to be allergic. The disease is considered to be autoimmune with destruction of nervous tissue secondary to cellular immune reactions. Inflammatory infiltrates are found in peripheral nerves, as well as roots, combined with segmental demyelination.

Diphtheria polyneuropathy

1-2 weeks after the onset of the disease, signs of damage to the cranial nerves of the bulbar group may appear: paresis of the soft palate, tongue, phonation disorder, swallowing; Possible breathing problems, especially if the phrenic nerve is involved in the process. Damage to the vagus nerve can cause bradycardia, tachycardia, and arrhythmia. The oculomotor nerves are often involved in the process, which is manifested by accommodation disorder. Less commonly observed is paresis of the external ocular muscles innervated by the III, IV and VI cranial nerves. Polyneuropathy in the extremities usually manifests itself as late (at 3-4 weeks) flaccid paresis with a disorder of superficial and deep sensitivity, which leads to sensory ataxia. Sometimes the only manifestation of late diphtheria polyneuropathy is loss of tendon reflexes.

If the early manifestations of cranial nerve neuropathy in diphtheria are associated with the direct entry of the toxin from the lesion, then the late manifestations of peripheral nerve neuropathy are associated with the hematogenous spread of the toxin. Treatment is carried out according to etiological and symptomatic principles.

Subacute demyelinating polyneuropathies

These are neuropathies of heterogeneous origin; have an acquired nature, their course is wavy, recurrent. Clinically, they are similar to the previous form, but there are also differences in the rate of development of the disease, in its very course, as well as in the absence of clear provoking moments or triggering mechanisms.

Chronic demyelinating polyneuropathies

Occur more often than subacute. These are hereditary, inflammatory, drug-induced neuropathies, as well as other acquired forms: with diabetes mellitus, hypothyroidism, dysproteinemia, multiple myeloma, cancer, lymphoma, etc. Most often with these diseases, especially with diabetes mellitus, an electrodiagnostic study gives a picture of mixed axonal-demyelinating processes. Very often it remains unknown which process is primary - axonal degeneration or demyelination.

Diabetic polyneuropathy

Develops in people suffering diabetes mellitus. Polyneuropathy may be the first manifestation of diabetes mellitus or occurs many years after the onset of the disease. Polyneuropathy syndrome occurs in almost half of patients with diabetes.

Treatment

Treatment of polyneuropathies depends on their type. Alpha lipolyic acid preparations (thiogamma, thioctacid, berlition, espolidone, etc.) and B vitamin complexes are often used. These drugs maximize the potential for reinnervation. For the treatment of demyelinating polyneuropathies, in addition to pharmacotherapy, agents that block pathological autoimmune mechanisms are used: the introduction of immunoglobulins and plasmapheresis. During the period of remission of the disease, comprehensive rehabilitation plays an important role.

Links

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ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. No. 170

The release of a new revision (ICD-11) is planned by WHO in 2017-2018.

With changes and additions from WHO.

Processing and translation of changes © mkb-10.com

Alcoholic polyneuropathy

Alcoholic polyneuropathy is a neurological disease that causes dysfunction of multiple peripheral nerves. The disease occurs in alcohol abusers in the later stages of alcoholism. Due to the toxic effects of alcohol and its metabolites on the nerves and the subsequent disruption of metabolic processes in the nerve fibers, pathological changes develop. The disease is classified as axonopathy with secondary demyelination.

General information

Clinical signs of the disease and their relationship with excessive alcohol consumption were described in 1787 by Lettsom, and in 1822 by Jackson.

Alcoholic polyneuropathy is detected in people who drink alcohol of any age and gender (with a slight predominance in women), and does not depend on race or nationality. On average, the distribution frequency is 1-2 cases per thousand. population (about 9% of all diseases that arise from alcohol abuse).

Forms

Depending on the clinical picture of the disease, the following are distinguished:

A sensory form of alcoholic polyneuropathy, which is characterized by pain in the distal parts of the extremities (usually the lower extremities are affected), a feeling of chilliness, numbness or burning, cramps of the calf muscles, pain in the area of large nerve trunks. The palms and feet are characterized by increased or decreased pain and temperature sensitivity of the “gloves and socks” type; segmental sensitivity disorders are possible. Sensory disorders in most cases are accompanied by vegetative-vascular disorders (hyperhidrosis, acrocyanosis, marbling of the skin on the palms and soles). Tendon and periosteal reflexes may be reduced (most often this concerns the Achilles reflex).
A motor form of alcoholic polyneuropathy, in which peripheral paresis expressed to varying degrees and a mild degree of sensory impairment are observed. Disorders usually affect the lower extremities (tibial or common peroneal nerves are affected). Damage to the tibial nerve is accompanied by impairment of plantar flexion of the feet and toes, inward rotation of the foot, and walking on toes. When the peroneal nerve is damaged, the functions of the extensors of the foot and fingers are impaired. There is muscle atrophy and hypotonia in the feet and legs (“clawed foot”). Achilles reflexes are reduced or absent, knee reflexes may be increased.
A mixed form, in which both motor and sensory disturbances are observed. With this form, flaccid paresis, paralysis of the feet or hands, pain or numbness along the large nerve trunks, increased or decreased sensitivity in the affected areas are detected. The lesion affects both the lower and upper limbs. Paresis when the lower extremities are affected are similar to the manifestations of the motor form of the disease, and when the upper extremities are affected, it is mainly the extensors that are affected. Deep reflexes are reduced and hypotension is present. The muscles of the hands and forearms atrophy.
The atactic form (peripheral pseudotabes), in which there is sensitive ataxia caused by disorders of deep sensitivity (impaired gait and coordination of movements), a feeling of numbness in the legs, decreased sensitivity of the distal limbs, absence of Achilles and knee reflexes, pain on palpation in the area of the nerve trunks.

Depending on the course of the disease, there are:

chronic form, which is characterized by slow (more than a year) progression of pathological processes (common);
acute and subacute forms (develops within a month and is observed less frequently).

In patients with chronic alcoholism, asymptomatic forms of the disease also occur.

Reasons for development

The etiology of the disease is not fully understood. According to existing data, about 76% of all cases of the disease are provoked by the reactivity of the body in the presence of alcohol dependence for 5 or more years. Alcoholic polyneuropathy develops as a result of hypothermia and other provoking factors in women more often than in men.

Also, the development of the disease is influenced by autoimmune processes, and the triggering factor is certain viruses and bacteria.

Provokes liver disease and dysfunction.

All forms of the disease develop as a result of the direct influence of ethyl alcohol and its metabolites on peripheral nerves. The development of the motor and mixed forms is also influenced by a deficiency in the body of thiamine (vitamin B1).

Thiamine hypovitaminosis in alcohol-dependent patients occurs as a result of:

insufficient intake of vitamin B1 from food;
decreased absorption of thiamine in the small intestine;
inhibition of phosphorylation processes (a type of post-translational modification of a protein), as a result of which the conversion of thiamine into thiamine pyrophosphate, which is a coenzyme (catalyst) in the catabolism of sugars and amino acids, is disrupted.

At the same time, the utilization of alcohol requires a large amount of thiamine, so drinking alcohol increases thiamine deficiency.

Ethanol and its metabolites enhance glutamate neurotoxicity (glutamate is the main excitatory neurotransmitter of the central nervous system).

The toxic effects of alcohol are supported by studies demonstrating a direct relationship between the severity of alcoholic polyneuropathy and the amount of ethanol consumed.

The condition for the development of a severe form of the disease is the increased vulnerability of the nervous tissue resulting from a hereditary predisposition.

Pathogenesis

Although the pathogenesis of the disease is not fully understood, it is known that the main target of acute form alcoholic polyneuropathy are axons (cylindrical processes of nerve cells transmitting impulses). The lesion affects thick myelinated and thin weakly myelinated or unmyelinated nerve fibers.

