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Health

Treatment of ischemic neuropathy

, medical expert
Last reviewed: 19.10.2021
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If it is a case of situational compression (for example, a person was sitting at the table for a long time, his leg was pinched, as a result of which blood circulation was complicated and symptoms of ischemia appeared), special treatment is not required. It is necessary to provide the leg with warmth (for example, put it in warm water) and make a massage that helps disperse blood.

Such treatment will help with short-term non-pathological nerve compression. If the compression of nerves and blood vessels is caused by diseases that cause swelling of the tissues and bad changes in them, the use of heat and massage can only intensify the pain. It is not recommended massage and thermal procedures without the permission of the doctor in the presence of vascular pathologies, especially the propensity to form blood clots.

As it is a question of mechanical or dystrophic nerve damage, the treatment of neuropathy is reduced to a reduction in the pain syndrome and restoration of the function of the damaged nerve, which, alas, is not always possible. If we talk about the ischemic variety of the pathology of the nerves, it becomes clear that without restoring the normal blood supply of nerve fibers, one can not expect improvement in the condition.

So, what are the groups of drugs prescribed by doctors for the treatment of ischemic neuropathy :

  • Means for improving blood circulation (nootropic and vasodilating drugs, anticoagulants and anti-clotting agents)
  • Preparations for normalization of arterial pressure, including diuretics
  • Anti-inflammatory and decongestants (nerve damage is often accompanied by an inflammatory process in nearby tissues that can be stopped with NSAIDs or corticosteroids)
  • Antihistamines that help reduce tissue swelling
  • Means that normalize the metabolism, improve trophic tissue and promote the stability of nerve fibers to hypoxia (oxygen starvation), i.e. Regenerating drugs
  • Miorelaxants and antispasmodics (for example, with compression-ischemic neuropathy, when the nerve is squeezed by spasmodic muscles, as well as to relieve the pain syndrome)
  • Vitamins C and E, preparations containing a complex of B vitamins.
  • Immunomodulators (with reduced immunity).

To treat nerve fibers by medication alone does not make sense. Much better results are provided by a comprehensive approach, which includes medical and  physiotherapy treatment.

If we are talking about peripheral neuropathies, therapeutic massage and LFK complex, reflexotherapy, magnetotherapy, medicinal electro-, phono- and plasmaphoresis will be useful. With ischemic neuropathy of the optic nerve, laser and electrostimulation of the affected nerve is used.

To improve blood circulation in tissues, hydrotherapy, darsonvalization, underwater shower massage, mud therapy will be useful. To relieve pain and restore sensitivity, acupuncture is used.

Surgical treatment  for optic nerve ischemia involves reconstructive operations on carotid arteries (stenting), tromoectomy, carotid endarterectomy. In the case of compression-ischemic neuropathy, operations such as medial epicondylectomy,  nerve decompression or decompression with transposition are performed  .

Medications

Ischemia - a condition that is dangerous by a violation of the functionality of nerves, degenerative changes in tissues, atrophy of nerve and muscle fibers. Treatment of this condition is possible with vasodilator drugs, anticoagulants, nootropics and other means that restore normal blood circulation.

Pentoxifylline

The drug that improves blood microcirculation, which reduces the viscosity of blood, slightly dilates blood vessels and reduces their resistance to blood flow, improves the oxygen supply of the central nervous system and peripheral nerves.

The drug is especially effective in ischemic neuropathy of the optic nerve and limbs.

The drug on sale can be found in the form of injection solution and tablets. In acute conditions, when drugs require speed, you can enter the drug intraarterially or intravenously.

Intravenous solution is administered as a slow infusion (1.5-3 hours). 1 ampoule of the drug is diluted in saline solution or glucose solution (10,25-0,5 l). It is possible to increase the daily dose to 2-3 ampoules.

Intraarterially, the drug is also administered slowly (10 minutes), diluting the ampoule solution in 30-50 mg saline. The dose of medication is about 1 to 3 ampoules per day.

Usually, injecting treatment is short-lived and subsequently the patient is transferred to oral forms of the drug. Tablets take 2 pieces three times a day (6 tablets) for one to two weeks. When the patient's condition returned to normal, the dose is reduced to 3 tablets per day, continuing treatment for 3 or more weeks.

Contraindications to the use of the drug are hypersensitivity to the active substance or auxiliary components of the drug, hemorrhagic stroke, the risk of bleeding, reduced blood coagulability, hemorrhages in the eye, acute stage of myocardial infarction.

