Cervical pleksit — defeat of a cervical nervous texture of infectious, traumatic, compression and ischemic, toxic, dismetabolichesky genesis. The clinical picture includes a pain syndrome, touch frustration, a hiccups, difficulties in attempt to cough or to speak loudly, superficial and frequent breath. Diagnostics is performed by means of a X-ray analysis, ultrasonography, a tomography, electrophysiological researches. The main task of treatment is elimination of a causal factor of development of a pleksit and performing recovery neurotyre-tread and vascular therapy.
The cervical texture settles down in the thickness of neck muscles sideways from cross shoots of vertebras and is covered in front - a clavicular and mastoidal muscle. It is created by forward branches of CI-CIV — the top cervical spinal nerves. Motive branches of a cervical texture innervate muscles of the head and a neck, the muscle raising a shovel, partially trapezoidal muscle. Sensitive branches are responsible for touch perception of skin of a nape, auricle, the front and side surface of a neck and a forward surface of the top part of a thorax. In a cervical texture originates the mixed diafragmalny nerve, the innervating diaphragm, a pericardium, a pleura and partially a peritoneum. Cervical pleksit meets much less often than a humeral pleksit and a lumbar and sacral pleksit. Distinguish bilateral, right-and left-side cervical pleksit. In most cases cervical pleksit is secondary and demands search of causal pathology owing to which it arose. Questions of diagnostics and treatment of defeats of a cervical texture are under authority of experts in the field of neurology, traumatology orthopedics.
Reasons of a cervical pleksit
Cervical pleksit owing to overcooling meets quite seldom. More often it has infectious and allergic or compression and ischemic character. In the first case pleksit arises against the background of an infectious disease (tuberculosis, a brucellosis, syphilis, flu, quinsy, etc.) or as a vaccine-challenged complication. In the second case the sdavleniye of branches of a cervical texture is tumoral process, a cervical edge or the increased lymph nodes the reason at cervical lymphadenitis. Defeat of a cervical texture can be observed at dismetabolichesky diseases (diabetes, gout) and intoxications.
Post-traumatic cervical pleksit can take place at incomplete dislocations of cervical vertebras, fractures, bruises and other spine injuries in cervical department. At newborns pleksit a cervical texture it is possible as a result of the patrimonial trauma which is followed by stretching or a sdavleniye of branches of a texture. Traumatic pleksit can have yatrogenny character and result from surgical interventions on a neck. To provoke cervical pleksit the pathological changes happening at the backbone osteochondrosis affecting cervical department can.
Symptoms of a cervical pleksit
The pain syndrome and disorders of sensitivity act as the main manifestations. Their localization depends on what branches of a cervical texture are struck. Pains arise in a front and lateral part of a neck, supraclavicular area, a nape, an auricle. At damage of a diafragmalny nerve they extend to a thorax. Touch violations include paresteziya (passing prickings, feeling of the goosebumps creeping on skin) and sleeps (decrease in sensitivity). If cervical pleksit resulted from overcooling, its sharp demonstration with the expressed pain syndrome is celebrated. At a pleksita of compression genesis gradual development of symptoms is, as a rule, observed.
Motive violations accompany cervical pleksit less often, than sensitive. Most often patients complain of difficulties in attempt to speak or cough loudly. At unilateral defeat of a texture the muscular wryneck can be observed. Damage of a diafragmalny nerve is shown by a hiccups. If defeat bilateral, then a diaphragm is switched off from the act of breath that provokes emergence of the speeded-up and more superficial breath, short wind. The intensive pain syndrome, in turn, limits a respiratory excursion of a thorax and aggravates short wind.
Diagnostics of a cervical pleksit
Cervical pleksit is diagnosed by the neurologist according to the anamnesis, complaints and objective survey. In diagnostics the important place is allocated to recognition of the reason of a pleksit. If the trauma took place, then the traumatologist has to examine the patient. At suspicion on emergence of a pleksit owing to tumoral process consultation of the oncologist is required. Diagnostics of vertebrogenny pathological processes is performed by means of a backbone X-ray analysis in cervical department, backbone KT or MPT. Performing ultrasonography of a neck is possible.
At thorax pains for an exception of pathology of visceral bodies the X-ray analysis of bodies of a chest cavity, KT of a sredosteniye, ultrasonography of heart is appointed. For the purpose of specification topics of defeat of nervous system the electromyography of muscles of a neck and an elektroneyrografiya can be carried out. To differentiate cervical pleksit it is necessary from displays of cervical osteochondrosis, a spondiloartroz, radicular syndrome, cervical spondilez, neuritis, a cervical miozit, miyelopatiya of cervical department.
Treatment of a cervical pleksit
Therapy has two main directions: knocking over of primary disease which is the reason of a pleksit and restoration of function of nervous fibers of a texture. The first depends on a type of the main pathology. So, at infectious process appoint antibacterial therapy, at a trauma — an immobilization, at a toxic pleksit carry out desintoxication, carry out correction of metabolic violations. For the purpose of knocking over of an inflammation resolvents are shown (, diclofenac, , an ibuprofen). Pleksit compression and ischemic genesis can demand surgical treatment with removal of a factor of a compression (a tumor, a lymph node, a hematoma, a cervical edge). Operation can be required also at a full break of branches of a texture. In such cases according to indications the seam of a nerve or its plastic is carried out.
Functional restoration of a texture is carried out by means of neurometabolic pharmaceuticals (B6, B and B12 vitamins, a galantamin) and the means improving blood circulation of the struck texture (nicotinic acid, a ksantinol of a nikotinat, a pentoksifillin). Along with pharmacotherapy, reparative processes in nervous tissue are promoted by physiotherapeutic treatment. Apply an amplipulsterapiya, diadynamic currents, UVCh, a hydrocortisone, an electrophoresis on area of a texture, ozokerite application, electroacupuncture, an elektromiostimulyation. For reduction of a pain syndrome acupuncture is used with novocaine. Massage and LFK begin approximately 14-21 days later, after subsiding of ostrovospalitelny processes. In the late recovery period mud cure and balneotherapy is shown by hydrosulphuric, coniferous, radonic bathtubs.
Forecast and prevention
The outcome depends mainly on an etiology of a pleksit and extent of defeat of a texture. At correct and in time the carried-out treatment the forecast is more often favorable. Lack of that can lead to formation of a muscular wryneck, complications from respiratory organs owing to diaphragm paresis over time.
Prevention is directed to the prevention of injuries of neck and backbone, especially in sport; effective therapy of infectious diseases; correction of the violations arising at dismetabolichesky pathology; timely recognition and treatment of new growths. Prevention of patrimonial injuries of a texture consists in adequate obstetric aid, a right choice of a way of a rodorazresheniye.