The increased vulnerability of nervous tissue is the result of the high sensitivity of neurons to various metabolic disorders, and especially to thiamine deficiency. Hypovitaminosis of thiamine and insufficient formation of thiamine pyrophosphate causes a decrease in the activity of a number of enzymes (PDG, α-CHCH and transketolase) involved in the catabolism of carbohydrates, the biosynthesis of certain cell elements and the synthesis of nucleic acid precursors. Infectious diseases, bleeding and a number of other factors that increase the body’s energy needs aggravate the deficiency of B vitamins, ascorbic and nicotinic acid, reduce the level of magnesium and potassium in the blood, and provoke protein deficiency.

With chronic alcohol consumption, the release of beta-endorphins from hypothalamic neurons is reduced, and the beta-endorphin response to ethanol is reduced.

Chronic alcohol intoxication causes an increase in the concentration of protein kinase, which increases the excitability of primary afferent neurons and increases the sensitivity of peripheral endings.

Alcohol damage to the peripheral nervous system also causes excessive formation of free oxygen radicals, which disrupt the activity of the endothelium (the layer of flat cells lining the inner surface of blood vessels that perform endocrine functions), cause endoneural hypoxia (endoneural cells cover the myelin sheath of the nerve fibers of the spinal cord) and lead to cell damage .

The pathological process can also affect Schwann cells, which are located along the axons of nerve fibers and perform a supporting (supporting) and nutritional function. These supporting cells of nerve tissue create the myelin sheath of neurons, but in some cases they destroy it.

In the acute form of alcoholic polyneuropathy, under the influence of pathogens, antigen-specific T and B cells are activated, which cause the appearance of antiglycolipid or antiganglioside antibodies. Under the influence of these antibodies, local inflammatory reactions develop, the set of blood plasma proteins (complement) involved in the immune response is activated, and a membrane-lytic attack complex is deposited in the area of the node of Ranvier on the myelin sheath. The result of the deposition of this complex is a rapidly increasing infection of the myelin sheath by macrophages with increased sensitivity, and subsequent destruction of the sheath.

Symptoms

In most cases, alcoholic polyneuropathy manifests itself as motor or sensory disturbances in the extremities, and in in some cases– muscle pain of various localizations. Pain may occur simultaneously with motor disturbances, sensations of numbness, tingling and “crawling” (paresthesia).

The first symptoms of the disease appear in paresthesia and muscle weakness. In half of the cases, the disorders initially affect the lower extremities, and after a few hours or days they spread to the upper extremities. Sometimes patients' arms and legs are affected at the same time.

Most patients experience:

diffuse decrease in muscle tone;
a sharp decrease, and then the absence of tendon reflexes.

There may be a violation of facial muscles, and in severe forms of the disease - urinary retention. These symptoms persist for 3-5 days, and then they disappear.

Alcoholic polyneuropathy in the advanced stage of the disease is characterized by the presence of:

Paresis expressed in varying degrees. Paralysis is possible.
Muscle weakness in the limbs. It can be either symmetrical or unilateral.
Sharp inhibition of tendon reflexes, progressing to complete extinction.
Surface sensitivity disorders (increased or decreased). They are usually weakly expressed and belong to the polyneuritic type (“socks”, etc.).

Severe cases of the disease are also characterized by:

Weakening of the respiratory muscles, requiring mechanical ventilation.
Severe damage to joint-muscular and deep vibration sensitivity. Observed in% of patients.
Damage to the autonomic nervous system, which is manifested by sinus tachycardia or bradycardia, arrhythmia and a sharp drop in blood pressure.
Presence of hyperhidrosis.

Pain in alcoholic polyneuropathy is more common in forms of the disease that are not associated with thiamine deficiency. It can be aching or burning in nature and localized in the foot area, but more often it is radicular in nature, in which pain is localized along the affected nerve.

In severe cases of the disease, damage to the II, III and X pairs of cranial nerves is observed.

The most severe cases are characterized by mental disorders.

Alcoholic polyneuropathy of the lower extremities is accompanied by:

changes in gait as a result of impaired sensitivity of the legs (“splashing” gait, legs rise high during motor form);
impairment of plantar flexion of the feet and toes, inward rotation of the foot, drooping and turning of the foot inward in the motor form of the disease;
weakness or absence of tendon reflexes in the legs;
paresis and paralysis in severe cases;
blue or marbling of the skin of the legs, reduction of hair on the legs;
coldness of the lower extremities with normal blood flow;
hyperpigmentation of the skin and the appearance of trophic ulcers;
pain that intensifies when pressing on the nerve trunks.

Painful phenomena can increase over weeks or even months, after which a stationary stage begins. With adequate treatment, the stage of reverse development of the disease occurs.

Diagnostics

Alcoholic polyneuropathy is diagnosed based on:

Clinical picture of the disease. Diagnostic criteria are progressive muscle weakness in more than one limb, relative symmetry of the lesions, the presence of tendon areflexia, sensory disorders, rapid increase in symptoms and cessation of their development in the 4th week of the disease.
Electroneuromyography data, which can detect signs of axonal degeneration and destruction of the myelin sheath.
Laboratory methods. Includes cerebrospinal fluid analysis and nerve fiber biopsy to exclude diabetic and uremic polyneuropathy.

In doubtful cases, MRI and CT are performed to exclude other diseases.

Treatment

Treatment of alcoholic polyneuropathy of the lower extremities includes:

Complete abstinence from alcohol and proper nutrition.
Physiotherapeutic procedures involving electrical stimulation of nerve fibers and the spinal cord. Magnetic therapy and acupuncture are also used.
Physical therapy and massage to restore muscle tone.
Drug treatment.

At drug treatment are appointed:

B vitamins (intravenously or intramuscularly), vitamin C;
pentoxifylline or cytoflavin, which improves microcirculation;
antihypoxants that improve oxygen utilization and increase resistance to oxygen deficiency (Actovegin);
neuromedin, which improves neuromuscular conduction;
to reduce pain - non-steroidal anti-inflammatory drugs (diclofenac), antidepressants, antiepileptic drugs;
to eliminate persistent sensory and motor disorders - anticholinesterase drugs;
cerebral gangliosides and nucleotide preparations that improve the excitability of nerve fibers.

In the presence of toxic liver damage, hepatoprotectors are used.

Symptomatic therapy is used to correct autonomic disorders.

Comments 3

Alcoholic polyneuropathy is a common complication of alcohol abuse. As a doctor, I can say that this is a very dangerous complication. And it is dangerous, among other things, because it sneaks up unnoticed and often until the very end the patient does not understand that he is already sick. It is no longer worth doing sports, especially active ones - only exercise therapy, swimming, massages, physiotherapy. Drug therapy is mandatory - B vitamins such as neuromultivit or combilipen, thioctic acid preparations (thioctacid bv), possibly neuromedin, if indicated.

Doctor Belyaeva, my sister is sick, she has fear, frequent urges (sometimes with an interval of 2 minutes), but of course she doesn’t go to the toilet, she’s afraid to eat, she constantly says that she’s dying, but she eats everything, she walks along the wall (to the toilet), what do you recommend?

My sister is sick, she has fear, frequent urges, although she doesn’t want to go to the toilet and immediately forgets, she walks “on the wall.”

Polyneuropathy

Classification

By etiology

Inflammatory
Toxic
Allergic
Traumatic

According to the pathomorphology of the injury

Axonal
Demyelinating

According to the nature of the flow

Acute
Subacute
Chronic

Axonal polyneuropathies (axonopathies)

Acute axonal polyneuropathies

Most often associated with suicidal or criminal poisonings and occur against the background of a picture of severe intoxication with arsenic, organophosphorus compounds, methyl alcohol, carbon monoxide, etc. The clinical picture of polyneuropathies usually develops within 2-4 days, and then recovery occurs within several weeks .

Subacute axonal polyneuropathies

They develop over several weeks, which is typical for many cases of toxic and metabolic neuropathies, but even more of the latter last for months.