The drug is not used during pregnancy lactation. In pediatrics, the use of medication is allowed only from the age of 12 years.

At the expressed atherosclerosis of vessels of heart and a brain it is recommended to enter a preparation peroralno.

It is necessary to strictly observe the prescribed dose, since an overdose of the drug is fraught with a drop in blood pressure, the appearance of convulsions, fever, impaired consciousness and respiratory function, gastric bleeding.

Reception of the drug may be accompanied by such side effects: headaches and dizziness, irritability, sleep disorders, frequent pulse, lower blood pressure, cardiac rhythm failure. With oral administration of the drug, one can observe nausea, abdominal pain, decreased intestinal peristalsis, the development of hepatitis due to congestive phenomena in the gallbladder (cholestatic hepatitis), dyspepsia, changes in body weight. Sometimes patients complain about such symptoms as bleeding, redness of the skin, the appearance of allergic reactions.

Fenindion

The drug from the group of indirect anticoagulants, which indirectly reduce the viscosity of the blood, which contributes to increased blood flow and prevents the formation of thrombi. It is used to treat ischemic neuropathy, which develops as a result of vascular thrombosis.

The dose of the drug depends on the day of therapy. On the first day, patients receive 40 mg 3 or 4 times a day, in the second 30 mg with the same frequency of application. Further anticoagulant is prescribed in a daily dose of 30 to 60 mg (the dosage is set depending on the level of prothrombin in the blood). Reduction in the dose of the drug in the future should be gradual.

The drug is not prescribed for individual sensitivity to its components, hemophilia and conditions in which there is a risk of bleeding, with menstruation, and also 2 days before the onset of menstrual bleeding.

The drug is dangerous to use during pregnancy, especially in the first months. It is dangerous to use the medicine in the first week after childbirth. The manufacturer does not recommend the drug during breastfeeding.

Precautions should be taken to treat the drug elderly patients, as well as those who have severe liver and kidney damage with a violation of their functions.

Among the side effects of the drug is nausea, diarrhea, impaired liver and kidney function, myocarditis, various bleeding and hemorrhages, fever, headaches, allergies. Sometimes patients notice a change in the color of the palms on the orange. Urine can also be dyed pink.

It is clear that the normalization of the circulation itself is not able to restore nerve conduction, it only prevents the defeat of the surviving cells. And because the nerve fiber is weakened, measures must be taken to help restore the conductivity of the impulses.

trusted-source[1], [2], [3], [4], [5]

Neyromidin

The drug with anticholestine action, promoting the restoration of nerve conduction, simulating neuromuscular transmission, increasing the tone of smooth muscles, improving intellectual and cognitive abilities. He also has a weak sedative and antiarrhythmic effect.

The drug is released in tablets, capsules and ampoules with an injection solution. Intramuscularly the drug can be administered 1 or 2 times a day. Single dose - 1 ampoule.

Peroral forms of the drug take 1 capsule 1 to 3 times a day for a long time. The maximum daily dose is 8 tablets. The therapeutic course is 30-60 days.

Severe overdose of the drug can cause bronchospasm, convulsions, a drop in pressure and pulse, a strong weakness right up to the coma.

The drug is not prescribed for hypersensitivity to the components of the drug, with epilepsy and bronchial asthma, with pathologies of the vestibular apparatus. Contraindications also include angina pectoris, stably decreased pulse, ulcers and erosion on the mucosa of the gastrointestinal tract.

The drug is able to penetrate the placenta and increase the tone of the uterus, which is dangerous during pregnancy, so during this period, "Neuromidine" is not prescribed. Undesirable for him and during breastfeeding.

Injectable solutions should not be administered to patients younger than 14 years of age.

During treatment with the drug, symptoms such as nausea, diarrhea, dizziness, intense saliva secretion, decreased heart rate, bronchospasm, allergic reactions can occur. Such symptoms appear very rarely and require a dose adjustment or a small break in taking the medication.

When it comes to ischemic neuropathy of the optic nerve as a drug that improves blood microcirculation, it is better to take "Vinpocetine", and from diuretics - "Diacarb".

Vinpocetin

A drug that improves cerebral metabolism and blood supply to the brain, normalizing blood viscosity. It is considered a neuroprotective agent. Its feature is the improvement of blood flow to the ischemic tissue sites.

The preparation is made in the form of tablets and concentrate for infusion composition in ampoules.

Solution for infusion is prepared on the basis of 4-10 ampoules of the drug and 0.5 liters of saline. Enter the formulation slowly at a rate of not more than 80 drops / min. Treatment is continued for 1.5-2 weeks.

