Treatment of ischemic neuropathy

If we are talking about situational compression (for example, a person sat at a table for a long time with his leg tucked up, as a result of which blood circulation was impeded and symptoms of ischemia appeared), no special treatment is required. It is necessary to provide warmth to the leg (for example, put it in warm water) and do a massage to promote blood circulation.

This treatment will help with short-term non-pathological compression of the nerve. If the compression of nerves and blood vessels is caused by diseases that cause tissue swelling and adverse changes in them, the use of heat and massage can only increase pain. Massage and heat treatments are not recommended without a doctor's permission in the presence of vascular pathologies, especially a tendency to form blood clots.

Since we are talking about mechanical or dystrophic damage to the nerve, the treatment of neuropathy comes down to reducing pain and restoring the function of the damaged nerve, which, unfortunately, is not always possible. If we talk about the ischemic type of nerve pathology, it becomes clear that without restoring normal blood supply to the nerve fibers, there is no hope of improving the condition.

So, what groups of drugs do doctors prescribe for the treatment of ischemic neuropathy:

• Means for improving blood circulation (nootropic and vasodilator drugs, anticoagulants and agents that prevent the formation of blood clots)
• Medicines to normalize blood pressure, including diuretics
• Anti-inflammatory and decongestant drugs (nerve damage is often accompanied by inflammation in nearby tissues, which can be relieved with NSAIDs or corticosteroids)
• Antihistamines that help reduce tissue swelling
• Means that normalize metabolism, improve tissue trophism and promote the resistance of nerve fibers to hypoxia (oxygen starvation), i.e. regenerating drugs
• Muscle relaxants and antispasmodics (for example, in case of compression-ischemic neuropathy, when the nerve is compressed by spasmodic muscles, and also to relieve pain)
• Vitamins C and E, preparations containing a complex of B vitamins.
• Immunomodulators (for reduced immunity).

Treating nerve fibers with medications alone makes no sense. A comprehensive approach that includes medication and physiotherapy gives much better results.

If we are talking about peripheral neuropathies, therapeutic massage and a complex of exercise therapy, reflexology, magnetic therapy, medicinal electro-, phono- and plasmapheresis will be useful. In case of ischemic neuropathy of the optic nerve, laser and electrical stimulation of the affected nerve is used.

Hydrotherapy, darsonvalization, underwater shower massage, and mud therapy are useful for improving blood circulation in tissues. Acupuncture is used to relieve pain and restore sensitivity.

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

Medicines

Ischemia is a condition that is dangerous due to disruption of nerve functionality, degenerative changes in tissues, and atrophy of nerve and muscle fibers. Treatment of this condition is possible with the help of vasodilators, anticoagulants, nootropics, and other means that restore normal blood circulation.

Pentoxifylline

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

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

The drug can be found on sale in the form of an injection solution and tablets. In acute conditions, when drugs require rapid action, the drug can be administered intra-arterially or intravenously.

The solution is administered intravenously as a slow infusion (1.5-3 hours). 1 ampoule of the drug is diluted in saline or glucose solution (10.25-0.5 l). It is possible to increase the daily dose to 2-3 ampoules.

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

Usually, injection treatment is short-lived and the patient is then transferred to oral forms of the drug. The tablets are taken 2 tablets three times a day (6 tablets) for one to two weeks. When the patient's condition has normalized, the dose is reduced to 3 tablets per day, continuing treatment for 3 weeks or more.

Contraindications to the use of the drug include hypersensitivity to the active substance or auxiliary components of the drug, hemorrhagic stroke, risk of bleeding, decreased blood clotting, hemorrhage in the eye, acute stage of myocardial infarction.

The drug is not used during pregnancy and lactation. In pediatrics, the use of the drug is permitted only from the age of 12.

In case of severe atherosclerosis of the vessels of the heart and brain, the drug is recommended to be administered orally.

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

Taking the drug may be accompanied by the following side effects: headaches and dizziness, irritability, sleep disturbances, rapid pulse, decreased blood pressure, and heart rhythm disturbances. When taking the drug orally, nausea, abdominal pain, decreased intestinal motility, development of hepatitis due to stagnation in the gallbladder (cholestatic hepatitis), dyspepsia, and changes in body weight may be observed. Sometimes patients complain of symptoms such as bleeding, reddening of the skin, and allergic reactions.

Phenindion

A drug from the group of indirect anticoagulants that indirectly reduce blood viscosity, which helps increase blood flow and prevents blood clots. It is used to treat ischemic neuropathy that develops as a result of vascular thrombosis.