Chronic axonal polyneuropathies

Demyelinating polyneuropathies (myelinopathies)

Acute inflammatory dimyelinating polyradiculoneuropathy (Guillain-Barré syndrome)

Diphtheria polyneuropathy

1-2 weeks after the onset of the disease, signs of damage to the cranial nerves of the bulbar group may appear: paresis of the soft palate, tongue, phonation disorder, swallowing; Possible breathing problems, especially if the phrenic nerve is involved in the process. Damage to the vagus nerve can cause bradycardia, tachycardia, and arrhythmia. The oculomotor nerves are often involved in the process, which is manifested by accommodation disorder. Less commonly observed is paresis of the external ocular muscles innervated by the III, IV and VI cranial nerves. Polyneuropathy in the extremities usually manifests itself as late (at 3-4 weeks) flaccid paresis with a disorder of superficial and deep sensitivity, which leads to sensory ataxia. Sometimes the only manifestation of late diphtheria polyneuropathy is loss of tendon reflexes.

Subacute demyelinating polyneuropathies

Chronic demyelinating polyneuropathies

Diabetic polyneuropathy

Develops in people with diabetes. Polyneuropathy may be the first manifestation of diabetes mellitus or occurs many years after the onset of the disease. Polyneuropathy syndrome occurs in almost half of patients with diabetes.

Treatment

Diabetic polyneuropathy code according to ICD-10

Polyneuropathy is a complex of diseases that includes multiple lesions of peripheral nerves. The disease most often progresses to a chronic stage and has an ascending path of spread, that is, the process initially affects small fibers and gradually covers increasingly larger branches.

The classification of polyneuropathy according to ICD 10 is officially recognized, but does not take into account the individual characteristics of the course and does not describe treatment tactics.

Symptoms and diagnosis

The clinical picture is primarily based on disorders of the musculoskeletal system and the cardiovascular system. The patient complains of muscle pain, weakness, cramps and lack of ability to move normally (paresis of the lower extremities). Added to the general symptoms are increased heart rate (tachycardia), jumps in blood pressure, dizziness and headaches due to changes in vascular tone and improper blood supply to the central nervous system.

When the patient’s health deteriorates, the muscles completely atrophy, the person mostly lies down, which negatively affects the nutrition of the soft tissues. Sometimes necrosis develops.

Initially, the doctor is obliged to listen to all the patient’s complaints, conduct a general examination, check tendon reflexes and skin sensitivity using special instruments.

Of the modern instrumental methods, electroneuromyography and nerve biopsy are preferable.

Treatment

In order to avoid the development of complications, a high-calorie diet (in the absence of contraindications), a complex of vitamins and minerals that restore the functioning of the immune system and cell trophism are prescribed.

To relieve symptoms, painkillers, antihypertensive drugs, and muscle stimulants are used.

What does polyneuropathy of the lower extremities mean and what are the treatment features?

Polyneuropathy of the lower extremities is a common pathology associated with damage to peripheral nerves. The disease is characterized by trophic and vegetative-vascular disorders affecting the lower extremities, manifested by sensory disturbances and flaccid paralysis.

The danger of the pathology is that over time its manifestations worsen, problems with movement arise, which affects the ability to work and interferes with a full life. Today we will talk about the symptoms and treatment of polyneuropathy of the lower extremities, and also consider methods aimed at preventing further progression of the pathology.

Polyneuropathy of the lower extremities - why does it occur?

Polyneuropathy of the lower extremities is not an independent disease. According to ICD 10, this condition is considered a neurological syndrome that accompanies a variety of diseases:

diabetes mellitus (diabetic polyneuropathy of the lower extremities);
chronic alcohol intoxication (alcoholic polyneuropathy of the lower extremities);
vitamin deficiencies (especially with a lack of vitamin B);
severe poisoning with drugs, arsenic, lead carbon monoxide, methyl alcohol (acute axonal polyneuropathy);
systemic diseases - biliary cirrhosis, malignant tumors, lymphoma, blood diseases, kidney diseases (chronic axonal polyneuropathy);
infectious diseases (diphtheria polyneuropathy);
hereditary and autoimmune pathologies (demyelinating polyneuropathies).

The cause of the disease can be a wide variety of health disorders and chronic diseases. Cancerous tumors can disrupt the functioning of the peripheral nervous system. In addition, signs of polyneuropathy may appear after a course of chemotherapy.

Infectious and inflammatory processes in the joints and any types of intoxication of the body (drugs, alcohol, chemicals) can cause problems with impaired sensitivity and damage to nerve fibers. In children, this disease is most often hereditary; for example, symptoms of porphyritic polyneuropathy appear in a child immediately after birth.

Thus, doctors divide all the factors that provoke the development of a pathological condition into several groups:

metabolic (associated with metabolic disorders);
hereditary;
autoimmune;
infectious-toxic;
toxic;
nutritional (caused by dietary errors).

Polyneuropathy never occurs as an independent disease; damage to nerve fibers is always associated with an etiological factor that negatively affects the state of the peripheral nervous system.

Clinical picture

Polyneuropathy of the upper and lower extremities begins with increasing muscle weakness, which is associated with developing damage to the nerve fibers. The distal parts of the limbs are damaged first. In this case, a feeling of numbness occurs in the area of the feet and gradually spreads to the entire leg.

Patients with polyneuropathy complain of a burning sensation, crawling, tingling, and numbness of the limbs. Various types of paresthesia are complicated by muscle pain. As symptoms increase, patients experience severe discomfort even when accidentally touching the problem area. In the later stages of the disease, there is unsteadiness of gait, loss of coordination of movements, and a complete lack of sensitivity in the area of damage to nerve fibers.

Muscular atrophy is expressed in weakness of the arms and legs and in severe cases can result in paresis or paralysis. Sometimes unpleasant sensations in the limbs occur at rest, causing reflex movements. Doctors characterize such manifestations as “restless legs syndrome.”

The pathology is accompanied by autonomic disorders, which are manifested by vascular disorders (a feeling of cold in the affected limbs, marbled pallor of the skin) or trophic lesions (ulcers and cracks, peeling and dry skin, the appearance of pigmentation).

Manifestations of polyneuropathy are difficult to miss; as the pathology progresses, they become obvious not only to the patient, but also to the people around him. The gait changes and becomes heavier, as the legs become “wobbly”, difficulties arise with movement, the person has difficulty covering even short distances that he previously covered in a few minutes. As the pathology progresses, the feeling of numbness in the limbs increases. A pain syndrome occurs, which manifests itself in different ways; some patients feel only minor discomfort, while others complain of aching or sharp, burning pain.

Patients experience swelling of the extremities, impaired knee reflexes, and lack of response to stimuli. In this case, only one or several characteristic symptoms may appear, it all depends on the severity of the damage to a particular nerve trunk.

Classification

According to the nature of the course, polyneuropathy of the lower extremities can be:

Spicy. It develops within 2-3 days most often against the background of severe poisoning with medications, methyl alcohol, mercury salts, and lead. Treatment takes on average 10 days.
Subacute. Symptoms of the lesion increase gradually over a couple of weeks. Pathology usually occurs against the background of toxicosis or metabolic disorders and requires long-term treatment.
Chronic. This form of the disease progresses against the background of diabetes, alcoholism, hypovitaminosis, blood diseases or oncology. It develops gradually over a long period of time (from six months or longer).

Taking into account the damage to nerve fibers, polyneuropathy is divided into several types:

Motor (motor). The neurons responsible for movement are damaged, as a result of which motor functions become difficult or completely lost.
Sensory polyneuropathy of the lower extremities. Nerve fibers directly related to sensitivity are damaged. As a result, painful, stabbing sensations occur even with a light touch to the problem area.
Vegetative. There is a violation of regulatory functions, which is accompanied by such manifestations as hypothermia, severe weakness, profuse sweating.
Mixed neuropathy of the lower extremities. This form includes a variety of symptoms from all of the above conditions.

Depending on the damage to cellular nerve structures, polyneuropathy can be:

Axonal. The axial cylinder of nerve fibers is affected, which leads to decreased sensitivity and impaired motor functions.
Demyelinating. Myelin, which forms the sheath of the nerves, is destroyed, resulting in a pain syndrome accompanied by inflammation of the nerve roots and weakness of the muscles of the proximal and distal parts of the extremities.

The demyelinating form of polyneuropathy is the most severe form of the disease, the mechanism of development of which is still not fully understood. However, as a result of a number of studies, scientists have put forward a theory about the autoimmune nature of the pathology. In this case, the human immune system perceives its own cells as foreign and produces specific antibodies that attack the roots of nerve cells, destroying their myelin sheaths. As a result, nerve fibers lose their functions and provoke innervation and muscle weakness.