The number of infusions is determined by the doctor, after which they switch to taking the oral forms of the medication. Tablets should be taken after meals, which does not worsen their absorption, but it helps protect the gastrointestinal mucosa. A day is prescribed from 3 to 6 tablets.

The drug is intended for the treatment of adult patients. It is not prescribed for hypersensitivity to its components, in severe cases of arrhythmia or ischemia of the heart, in the acute stage of hemorrhagic stroke, with low vascular tone and unstable pressure. Caution is observed in the treatment of patients with hypotension and liver failure.

The drug is able to increase blood circulation in the placenta, which can provoke miscarriage, and penetrate the placental barrier. This makes it very undesirable to use it during pregnancy. Large concentrations of the active substance in breast milk suggest that breastfeeding during the treatment period is better not to be performed.

Taking the drug can cause changes in the cardiogram (various malfunctions in the heart) and blood composition, the development of hypercholesterolemia and diabetes mellitus, nervous excitement and irritability, hearing impairment and the appearance of tinnitus. Symptoms such as headaches, drowsiness, trembling in the body, fainting, vision impairment, fluctuations in blood pressure, various reactions from the gastrointestinal tract, allergic reactions can also be noted.

Diakarb

This drug is not a simple diuretic, effectively fighting with edematous syndrome. Due to the diuretic effect, it is able to reduce intraocular pressure, which prevents the development of glaucoma. He also has an antiepileptic effect.

The drug can be prescribed to adults in a daily dosage of 1 to 4 tablets depending on the diagnosis and condition of the patient. The dose for children is calculated as 10-30 mg per kilogram of the child's weight. The daily dose should be divided into several receptions.

The drug is not accepted for individual sensitivity to the drug, potassium and sodium deficiency in the body (hypokalemia and hyponatremia), increased acidity of the internal environment (acidosis), a decrease in the function of the adrenal cortex, diabetes, intoxication due to kidney disease (uremia). Contraindicated in the treatment of cirrhosis of the liver and urolithiasis, with severe violations of the liver and kidneys.

In pediatrics, the drug can be used from 3 years of age. It is dangerous to use the drug in the first months of pregnancy.

Caution should be observed in the treatment of pregnant women in the 2-3 trimester, edematous syndrome caused by liver and kidney disease, severe pulmonary pathologies, closed-angle glaucoma (can only be a short course).

During therapy with the drug, side effects such as hearing loss and sensitivity of the body, dizziness, convulsions, photophobia, and weakness in muscles can be noted. Tablets can irritate the gastrointestinal mucosa resulting in nausea and vomiting, diarrhea, impaired taste, deterioration of appetite. Allergic reactions are possible. It is necessary to prepare for the fact that the frequency of urination will increase.

trusted-source[6]

Alternative treatment of ischemic neuropathy

Alternative recipes have helped each of us with various diseases more than once. But in the case of ischemic neuropathy, there is no point in counting on them alone. Such recipes will help relieve pain and swelling, but they can hardly fundamentally affect the blood circulation and conductivity of nerve fibers. It's not for nothing that doctors recommend alternative treatment to be used as an additional means, helping to quickly improve the condition.

So, how can you help yourself in case of symptoms of neuropathy? First, let's talk about the use of various products and products, and then we will touch on herbal therapy, which has a fairly good effect and is generally harmless.

Even our grandparents, in the absence of effective drugs in peripheral neuropathy, used clay. But experts advise to enhance the effect of taking not ordinary clay, but blue or green.

Clay can be diluted with water to a semi-liquid slurry, apply the composition to the fabric and apply as a compress to a sore spot. Keep the compress until the curative composition dries.

Treatment with compresses can be supplemented by taking clay solution inside. For its preparation a piece of dry clay weighing about 20-25 g is poured 3/4 cup warmed to a warm water and taken for a quarter of an hour before eating. The procedure is repeated three times a day by a course of 1.5-2 weeks.

Ischemic neuropathy of the facial nerve alternative healers offer to treat with the help of the flesh of dates, which must be consumed three times a day after meals. At a time you need to eat three or four teaspoons of the crushed product. The course of treatment is 1 month.

With neuropathies of the peripheral nerves, you can try to do a warming massage with camphor oil. After a quarter of an hour rubbing with alcohol (vodka) and heat wrapped.

Trimming can be done with triple cologne. This fragrant means helps to relieve inflammation and pain in the place of nerve damage. Treatment is carried out for 2 weeks.