The dose of the drug depends on the day of therapy. On the first day, patients are given 40 mg 3 or 4 times a day, on the second day - 30 mg with the same frequency of use. Then the anticoagulant is prescribed in a daily dose of 30 to 60 mg (the dosage is determined depending on the level of prothrombin in the blood). The dose of the drug should be reduced gradually.

The drug is not prescribed for individuals with individual sensitivity to its components, hemophilia and conditions that increase the risk of bleeding, during menstruation, and 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 drug in the first week after childbirth. The manufacturer does not recommend the drug during breastfeeding.

Caution should be exercised when treating elderly patients with the drug, as well as those with severe liver and kidney damage with impaired function.

Side effects of the drug include nausea, diarrhea, liver and kidney dysfunction, myocarditis, various bleedings and hemorrhages, fever, headaches, and allergies. Sometimes patients notice a change in the color of their palms to orange. Urine may also turn pink.

It is clear that normalization of blood circulation in itself is not capable of restoring nerve conductivity, it only prevents damage to surviving cells. And since the nerve fiber is weakened, it is necessary to take measures that will help restore the conductivity of impulses.

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Neuromidin

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

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

Oral forms of the drug are taken 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.

A severe overdose of the drug can cause bronchospasm, convulsions, a drop in blood pressure and pulse, severe weakness, and even coma.

The drug is not prescribed for hypersensitivity to the components of the drug, epilepsy and bronchial asthma, and vestibular pathologies. Contraindications also include angina pectoris, persistently low pulse, ulcers and erosions on the mucous membrane of the gastrointestinal tract.

The medicine can penetrate the placenta and increase the tone of the uterus, which is dangerous during pregnancy, so Neuromidin is not prescribed during this period. It is also undesirable to take it during breastfeeding.

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

During treatment with the drug, symptoms such as nausea, diarrhea, dizziness, intense salivation, decreased pulse, bronchial spasm, allergic reactions may occur. Such symptoms occur very rarely and require dose adjustment or a short break in taking the drug.

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

Vinpocetine

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

The drug is produced in the form of tablets and concentrate for infusion in ampoules.

The infusion solution is prepared on the basis of 4-10 ampoules of the drug and 0.5 l of saline. The composition is administered slowly at a rate of no more than 80 drops/min. Treatment continues for 1.5-2 weeks.

The number of infusions is determined by the doctor, after which they switch to taking oral forms of the drug. Tablets should be taken after meals, which does not worsen their absorption, but allows you to protect the gastrointestinal mucosa. From 3 to 6 tablets are prescribed per day.

The drug is intended for the treatment of adult patients. It is not prescribed in case of hypersensitivity to its components, in severe cases of arrhythmia or cardiac ischemia, 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 can increase blood circulation in the placenta, which can provoke a miscarriage, and penetrate the placental barrier. This makes its use during pregnancy very undesirable. High concentrations of the active substance in breast milk indicate that it is better not to breastfeed the child during the treatment period.

Taking the drug may cause changes in the cardiogram (various malfunctions of the heart) and blood composition, the development of hypercholesterolemia and diabetes, nervous excitement and irritability, hearing impairment and the appearance of noise in the ears. The following symptoms may also be noted: headaches, drowsiness, tremors in the body, fainting, deterioration of vision, fluctuations in blood pressure, various reactions from the gastrointestinal tract, allergic reactions.

Diacarb

This drug is not a simple diuretic, effectively combating edema syndrome. Due to the diuretic effect, it is able to reduce intraocular pressure, which prevents the development of glaucoma. It 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 the patient's condition. 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 doses.

The drug is not prescribed in case of individual sensitivity to the drug, deficiency of potassium and sodium in the body (hypokalemia and hyponatremia), increased acidity of the internal environment (acidosis), decreased function of the adrenal cortex, diabetes mellitus, intoxication due to kidney disease (uremia). The drug is contraindicated in liver cirrhosis and urolithiasis, in severe liver and kidney dysfunction.

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

Caution should be exercised when treating pregnant women in the 2nd-3rd trimester, edema syndrome caused by liver and kidney diseases, severe pulmonary pathologies, closed-angle glaucoma (only a short course is possible).

During therapy with the drug, side effects such as hearing loss and body sensitivity, dizziness, convulsions, photophobia, muscle weakness may be observed. The tablets may irritate the gastrointestinal mucosa, resulting in nausea and vomiting, diarrhea, taste disturbance, and loss of appetite. Allergic reactions are possible. You should be prepared for the fact that the frequency of urination will increase.

Folk treatment of ischemic neuropathy

Folk remedies have helped each of us with various diseases more than once. But in the case of ischemic neuropathy, relying on them alone makes no sense. Such remedies will help relieve pain and swelling, but they are unlikely to have a dramatic effect on blood circulation and nerve conductivity. It is not for nothing that doctors recommend using folk remedies as additional means to help improve the condition faster.