Diagnostics

If polyneuropathy is suspected, the patient will have to undergo a series of diagnostic procedures, including laboratory and instrumental studies. After collecting an anamnesis, the doctor will conduct an external examination, examine reflexes, and then send the patient to the laboratory to donate blood for a general and biochemical analysis.

In addition, the patient will undergo an ultrasound internal organs, X-ray of the affected areas, cerebrospinal fluid will be collected. If necessary, a biopsy of nerve fibers will be taken for examination. The choice of treatment regimen begins only after a full examination and diagnosis.

Treatment

The basis of therapeutic measures for polyneuropathy is a combination of medication and physiotherapeutic methods aimed at preventing the progression of pathology and restoring impaired innervation of nerve fibers. Treatment methods will largely depend on the cause contributing to the development of the pathology.

If severe chronic diseases are to blame, first of all they treat the underlying disease. Thus, for diabetic polyneuropathy, drugs are selected that will not affect the level of the glycemic index, and the therapy itself is carried out in stages. First, the diet is adjusted, body weight is normalized, and a complex of therapeutic exercises is developed for the patient. Subsequently, neurotropic vitamins and alpha-lipoic acid injections are included in the treatment regimen, immunosuppressive drugs and glucocorticoids are prescribed.

If the disease is of a toxic nature, detoxification measures are carried out first, after which the necessary medications are prescribed. If the pathology develops against the background of dysfunction of the thyroid gland, the treatment process uses hormonal drugs. Malignant neoplasms are treated surgically, removing the tumor that compresses the nerve roots.

To develop limbs and eliminate movement disorders, methods of physical therapy (physical therapy) are used. B vitamins help restore sensitivity; to relieve pain, analgesics are prescribed in the form of ointments, tablets or injections.

Main groups of drugs for the treatment of polyneuropathy

Metabolic agents

These are the drugs of first choice in the treatment of polyneuropathy; their therapeutic effect is aimed at improving blood circulation in the area of damage, improving tissue trophism and regeneration of nerve fibers. Most often, medications from this list are included in the treatment regimen:

The action of the drugs is aimed at improving neuromuscular conduction, accelerating metabolism, and improving the supply of tissues with blood and oxygen. Metabolic agents can have an antioxidant effect, fight free radicals, stop the processes of destruction of nervous tissue and help restore impaired functions.

Vitamin complexes

During treatment important role allocated to B vitamins (B1, B12, B6). Preference is given to combination drugs that are released in tablet form or as injections. Among the injection forms most often prescribed:

In addition to the optimal set of vitamins, these medications include lidocaine, which additionally provides an analgesic effect. After a course of injections, vitamin preparations are prescribed in tablet form - Neuromultivit, Neurobion, Keltican.

Painkillers

In case of polyneuropathy, the use of conventional painkillers (Analgin, Pentalgin, Sedalgin) does not help desired effect. Previously, lidocaine injections were prescribed to relieve pain. But its use provoked surges in blood pressure and heart rhythm disturbances. Today, a safer option has been developed that allows the anesthetic to be applied topically. To relieve pain, it is recommended to use the Versatis patch, which is based on lidocaine. It is simply fixed to the problem area, which allows you to achieve pain relief without irritation or adverse reactions.

If the pain syndrome has a clear localization, you can use local agents - ointments and gels with an anesthetic effect (for example, Capsicum).

Anticonvulsants - Gabapentin, Neurontin, Lyrica, which are produced in the form of capsules or tablets, cope well with the manifestations of pain syndrome. Taking such drugs begins with minimal doses, gradually increasing the volume of the medicine. The therapeutic effect is not immediate, it accumulates gradually. The effectiveness of the drug can be judged no earlier than 1-2 weeks from the start of administration.

In severe cases, when the pain cannot be relieved by the above remedies, opioid analgesics (Tramadol) are prescribed in combination with the drug Zaldiar. If necessary, your doctor may prescribe antidepressants. Most often, Amitriptyline is prescribed; if it is poorly tolerated, Ludiomil or Venlaxor are prescribed.

Medicines that improve nerve conduction

In the process of treating polyneuropathy, drugs that improve the conduction of nerve impulses to the arms and legs must be used. Tablets or injections of Axamon, Amiridin or Neuromidin help restore sensitivity. The course of therapy with these drugs is quite long - at least a month.

During the treatment process, the doctor can combine different groups of drugs to achieve the most pronounced therapeutic effect.

Physiotherapy methods

Along with physical therapy methods, the composition complex treatment polyneuropathy necessarily includes physiotherapeutic procedures. The doctor may recommend the following methods:

darsonvalization;
ultratonotherapy;
taking galvanic baths;
paraffin or ozokerite applications;
medicinal electrophoresis;
massotherapy;
underwater shower-massage.

The patient must undergo therapeutic exercises under the guidance of an experienced instructor, who will individually select a rehabilitation program and conduct health-improving classes.

Regular courses of physiotherapy will help restore muscle tone, restore lost sensitivity, improve the supply of tissues with oxygen and nutrients, activate nerve conduction and literally put the patient on his feet.

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Before using medications, consult your doctor!

The spread of this disease is very high, in the initial stages it can be treated, otherwise it can lead to problems with breathing, heart function and limited mobility.

What is alcoholic polyneuropathy

The long-term toxic effects of alcohol do not go unnoticed for an addicted person. All systems of the body are negatively affected. From the side of interconnected nervous structures, the reaction to systematic alcohol consumption is the emergence of a dangerous disease. Alcoholic polyneuropathy is a disease that is caused by chronic alcohol abuse, which leads to disruption and pathological changes in metabolic processes.

Alcoholic polyneuropathy code according to ICD 10

Decreased sensitivity of nerve endings is the result of prolonged consumption of alcoholic beverages. The toxic effect of alcohol provokes the development of pathological changes in the metabolic processes of nerve fibers. Since the disease is widespread throughout the world, and certain methods are used to treat it, according to international rules it has a certain labeling. The code for alcoholic polyneuropathy according to ICD 10 is G 62.1; behind these symbols is the name of the disease of the same name, which is characterized by dysfunction of the peripheral nerves.

Symptoms of polyneuropathy

Toxic neuropathy or atrophy of the muscles of the limbs makes itself felt gradually with slight numbness and a tingling sensation. The first symptoms of polyneuropathy do not cause much concern for some time, but if the development of the neurological disease is not stopped and the fight is not started, this will inevitably lead to paralysis of the legs and speech disorder. The main signs of toxic polyneuropathy are as follows:

muscle tension, slight numbness of the limbs;
weakness in the legs;
convulsions;
excessive sweating;
cyanosis of hands and feet;
speech disorder;
dry skin, the appearance of ulcers;
burning sensation;
disorientation.

Causes of polyneuropathy

The appearance of such disturbances in the functioning of the nervous system can provoke other diseases. The clinical picture of the disease is similar, but it is caused by different reasons polyneuropathy. Overdose of drugs, diabetes mellitus, cancer, chemical poisoning, epilepsy - this is what can be a source of development of pathological changes. If it is alcoholic neuropathy, then the following factors contribute to the development of the neurological disease:

metabolic disorders in nerve fibers;
long-term toxic effects of ethyl alcohol;
liver dysfunction;
lack of B vitamins;
prolonged squeezing in a monotonous position while intoxicated;
the presence of a gene that affects the process of ethanol breakdown and the formation of enzymes that have a destructive effect on the entire nervous system of the body.

Forms of alcoholic polyneuropathy

Pathological changes can be asymptomatic, and yet these are rare cases among patients with alcoholism. More often observed forms are chronic (more than a year) and acute (month), which serve not only as evidence of the presence of the disease, but also as confirmation of the progressive nature of the process. Based on the clinical picture of the disease, in medicine it is customary to distinguish between the following forms of alcoholic polyneuropathy:

Motor. It is characterized by sensory disturbances (mild), peripheral paresis ( varying degrees), damage to the lower extremities, which accompanies impaired flexion of the fingers, rotation of the foot, and decreased Achilles reflex.
Sensory. Reduced temperature, pain sensitivity of the extremities, numbness, convulsions, feeling of chilliness, marbling of the skin, vegetative changes - all this characteristic features, which indicate sensory impairment.
Atactic. It is indicated by a lack of coordination of movements, numbness of the legs, a staggering gait, painful sensations when palpating the nerve trunks, and the absence of a tendon reflex.
Mixed. It is a combination of motor and sensory disorders, and this manifests itself through numbness, pain, flaccid paresis, paralysis of the upper and lower extremities. This form may be accompanied by such signs as atrophy of the muscles of the forearm and hand, decreased deep reflexes, and hypotension.

