Diseases and Conditions » Neuritis

Neuritis is the general inflammation of the peripheral nervous system. Neuritis is one of the serious nervous disorders. It refers to an inflammation of the nerves, involving a single nerve or a series of nerves. At times, several different groups of nerves in various parts of the body may be involved. This condition is known as polyneuritis. It is also known as polyneuropathy, for strictly speaking, the condition is not an inflammation, but a change in the state of the nerves resulting in weakness, loss of the reflexes and changes of sensation.

·         Contents

o    Symptoms

o    Causes

o    Types of Neuritis

·         Symptoms

Symptoms depend on the nerves involved, but may include pain, paresthesia paresis, hypoesthesia (numbness), anesthesia, paralysis, wasting, and disappearance of the reflexes.

The main symptoms of neuritis are tingling, burning, and stabbing pains in the affected nerves. IN severe cases, there may be numbness and loss of sensation and paralysis of the nearby muscles. Thus a temporary paralysis of the face may result from changes in the facial nerves on the affected side. During the acute stage of this condition, the patient may not be able to close the eyes due to loss of normal tone and strength by the muscles on the affected side of the face. Neuritis may also be caused by pernicious anaemia, involving the nerves of the spine. The patient with this condition may find it very difficult to walk in the dark.

·         Causes

See also underlying causes of neuropathy.

§  Infection

o    Herpes simplex

o    Shingles

o    Leprosy

o    Guillain-Barre syndrome

§  Chemical injury

·         Physical injury

·         Radiation

·         Underlying conditions causing localized neuritis (affecting a single nerve):

o    Diphtheria

o    Localized injury

o    Diabetes

·         Underlying conditions causing polyneuritis:

o    Beriberi

o    Vitamin B12 deficiency

o    Metabolic diseases

o    Diabetes

o    Hypothyroidism

o    Porphyria

o    Infections, bacterial and/or viral

o    Autoimmune disease, especially Multiple Sclerosis

o    Cancer

o    Alcoholism

·         Types of Neuritis

o    Polyneuritis or Multiple neuritis

o    Brachial neuritis

o    Optic neuritis

o    Peripheral neuritis, also known as Peripheral neuropathy

o    Vestibular neuritis

o    Cranial neuritis, often representing as Bell's Palsy

o    Arsenic neuritis

§  Peripheral neuropathy

Peripheral neuropathy is the term for damage to nerves of the peripheral nervous system, which may be caused either by diseases of the nerrve or from the side-effects of systemic illness. Peripheral neuropathies vary in their presentation and origin, and may affect the nerve or the neuromuscular junction.

Major causes of peripheral neuropathy include diabetes mellitus, nutritional deficiencies, alcoholism, Sjögren's syndrome and HIV.

Mechanical pressure from staying in one position for too long, a tumor, intraneural hemorrhage, exposing the body to extreme conditions such as radiation, cold temperatures, or toxic substances (including some chemotherapy drugs such as vincristine) can also cause peripheral neuropathy.

Many of the diseases of the peripheral nervous system may present similarly to muscle problems (myopathies), and so it is important to develop approaches for assessing sensory and motor disturbances in patients so that a physician may make an accurate diagnosis.

Ø  Generalized peripheral neuropathy

Generalized peripheral neuropathies are symmetrical, and usually due to various systematic illnesses and disease processes that affect the peripheral nervous system in its entirety. They are further subdivided into several categories:

·         Distal axonopathies are the result of some metabolic or toxic derangement of neurons. They may be caused by metabolic diseases such as diabetes, renal failure, deficiency syndromes such as malnutrition and alcoholism, or the effects of toxins or drugs.

·         Myelinopathies are due to a primary attack on myelin causing an acute failure of impulse conduction. The most common cause is acute inflammatory demyelinating polyneuropathy (AIDP; aka Guillain-Barré syndrome), though other causes include chronic inflammatory demyelinating polyneuropathy (CIDP), genetic metabolic disorders (e.g., leukodystrophy), or toxins.

·         Neuronopathies are the result of destruction of peripheral nervous system (PNS) neurons. They may be caused by motor neurone diseases, sensory neuronopathies (e.g., Herpes zoster), toxins or autonomic dysfunction. Neurotoxins may cause neuronopathies, such as the chemotherapy agent vincristine.

Ø  Signs and symptoms

Those with diseases or dysfunctions of their peripheral nerves can present with problems in any of the normal peripheral nerve functions.

