PLEKSIT

PLEKSIT - defeat of the nerve plexus formed by the anterior branches of the spinal nerves; Characterized by sensitive, motor and trophic disorders. It can be infectious (for influenza, tuberculosis, brucellosis, etc.), infectious-allergic (for example, postvaccinal plexitis), intoxication (as a result of lead poisoning, arsenic, carbon monoxide, alcohol, etc.), traumatic (due to gunshot, knife and Other wounds), compression-ischemic (with compression of the plexus with fragments of bones in the fracture, tumor, infiltration, etc.).

Clinically, plexitis is characterized by motor, sensory and vegetative-trophic disorders. The defeat of the plexus is total, or partial, in which only individual trunks, bundles and branches are damaged. Plexitis can be one-sided and two-sided.

In the course of plexitis, two stages are distinguished: neuralgic and paralytic. In the neuralgic stage, spontaneous pain is noted, which is aggravated by movement or compression of the plexus. In the paralytic stage, peripheral paresis and paralysis of the muscles innervated by the branches of the affected plexus develop, corresponding deep reflexes decrease, all kinds of sensitivity and trophism in the innervation zone are broken, which is manifested by pastose, edema, vasomotor disorders, etc.

With the defeat of the cervical plexus, the pain spreads to the occipital region, paresis develops deep muscles of the neck and diaphragm. As a result of irritation of the diaphragmatic nerve, a hiccup appears.

In case of defeat of the brachial plexus, the pain is localized in the supra- and subclavian areas, radiating into the arm. The muscles of the shoulder girdle and upper limb are affected, deep reflexes on the upper limb decrease or disappear. Vegetative-trophic disorders develop in the form of cyanosis or paleness of the hand, brush stroking, sweating, trophism of the nails, etc.

Plexitis of the lumbosacral plexus is characterized by sensory, motor and vegetative-trophic disorders in the innervation zone. The pains are localized in the lumbar region and in the leg. There are paresis of the muscles of the thigh, lower leg and foot, atrophy of these muscles, pastosity of the foot and lower leg, trophic disorders of the nails.

The diagnosis is based on the localization of pain and motor disorders, on the data of electrophysiological (electromyography, electroneurography) and radiographic studies.

Treatment can be carried out on an outpatient basis, in severe cases - in a hospital. In infectious plexitis, anti-inflammatory therapy is performed, painkillers, dehydrating agents, physiotherapeutic procedures (iontophoresis with novocaine solution, diadynamic currents, amplipulse therapy), novocain blockades are used. After the removal of acute phenomena prescribed therapeutic exercise, massage, balneotherapy, vitamins B1 and B12; When paresis - anticholinesterase drugs (proserine, galantamine), ATP, lidazu, nootropic drugs. Similarly, the treatment of infectious-allergic and intoxicating plexites. In traumatic plexitis, as well as in compression processes (cervical ribs, tumors , vertebral fractures, clavicle, aneurysm of the arteries), surgical treatment is performed to eliminate compression and restoration of conduction of the plexus branches. In the chronic course of plexitis, sanatorium treatment (radon, hydrogen sulphide baths, mud applications) is indicated.

The prognosis with the timely and intensive treatment is favorable.