Diagnosis of alcoholic polyneuropathy

The main method of confirming the diagnosis is electroneuromyography (ENMG), which is used on early stages. Diagnosis of alcoholic polyneuropathy in severe cases involves a biopsy of nerve fibers; in addition, this method is used when it is necessary to exclude other types of disease: is polyneuropathy toxic or diabetic? An examination using ENMG helps to determine the severity of the damage, how much the neuron, root, nerve, and muscles are affected, but first the neurologist must conduct an objective examination and collect an anamnesis.

Treatment of polyneuropathy

A neurological disease can manifest itself either after a long period of heavy drinking, or against the background of gradual toxic effects over a long period of time. Taking these factors into account, treatment of polyneuropathy will proceed in different directions, but any therapy will involve a complete cessation of alcohol consumption and increased attention to nutrition. To improve microcirculation, neuromuscular conduction, and pain, the doctor may prescribe antihypoxants, analgesics, anti-inflammatory drugs, antioxidants, and B vitamins.

Treatment of neuropathy of the lower extremities with drugs

It will be easier to achieve a full recovery if the disease is diagnosed in the early stages. Treatment of neuropathy of the lower extremities with drugs is aimed at restoring the functions of nerve fibers and improving blood circulation in the area of nerve endings. The subtlety of therapy lies in identifying the true causes of the disease, taking into account the individual characteristics of the patient’s body, for example, a predisposition to allergic reactions.

To improve the patient’s condition, when toxic polyneuropathy of the lower extremities is correctly diagnosed, the following types of therapy are used:

medication with the prescription of a course of vasoactive drugs (Emoxipine, Vasonit, Nicotinic acid, Instenon);
use of antidepressants (Mexidol, Actovegin, Sertraline, Berlition, Venlafaxine);
a course of B vitamins, Benfotiamine, Thiamine to replenish the deficiency;
taking painkillers non-steroidal anti-inflammatory drugs (Nimesulide, Ketoprofen, Meloxicam);
anticonvulsants (Gabapentin, Pregabalin);
use ointments and creams for local anesthesia (Ketoprofen, Diclofenac, Finalgon, Capsicam, Capsaicin).

Non-drug methods

Treatment methods other than medications can also help speed up the healing process. Physiotherapeutic procedures have formed the basis of a non-drug method of treating toxic polyneuropathy; among them, electrical stimulation of nerve fibers, the spinal cord, and magnetic therapy have been successfully used. Research shows the effectiveness of massage in helping to restore muscle activity. The list of comprehensive measures should include physical therapy, mud therapy, and acupuncture.

Combining medicinal, non-medicinal, and traditional methods of treatment allows you to achieve excellent results and speed up recovery. The treatment will be helped by a freshly prepared cocktail of kefir (150 grams), parsley, sunflower seeds (2 tablespoons each), which is taken an hour before meals twice a day. A powerful natural antioxidant - cinnamon - goes perfectly with oregano and honey. To prepare a healthy decoction, you need to take all the ingredients in equal proportions, mix and take 1 teaspoon three times a day with a glass of warm water.

Prognosis of polyneuropathy

An advanced form of the disease or untimely initiation of treatment leads to disability, so it is necessary to start therapy and decide on a treatment regimen on time. A favorable prognosis for polyneuropathy with possible complete recovery is observed only in those patients who promptly consulted a doctor and underwent a course of therapy. It will not be possible to recover from a neurological disease in a short time; to achieve the desired goal, you will have to apply perseverance, adhere to proper nutrition, and avoid drinking any alcoholic beverages.

Video: Alcoholic polyneuropathy of the lower extremities

The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment based on the individual characteristics of a particular patient.

Other polyneuropathies (G62)

In Russia, the International Classification of Diseases, 10th revision (ICD-10) has been adopted as a single normative document for recording morbidity, reasons for the population's visits to medical institutions of all departments, and causes of death.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. No. 170

The release of a new revision (ICD-11) is planned by WHO in 2017-2018.

With changes and additions from WHO.

Processing and translation of changes © mkb-10.com

What kind of disease is diabetic polyneuropathy: ICD-10 code, clinical picture and treatment methods

Polyneuropathy is a complex of diseases that includes the so-called multiple lesions of peripheral nerves.

The disease usually develops into a so-called chronic form and has an ascending path of spread, that is, this process initially affects the smallest fibers and slowly spreads to larger branches.

This pathological condition called diabetic polyneuropathy ICD-10 is encoded and divided depending on the origin and course of the disease into the following groups: inflammatory and other polyneuropathies. So what is diabetic polyneuropathy according to the ICD?

What it is?

Polyneuropathy is a so-called complication of diabetes mellitus, the whole point of which is complete damage to the vulnerable nervous system.

Nerve damage due to polyneuropathy

Usually it manifests itself after an impressive period of time, which has passed since the diagnosis of disturbances in the functioning of the endocrine system. More precisely, the disease may appear twenty-five years after the onset of problems with insulin production in humans.

But, there were cases when the disease was discovered in patients of endocrinologists within five years from the moment the pathologies were detected by the pancreas. The risk of getting sick is the same in patients with diabetes, both type 1 and type 2.

Causes

As a rule, with a prolonged course of the disease and fairly frequent fluctuations in sugar levels, metabolic disorders are diagnosed in all organs and systems of the body.

Moreover, it is the nervous system that suffers first. As a rule, nerve fibers feed the smallest blood vessels.

Under the prolonged influence of carbohydrates, a so-called nerve nutrition disorder appears. As a result, they fall into a state of hypoxia and, as a result, primary symptoms of the disease appear.

With its subsequent course and frequent decompensations, existing problems with the nervous system become significantly more complicated, which gradually become irreversible and chronic.

Diabetic polyneuropathy of the lower extremities according to ICD-10

This diagnosis is most often heard by patients who suffer from diabetes.

This disease affects the body when the peripheral system and its fibers are significantly disrupted. It can be triggered by a variety of factors.

As a rule, middle-aged people are primarily affected. It is noteworthy that men get sick much more often. It is also worth noting that polyneuropathy is not uncommon in children preschool age and teenagers.

Diabetic polyneuropathy, whose ICD-10 code is E10-E14, usually affects the upper and lower extremities of a person. As a result, sensitivity and performance are significantly reduced, limbs become asymmetrical, and blood circulation also significantly deteriorates. As you know, the main feature of this disease is that, spreading throughout the body, it first affects the long nerve fibers. Therefore, it is not at all surprising why the feet suffer first.

Signs

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The disease, manifesting mainly in the lower extremities, has a large number of symptoms:

feeling of severe numbness in the legs;
swelling of the feet and legs;
unbearable pain and stabbing sensations;
muscle weakness;
increase or decrease in sensitivity of the limbs.

Each form of neuropathy has separate symptoms:

diabetic in the early stages. It is characterized by numbness of the lower extremities, a feeling of tingling and severe burning in them. There is barely noticeable pain in the feet, ankle joints, and also in the calf muscles. As a rule, it is at night that symptoms become more vivid and pronounced;
diabetic in later stages. If it is present, the following alarming symptoms are noted: unbearable pain in the lower extremities, which can also appear even at rest, weakness, muscle atrophy and changes in skin pigmentation. With the gradual development of the disease, the condition of the nails worsens, as a result of which they become more brittle, thicken or completely atrophy. The patient also develops a so-called diabetic foot: it increases significantly in size, flat feet, ankle deformity appear, and neuropathic edema develops;
diabetic encephalopolyneuropathy. It is characterized by the following symptoms: persistent severe headaches, immediate fatigue and increased fatigue;
toxic and alcoholic. It is characterized by the following pronounced symptoms: cramps, numbness of the legs, significant loss of sensation in the feet, weakening of the tendons and muscle reflexes, a change in the shade of the skin to bluish or brown, a decrease in hair growth and a decrease in temperature in the legs, which does not depend in any way on the blood flow. As a result, trophic ulcers and swelling of the legs are formed.