In terms of sensory function, there are commonly loss of function (negative) symptoms, which include numbness, tremor, and gait imbalance.

Gain of function (positive) symptoms include tingling, pain, itching, crawling, and pins and needles. Pain can become intense enough to require use of opiate drugs (i.e., morphine, oxycontin).

Skin can become so hypersensitive that patients are prohibited from having anything touch certain parts of their body, especially the feet. People with this degree of sensitivity cannot have a bedsheet touch their feet or wear socks or shoes, and eventually become housebound.

Motor symptoms include loss of function (negative) symptoms of weakness, tiredness, heaviness, and gait abnormalities; and gain of function (positive) symptoms of cramps, tremor, and fasciculations.

There is also pain in the muscles (myalgia), cramps, etc., and there may also be autonomic dysfunction.

During physical examination, those with generalized peripheral neuropathies most commonly have distal sensory or motor and sensory loss, though those with a pathology (problem) of the peripheral nerves may be perfectly normal; may show proximal weakness, as in some inflammatory neuropathies like Guillain-Barré syndrome); or may show focal sensory disturbance or weakness, such as in mononeuropathies, radiculopathies and plexopathies.

Common disorders of the peripheral nerves include focal entrapment neuropathies (e.g., carpal tunnel syndrome), generalized peripheral neuropathies (e.g., diabetic neuropathy), plexopathies (e.g., brachial neuritis) and radiculopathies (e.g., of cranial nerve VII; Facial nerve).

·         Treatment

Treatment of neuritis by painkilling drugs may give temporary relief but it does not remove the trouble effectively. The pain is relieved for the time being at the cost of the health of other parts of the body, especially the heart and the kidneys, and the neuritis remains. The best treatment for neuritis is to ensure that the patient gets optimum nutrition, well assimilated with all the vitamins and other nutrients. The emphasis should be on whole grains, particularly whole wheat, brown rice, raw and sprouted seeds, raw milk, especially in soured form, and home-made cottage cheese.

In this regimen, the breakfast may consist of fresh fruits, a handful of raw nuts or a couple of tablespoons of sunflower and pumpkin seeds. Steamed vegetables, whole wheat, chappatis and a glass of butter-milk may be taken for lunch. The dinner may comprise a large bowl of fresh, green, vegetable salad, fresh home made cottage cheese, fresh butter and a glass of butter milk.

In severe cases, the patient should be put on a short juice fast for four or five days before being given the optimum diet. Carrot, beet, citrus fruits, apple and pineapple may be used for juices. All vitamins of the B group have proved highly beneficial in the prevention and treatment of neuritis. The disorder has been helped when vitamins B1, B2, B6, B12, and pantothenic acid have been given together, and extreme pain,weakness and numbness in some cases have been relieved within an hour.

The patient should avoid white bread, white sugar,refined cereals, meat, fish, tinned foods, tea, coffee, and condiments which are at the root of the trouble, by continuously flooding the tissues with acid impurities.

Certain remedies have been found highly beneficial in the treatment of neuritis. One such remedy is soyabean milk. A cupful of soyabean milk mixed with a teaspoonful of honey should be taken every night in this condition. It tones up the nervous system due to its rich concentration of lecithin, vitamin B1 and glutanic acid.

Soyabean milk is prepared by soaking the beans in water for about 12 hours. The skin of the beans is then removed and after a thorough wash, they are turned into a fine paste in a grinding machine. The paste is mixed with water, three times its quantity. The milk should then be boiled on a slow fire, stirring it frequently. After it becomes little cooler, it should be strained through a cheese cloth and sugar added.

Barley brew is another effective remedy for neuritis. It is prepared by boiling one-quarter cup of all natural pearled barley in two quarters of water. When the water has boiled down to about one quarter, it should be strained carefully. For better results, it should be mixed with butter-milk and lime juice.

Raw carrot and spinach have proved valuable in neuritis as both these vegetables are rich in elements, the deficiency of which has led to this disease. The quickest and most effective way in which the body can obtain and assimilate these elements is by drinking daily at least half a litre of the combined raw juices of carrot and spinach.

The patient should be given two or three hot Epsom-salt baths weekly. He should remain in the bath for 25 to 30 minutes. The affected parts should also be bathed several times daily in the hot water containing Epsom salt - a table- spoon of salt to a cupful of hot water. The patient should undertake walking and other moderate exercises.