If the cause of ischemia of the nerves is the atherosclerosis of the vessels, it is possible to fight the disease with the help of sea kale. It is necessary to take the dried product, grind it into powder and take 1 coffee spoon every day.

Helps to clean the clogged vessels and such burning spices as onions and garlic. In case of illness, they should also be consumed daily.

And now let's talk about herbal treatment. Since the cause of ischemic neuropathy is still a violation of blood circulation, then for treatment it is necessary to choose such herbs that possess the properties of blood thinning and lowering blood pressure.

Helps reduce the fragility of blood vessels, improve blood circulation and nutrition of tissues, reduce the excitability of the central nervous system flowers and hawthorn fruits. As a medicine, use a tincture (alcohol and vegetable raw material take 1: 1 and insist for 3 weeks) and decoction of the plant (a glass of fruit should take half a liter of boiling water, you can add 2 tablespoons of sugar, boil until the volume of the liquid is halved).

Tincture should be taken on 1 teaspoonful, and decoction of 1 tablespoon before eating, as well as retiring to bed.

It is good to mix such a remedy with broth of wild rose, which will help make blood less viscous and strengthen immunity.

As a means for liquefaction of blood, plants are used: goatskin and sweet potato. Any of the herbs in dry form for preparation of medicine is taken in the amount of 1 stalk spoon. Pour vegetable raw materials with two glasses of boiling water and leave for 2-3 hours. Filtered infusion should be taken three times a day for 100 g.

Seeds of dill and carrots have a vasodilating effect. For treatment of ischemia, they can be used as infusions or decoctions, as well as in the composition of plant charges.

Here, for example, the collection, which is prescribed for cerebral circulation, which may well cause ischemia of the optic nerve. It consists of: herb wort and flowers of borago (20g each), herbs of thyme, motherwort, mint, cucumbers and dill seed (10g each). At 3 tablespoons. Mixtures are taken 750 ml of boiling water. The infusion is left in the heat for 2 hours. Diluted for 3 times. You can take food after 15-20 minutes.

And another therapeutic herbal collection, which, with prolonged use, can improve blood circulation, normalize metabolic processes in tissues and activate the work of the nervous system. In its composition we find: seeds of flax and mint (10 grams), oregano, carrot, nettle, immortelle flowers and rose hips (20 g each), herb grass, birch leaves, hawthorn fruit (40 g each), kidney tea ( 40 g), St. John's wort (60 g).

2 spoons of dry collection steam for the night 2 cups of boiling water. In the morning, the infusion is filtered and drunk all parts during the day. The course of treatment is not less than 2 weeks.

trusted-source[7], [8], [9], [10], [11], [12], [13], [14]

Homeopathy

Probably, about homeopathy, you can say everything is the same as with regard to alternative treatment. As a supplement to the traditional treatment, homeopathic remedies are very popular, but they can be used as the main medicines only in mild cases of ischemic neuropathy.

Preparations are prescribed, based on the cause that caused nerve damage due to ischemic processes, as well as the constitutional characteristics of the patient.

With violations of cerebral circulation and atherosclerosis of vessels can be prescribed drugs: Edas-138, Cerebralik, Barijodeel, Cerebrum compositum. In cases of coronary blood flow disorders, Angio-Injeel, drops and Cactus compositum solution, Cor compositum solution, will be useful.

With violations of peripheral blood circulation, the choice drugs can be: drops Aesculus compositum, Arteria-Heel, Circulo-Injeel, Placenta compositum. With venous stasis and thrombophlebitis - Hamamelis-Homaccord ointment and Aesculus-Heel drops.

In neuropathies due to joint diseases, a solution of Discus compositum Ampulen, ampoules and drops of Gelsemium-Homaccord, Kalmia Compositum can be prescribed.

For any neurological disorders, the preparation Cimicifuga-Homaccord, Neuralgo-Rheum-Injeel, Thalamus compositum will prove useful.

Apis-Homacsord drops are suitable for removing tissue swelling. If neuropathy develops as a result of trauma, they use the popular drug Traumeel, which is available in drops, tablets, ampoules, as an ointment. To relieve pain and inflammation with neuropathy, you can use Bryaconeel tablets, Rhododendroneel S drops.

A lot of useful for ischemic neuropathy homeopathic drugs is produced by the German company Heel. Its products occupy an honorable place on the shelves of homeopathic pharmacies in Ukraine for more than 20 years, which enabled many patients to be convinced of their high efficiency.

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