Diagnostics

Since one type of study cannot show the complete picture, diabetic polyneuropathy is diagnosed according to the ICD-10 code using several popular methods:

As a rule, the first research method consists of a detailed examination by several specialists: a neurologist, a surgeon and an endocrinologist.

The first doctor studies external symptoms, such as: blood pressure in the lower extremities and their increased sensitivity, the presence of all necessary reflexes, checking for swelling and studying the condition of the skin.

As for laboratory testing, this includes: urine analysis, concentration of glucose in the blood plasma, cholesterol, as well as determination of the level of toxic substances in the body if toxic neuropathy is suspected.

But instrumental diagnosis of the presence of diabetic polyneuropathy in the patient’s body according to ICD-10 involves MRI, as well as electroneuromyography and nerve biopsy.

Treatment

It is important to remember that treatment must be comprehensive and mixed. It must certainly include certain medications that are aimed at all areas of the development of the process.

It is very important that treatment includes taking these medications:

vitamins. They must enter the body along with food. Thanks to them, the transport of impulses along the nerves is improved, and the negative effects of glucose on the nerves are blocked;
alpha lipoic acid. It prevents the accumulation of sugar in the nervous tissue, activating certain groups of enzymes in the cells and restoring already damaged nerves;
painkillers;
aldose reductase inhibitors. They will interfere with one of the pathways of transformation of sugar in the blood, thereby reducing its effect on nerve endings;
Actovegin. It promotes the use of glucose, improves blood microcirculation in the arteries, veins and capillaries that nourish the nerves, and also prevents the death of nerve cells;
potassium and calcium. These substances have the property of reducing cramps and numbness in human limbs;
antibiotics. Their use may be necessary only when there is a risk of developing gangrene.

Based on what particular form of diabetic polyneuropathy ICD-10 is detected, the attending doctor prescribes professional treatment that completely eliminates the symptoms of the disease. In this case, one can hope for a complete cure.

A competent specialist prescribes both drug and non-drug treatment.

It is very important to first significantly lower your blood sugar levels and only then begin treatment for diabetic polyneuropathy according to the ICD. If this is not done, then all efforts will be completely ineffective.

In case of a toxic form, it is very important to completely exclude alcoholic drinks and follow a strict diet. The attending physician must prescribe special medications that improve blood microcirculation and prevent the formation of blood clots. It is also very important to get rid of swelling.

Video on the topic

Candidate of Medical Sciences on polyneuropathy in patients with diabetes:

As you can understand from all the information presented in the article, diabetic neuropathy is quite treatable. The most important thing is not to start this process. The disease has pronounced symptoms that are difficult to miss, so with a reasonable approach you can get rid of it fairly quickly. After detecting the first alarming symptoms, it is important to undergo a full medical examination, which will confirm the suspected diagnosis. Only after this can you proceed to treatment of the disease.

Eliminates the causes of pressure disorders
Normalizes blood pressure within 10 minutes after administration

Diabetic polyneuropathy code according to ICD-10

ICD 10 encodes this pathology and divides it into the following groups depending on the etiology and course of the disease:

Symptoms and diagnosis

The clinical picture is primarily based on disorders of the musculoskeletal system and the cardiovascular system. The patient complains of muscle pain, weakness, cramps and lack of ability to move normally (paresis of the lower extremities). Added to the general symptoms are increased heart rate (tachycardia), jumps in blood pressure, dizziness and headaches due to changes in vascular tone and improper blood supply to the central nervous system.

When the patient’s health deteriorates, the muscles completely atrophy, the person mostly lies down, which negatively affects the nutrition of the soft tissues. Sometimes necrosis develops.

Initially, the doctor is obliged to listen to all the patient’s complaints, conduct a general examination, check tendon reflexes and skin sensitivity using special instruments.

Of the modern instrumental methods, electroneuromyography and nerve biopsy are preferable.

Treatment

To relieve symptoms, painkillers, antihypertensive drugs, and muscle stimulants are used.

What is polyneuropathy? Symptoms and treatment of lesions of the neuromuscular system

1. Basic concepts 2. Causes of the disease 3. Classification 4. Clinical manifestations disease 5. Treatment

Polyneuropathies (polyneuropathies) are a broad group of diseases manifested by damage to the neuromuscular system. Moreover, the pathology is common not only among diseases of the nervous system, but is also considered as a complication of a number of somatic diseases, intoxications and vitamin deficiencies.

In neurological practice, the proportion of polyneuropathies among all diseases of the peripheral nervous system is 60%. Moreover, approximately one quarter of the patients in the neurological department are being treated for this particular pathology. A long-term relapsing course and the presence of a pronounced neurological deficit quite often causes the patient’s loss of ability to work, even disability, and a decrease in his quality of life. Treatment of polyneuropathy, due to the characteristics of its pathogenesis, also presents a number of difficulties. Progressive and chronic forms are especially difficult to treat. All these points determine the significance of multiple damage to peripheral nerves as a medical and social problem.

Basic Concepts

Polyneuropathy is multiple lesions of peripheral nerves, mainly their distal segments. When the roots of the spinal and cranial nerves are involved in the pathological process, the diagnosis sounds like “polyradiculoneuropathy.” The disease most often represents damage to both motor and sensory fibers. The root causes of such disorders are exogenous intoxication or endogenous disruption of metabolic processes. The lesion is predominantly symmetrical.

The development of polyneuropathy is associated with the impact on the human body of factors that can lead to changes in the connective tissue interstitium, myelin sheath and axial cylinder. These include:

infectious and toxic factors;
metabolic disorders;
dystrophic processes;
metabolic disorders;
ischemic influences;
mechanical damage.

Damage to peripheral nerves may be caused by one or more of these factors.

Polyneuropathies have an ambiguous prognosis for recovery - there are options from complete restoration of the functional activity of peripheral nerves to death due to the development of acute respiratory failure.

IN international classification diseases of the 10th revision of polyneuropathy are encrypted with the codes “inflammatory polyneuropathy” and “other polyneuropathies” (ICD 10 code G61 and G62, respectively). Inflammatory ones include Guillain-Barré syndrome (acute infectious polyradiculoneuropathy), serum neuropathy, other inflammatory polyneuropathies and unspecified inflammatory polyneuropathy. Code G62 includes medicinal, alcoholic, toxic, other specified and unspecified polyneuropathies.

Causes of the disease

The distal peripheral nerve, due to the peculiarities of its histological structure, is most vulnerable to the damaging influence of pathological factors. It is the nerve fibers of the hands and feet that are most susceptible to tissue hypoxia and are the first to respond to dysmetabolic changes in the body.

The following can be considered as a trigger for the development of peripheral nerve damage:

acute and chronic intoxication;
infectious diseases (both viral and bacterial);
connective tissue diseases;
vitamin deficiencies;
tumor processes (paraneoplastic polyneuropathy is formed);
somatic diseases (including pathology of the endocrine system);
administration of serums, vaccines and drugs;
hereditary factors.

Despite the fact that polyneuropathy occurs in children in a lower percentage of cases than among adults, common reasons Their development is caused by childhood infections (measles, rubella, chicken pox). At the same time, a child under 5 years of age and an adult have a greater risk of damage to the peripheral nervous system after suffering from these diseases. However, in the vast majority of cases, polyneuropathy is complicated by diseases such as diabetes mellitus and chronic alcoholism.

When collecting anamnesis, it is necessary to pay attention to information about past infections, taking medications, working in hazardous enterprises or with toxic substances (varnishes, paints), habitual alcohol consumption, and latent somatic diseases.

Classification

Depending on the mechanism of damaging action, polyneuropathies are divided into axonal and demyelinating. In the first case, the axial cylinder of the peripheral nerve is initially affected. During demyelinating processes, Schwann cells (myelin sheath) are damaged. Demyelinating processes have a more favorable prognosis compared to axonopathies.

The form of the disease is determined by the duration of its course. Highlight:

Acute polyneuropathy (symptoms subside within a week from the onset of neurological deficit);
Subacute (lasting no more than a month);
Chronic (disease manifestations last more than 30 days);
Progressive (developing gradually over 3-5 years).

There is a classification of polyneuropathies depending on of various etiologies diseases. There are inflammatory, toxic, allergic, traumatic polyneuropathies (polyradiculoneuropathy). Therapeutic measures are primarily based on identifying the leading trigger mechanism. Polyneuropathy, the causes of which cannot be determined, is considered unspecified, in which case the attending physician prescribes undifferentiated treatment. The genesis of the disease must be reflected in the diagnosis.

Clinical manifestations of the disease

The clinical manifestations of polyneuropathies will depend on the form of the disease. Anamnestic history establishes the period preceding the disease, during which the person was exposed to the influence of any unfavorable factor (toxic, infectious, mechanical, and so on).

If we are talking about axonopathies at the onset of the disease, as a rule, subacute - the symptoms of polyneuropathy increase gradually. The distal parts of the lower extremities are the first to be affected. There is a decrease in deep and superficial sensitivity of the “glove” and “sock” type (areas of hypoesthesia are highlighted in the photo). In another way, such a sensitivity disorder is called polyneuropathic or polyneuritic.

Later, the extinction of the Achilles and carporadial reflexes is revealed (while the proximal ones are preserved). Electroneuromyography (the main instrumental diagnosis of polyneuropathy) reveals a moderate decrease in the speed of nerve impulses along the peripheral nerve, but there are often cases when these parameters remain normal. Needle myography diagnoses neurogenic damage to muscle fibers.

When multiple neuropathy is combined with radiculopathy, the neurological deficit is complemented by symptoms of radicular damage.

In myelinopathies, triggers begin to demyelinate the axial cylinder. The disease develops gradually or acutely. More often, not only distal, but also proximal sections of nerves are involved in the process. Hyporeflexia develops early. Sensitivity disorders can be both polyneuritic and radicular in nature. Electroneuromyographic signs of polyneuropathies that are demyelinating in nature are reduced to a gross drop in the speed of impulse transmission along nerve fibers.

In addition to motor and sensory disorders for polyneuropathies (in to a greater extent for axonopathies) are characteristic autonomic symptoms. They manifest themselves in the form of trophic changes in the skin, peripheral vascular disorders and sweating disorders.

Subjectively, peripheral polyneuropathy is manifested by pain or abnormal sensations on the skin of the feet and hands in the form of tingling, burning, crawling (polyneuralgia). Subsequently, numbness and weakness of the distal limbs develop.

There are separate forms of polyneuropathies, the description of the clinical picture of which is supplemented by a number of neurological and somatic symptoms. Thus, acute inflammatory demyelinating polyneuropathy often occurs with the involvement of cranial nerves in the pathological process. A particular manifestation of Guillain-Barré polyradiculoneuropathy (Miller Fisher syndrome) is characterized by the presence of cerebellar disorders. Acute pandysautonomia is an isolated damage to sympathetic and parasympathetic autonomic fibers with relative sparing of the motor and sensory nerves. Additionally, the digestive, cardiovascular, respiratory, urinary and reproductive systems may be affected.

Treatment

Treatment of patients with polyneuropathic syndrome should be comprehensive and depend on the form of the disease. First of all, having established the direct trigger of the disease, they neutralize it - they stop contact with toxic substances, stabilize blood glucose levels, and suppress the main pathological process in infectious diseases. For this purpose, patient management tactics are developed by a neurologist and doctors of related specialties (infectious disease specialist, endocrinologist, occupational pathologist, narcologist, and so on). Axonopathies take longer and are more difficult to treat than demyelinating polyneuropathies.

The question of how to treat polyneuropathy is decided by a council of doctors.

In case of an acutely developed process (acute polyneuroradiculopathy), a course of plasmapheresis is carried out (maximum 4 courses). In case of autoimmune genesis of the disease, intravenous administration of immunoglobulin is justified. The issue of treating patients with polyneuropathy with glucocorticosteroids (use of pulse therapy) is still controversial. Additionally, vitamins (mainly group B), antihistamines and anti-inflammatory drugs, alpha-lipoic acid preparations, angioprotectors and antioxidants are used.

Analgesics are used as symptomatic drugs. When neuropathic pain becomes severe, antidepressants and anticonvulsants are used to relieve it. The presence of symptoms of damage to other organs and systems predetermines the use of medicines for the prevention of secondary infections, thrombosis, and correction of blood pressure levels.

After the condition has stabilized, the list of therapeutic agents begins to expand. Physiotherapeutic procedures, massage, therapeutic exercises, and acupuncture are prescribed.

Subsequently, comprehensive rehabilitation of a patient who has suffered polyneuropathy is important.

Despite the widespread prevalence of polyneuropathy and polyradiculoneuropathy, many years of experience in identifying and treating these diseases, quite often the causes of their development remain hidden. This significantly reduces therapeutic options in the management of such patients. The difficulties in treating polyneuropathy and diagnosing its forms are also due to the complexity of the pathogenetic effects. In parallel with this, pronounced subjective symptoms are noted, which significantly reduce the patient’s quality of life and lead to the loss of his ability to work. Unfortunately, it is quite difficult to prevent the development of polyneuropathy, but adherence to a number of preventive measures (abstinence from alcohol, monitoring blood glucose levels, protective equipment when working with toxic substances, and so on) can reduce the likelihood of damage to peripheral nerves.

Polyneuropathy is a complex of diseases that includes the so-called multiple lesions of peripheral nerves.

The disease usually develops into a so-called chronic form and has an ascending path of spread, that is, this process initially affects the smallest fibers and slowly spreads to larger branches.

What it is?

Polyneuropathy is a so-called complication of diabetes mellitus, the whole point of which is complete damage to the vulnerable nervous system.

Nerve damage due to polyneuropathy

Causes

As a rule, with a prolonged course of the disease and fairly frequent fluctuations in sugar levels, they are diagnosed in all organs and systems of the body.

Moreover, it is the nervous system that suffers first. As a rule, nerve fibers feed the smallest blood vessels.

Under the prolonged influence of carbohydrates, a so-called nerve nutrition disorder appears. As a result, they fall into a state of hypoxia and, as a result, primary symptoms of the disease appear.

With its subsequent course and frequent decompensations, existing problems with the nervous system become significantly more complicated, which gradually become irreversible and chronic.

Since the smooth functioning of the nervous system and the prevention of malfunctions in it require special vitamins and minerals, and in diabetes the absorption and processing of all useful substances is significantly impaired, the nervous tissues suffer from insufficient nutrition and, accordingly, are subject to the undesirable development of polyneuropathy.

Diabetic polyneuropathy of the lower extremities according to ICD-10

This diagnosis is most often heard by patients who suffer from diabetes.

This disease affects the body when the peripheral system and its fibers are significantly disrupted. It can be triggered by a variety of factors.

As a rule, middle-aged people are primarily affected. It is noteworthy that men get sick much more often. It is also worth noting that polyneuropathy is not uncommon in preschool children and adolescents.

Signs

The disease, manifesting mainly in the lower extremities, has a large number of symptoms:

feeling of severe numbness in the legs;
swelling of the feet and legs;
unbearable pain and stabbing sensations;
muscle weakness;
increase or decrease in sensitivity of the limbs.

Each form of neuropathy has different symptoms th:

With a sufficiently long course of toxic and alcoholic forms of the disease, paresis and even paralysis of the lower extremities develop.

Diagnostics

Since one type of study cannot show the complete picture, diabetic polyneuropathy is diagnosed according to the ICD-10 code using several popular methods:

visually;
instrumental;
laboratory

As a rule, the first research method consists of a detailed examination by several specialists: a neurologist, a surgeon and an endocrinologist.

But instrumental diagnosis of the presence of diabetic polyneuropathy in the patient’s body according to ICD-10 involves MRI, as well as electroneuromyography and nerve biopsy.

Many patients, up to about seventy percent of the total number of diabetics, do not show any complaints. And all because they do not notice any symptoms.

Treatment

It is important to remember that treatment must be comprehensive and mixed. It must certainly include certain medications that are aimed at all areas of the development of the process.

It is very important that treatment includes taking these medications:

vitamins. They must enter the body along with food. Thanks to them, the transport of impulses along the nerves is improved, and the negative effects of glucose on the nerves are blocked;
alpha lipoic acid. It prevents the accumulation of sugar in the nervous tissue, activating certain groups of enzymes in the cells and restoring already damaged nerves;
painkillers;
aldose reductase inhibitors. They will interfere with one of the pathways of transformation of sugar in the blood, thereby reducing its effect on nerve endings;
Actovegin. It promotes the use of glucose, improves blood microcirculation in the arteries, veins and capillaries that nourish the nerves, and also prevents the death of nerve cells;
potassium and calcium. These substances have the property of reducing cramps and numbness in human limbs;
antibiotics. Their use may be necessary only when there is a risk of developing gangrene.

A competent specialist prescribes both drug and non-drug treatment.

In case of a toxic form, it is very important to completely eliminate alcoholic beverages and follow a strict diet.. The attending physician must prescribe special medications that improve blood microcirculation and prevent the formation of blood clots. It is also very important to get rid of swelling.

With proper and competent treatment, as well as compliance with the diet, the prognosis is always quite favorable. But you should not self-medicate, but it is better to immediately contact qualified specialists who will help you get rid of this unpleasant disease.

Video on the topic

Candidate of Medical Sciences on polyneuropathy in patients with diabetes:

As you can understand from all the information presented in the article, diabetic neuropathy is quite treatable. The most important thing is not to start this process. The disease has pronounced symptoms that are difficult to miss, so with a reasonable approach you can get rid of it fairly quickly. After detecting the first alarming symptoms, it is important to undergo a full medical examination, which will confirm the suspected diagnosis. Only after this can you proceed to treatment of the disease.

Diabetes mellitus is a common disease throughout the world. The clinical course of the disease is often accompanied by the development of chronic complications. One of the complications of the disease is diabetic polyneuropathy.

Chronic diabetic (sensorimotor) polyneuropathy is a common form of neuropathy, which is accompanied by sensory, autonomic and motor disorders.

ICD-10 code
E 10.42 diabetic polyneuropathy in T1DM,
E11.42diabetic polyneuropathy in type 2 diabetes,
G 63.2 diabetic distal polyneuropathy.

Diabetic polyneuropathy is accompanied by pain and significantly reduces the standard of living of patients.

The development of the disease can lead to even more serious complications. Such as: ataxia, Charcot joint, diabetic foot syndrome, diabetic osteoarthropathy.

Diabetic polyneuropathy of the extremities can lead to gangrene and subsequent amputation.

Therefore, it is important to prevent development, and start effective treatment already at the first signs in patients with diabetes.

The main etiological factors that provoke the development of diabetic polyneuropathy are considered to be:

Smoking and alcohol;
Poor blood glucose control;
Age;
Arterial pressure;
Violation of the ratio of blood lipids (fat-like substances);
Reduced insulin levels in the blood;
Long-term course of diabetes mellitus.

Numerous studies indicate that constant monitoring of glucose levels and blood pressure significantly reduce the development of pathology. And timely use of insulin therapy reduces the risk of development by half.

Symptoms

Symptoms of diabetic polyneuropathy include pain in the lower extremities. Burning, dull or itchy pain, less often sharp, stabbing and piercing. It most often occurs in the foot and intensifies in the evening. In the future, pain may appear in the lower third of the leg and arms.

Patients complain of frequent muscle numbness, joint pain, and gait disturbances. This is due to the development of a disorder in the nervous system. Temperature sensitivity is lost, and trophic ulcers may appear.

The patient experiences discomfort from the touch of clothing. The pain syndrome in such cases is permanent and significantly worsens the general well-being of the patient.

How to identify and clarify the diagnosis?

Diagnosis of polyneuropathy begins with a visit to a doctor, who carefully collects anamnesis and prescribes the necessary types of studies.
Electroneuromyography is preferred as the main study. In addition, studies of VCSP (vegetative cutaneous sympathetic potentials) can be used.

Treatment of pathology

After the diagnosis of diabetic polyneuropathy is established, treatment begins with etiotropic therapy. It is important to normalize blood glucose levels. After constant monitoring, pain decreases in 70% of cases. In some cases, insulin therapy is prescribed.

In the treatment regimen for oxidative stress, to restore the affected ones, medications with a pronounced antioxidant effect are prescribed. The drugs are taken in courses for quite a long time. During this period, the patient is monitored and monitored.

Analgesics and anti-inflammatory drugs are prescribed to relieve pain. But, as experts point out, they are not able to completely relieve pain, and long-term use can harm the proper functioning of the stomach.

For symptoms of chronic neuropathic pain, anesthetics, antidepressants and antiepileptic drugs are prescribed. As an addition to the medications, it is recommended to use lidocaine patches, gels, ointments and creams.

To consolidate the complex treatment of diabetic polyneuropathy, depending on the patient’s condition, the following is prescribed:

physiotherapy,
magneto and phototherapy,
electropheresis and currents,
electrical stimulation of muscles,
acupuncture,
hyperbaric oxygenation,
monochromatic infrared irradiation.

Treatment folk remedies are allowed only with the consent of the attending physician. Herbal medicine and the use of healing ointments can be used as a complement to traditional methods of treatment.

Effective treatment of diabetic polyneuropathy is considered to be an individual doctor's approach to each patient with a complex of conservative treatment methods.

ICD 10 dismetabolic polyneuropathy. Toxic polyneuropathy of the lower extremities: causes, symptoms and treatment

Polyneuropathy of the lower extremities: code according to ICD-10

Axonal and demyelinating neuropathy

Classification by causes of illness

Conclusion on the topic

Categories

Diabetic polyneuropathy code according to ICD-10

Symptoms and diagnosis

Treatment

Definition and treatment of polyneuropathy according to ICD-10?

Code 10 μb - diabetic polyneuropathy

Why is it dangerous?

Symptoms of pathology

Diagnostics

Treatment of pathology

Possible risks

Forecast

Polyneuropathy

Classification

By etiology

According to the pathomorphology of the injury

According to the nature of the flow

Axonal polyneuropathies (axonopathies)

Acute axonal polyneuropathies

Subacute axonal polyneuropathies

Chronic axonal polyneuropathies

Demyelinating polyneuropathies (myelinopathies)

Acute inflammatory dimyelinating polyradiculoneuropathy (Guillain-Barré syndrome)

Diphtheria polyneuropathy

Subacute demyelinating polyneuropathies

Chronic demyelinating polyneuropathies

Diabetic polyneuropathy

Treatment

Links

See what “Polyneuropathy” is in other dictionaries:

Books

Alcoholic polyneuropathy

General information

Forms

Reasons for development

Pathogenesis

Symptoms

Diagnostics

Treatment

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Comments 3

Polyneuropathy

Classification

By etiology

According to the pathomorphology of the injury

According to the nature of the flow

Axonal polyneuropathies (axonopathies)

Acute axonal polyneuropathies

Subacute axonal polyneuropathies

Chronic axonal polyneuropathies

Demyelinating polyneuropathies (myelinopathies)

Acute inflammatory dimyelinating polyradiculoneuropathy (Guillain-Barré syndrome)

Diphtheria polyneuropathy

Subacute demyelinating polyneuropathies

Chronic demyelinating polyneuropathies

Diabetic polyneuropathy

Treatment

Links

See what “Polyneuropathy” is in other dictionaries:

Books

Diabetic polyneuropathy code according to ICD-10

Symptoms and diagnosis

Treatment

What does polyneuropathy of the lower extremities mean and what are the treatment features?

Polyneuropathy of the lower extremities - why does it occur?

Clinical picture

Classification

Diagnostics

Treatment

Main groups of drugs for the treatment of polyneuropathy

Metabolic agents

Vitamin complexes

Painkillers

Medicines that improve nerve conduction

Physiotherapy methods