So, how can you help yourself if you have symptoms of neuropathy? First, let's talk about using different products and remedies, and then we'll touch on herbal treatment, which has a pretty good effect and is generally harmless.

Even our grandparents used clay for peripheral neuropathy due to the lack of effective medications. But experts advise to take not ordinary clay, but blue or green one to enhance the effect.

Clay can be diluted with water to a semi-liquid gruel, the composition can be applied to a cloth and applied as a compress to the sore spot. The compress should be kept until the medicinal composition dries.

Treatment with compresses can be supplemented by taking a clay solution internally. To prepare it, a piece of dry clay weighing about 20-25 g is poured with 3/4 cup of warm water and taken a quarter of an hour before meals. The procedure is repeated three times a day for a course of 1.5-2 weeks.

Traditional healers suggest treating ischemic neuropathy of the facial nerve with date pulp, which should be consumed three times a day after meals. Three to four teaspoons of the crushed product should be eaten at a time. The course of treatment is 1 month.

In case of neuropathies of peripheral nerves, you can try to do a warming massage with camphor oil. After a quarter of an hour, rub with alcohol (vodka) and wrap up warmly.

Rubbing can also be done with triple cologne. This fragrant remedy helps relieve inflammation and pain in the area of the nerve lesion. The treatment is carried out for 2 weeks.

If the cause of nerve ischemia is atherosclerosis of the vessels, you can fight the disease with the help of seaweed. You need to take the dried product, grind it into powder and take 1 coffee spoon every day.

Hot spices such as onions and garlic also help to clear clogged vessels. When sick, they should also be consumed daily.

Now let's talk about herbal treatment. Since the cause of ischemic neuropathy is still a circulatory disorder, then for treatment you need to choose herbs that have blood thinning and blood pressure lowering properties.

Flowers and fruits of hawthorn help to reduce the fragility of blood vessels, improve blood circulation and tissue nutrition, and reduce the excitability of the central nervous system. As a medicine, a tincture is used (alcohol and plant materials are taken 1:1 and infused for 3 weeks) and a decoction of the plant (for a glass of fruit, you need to take half a liter of boiling water, you can add 2 spoons of sugar, boil until the volume of liquid is reduced by half).

The tincture should be taken 1 teaspoon, and the decoction 1 tablespoon before meals and before going to bed.

It is good to mix this remedy with rosehip decoction, which will help make the blood less viscous and strengthen the immune system.

The following plants are used as blood thinners: goat's rue and sweet clover. Any of the herbs in dry form for the preparation of the medicine is taken in the amount of 1 tablespoon. Pour two glasses of boiling water over the plant material and leave for 2-3 hours. The strained infusion should be taken three times a day, 100 g each.

Dill and carrot seeds have a vasodilatory effect. For the treatment of ischemia, they can be used in the form of infusions or decoctions, as well as in herbal mixtures.

Here, for example, is a collection that is prescribed for cerebrovascular accidents, which may well cause optic nerve ischemia. It includes: lungwort herb and borage flowers (20g each), thyme, motherwort, mint, immortelle and dill seed herbs (10g each). For 3 tbsp of the mixture, take 750 ml of boiling water. Leave the infusion in a warm place for 2 hours. Drink the strained mixture 3 times. You can eat after 15-20 minutes.

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

2 spoons of dry collection are steamed overnight with 2 glasses of boiling water. In the morning, the infusion is filtered and drunk in parts throughout the day. The course of treatment is not less than 2 weeks.

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Homeopathy

Probably, the same can be said about homeopathy as about folk treatment. As a supplement to traditional treatment, homeopathic remedies are very popular, but they can be used as primary medicines only in mild cases of ischemic neuropathy.

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

In case of cerebrovascular disorders and vascular atherosclerosis, the following medications may be prescribed: Edas-138, Cerebralic, Barijodeel, Cerebrum compositum. In case of coronary blood flow disorders, the following will be useful: Angio-Injeel, Cactus compositum drops and solution, Cor compositum solution.

In case of peripheral circulation disorders, the drugs of choice may be: Aesculus compositum drops, Arteria-Heel, Circulo-Injeel, Placenta compositum. In case of venous congestion and thrombophlebitis – Hamamelis-Homaccord ointment and Aesculus-Heel drops.

For neuropathies caused by joint diseases, the following may be prescribed: Discus compositum Ampulen solution, Gelsemium-Homaccord ampoules and drops, Kalmia Compositum.

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

Apis-Homaccord drops are suitable for removing tissue swelling. If neuropathy develops as a result of injury, use the popular drug Traumeel, which is available in drops, tablets, ampoules, and ointment. Bryaconeel tablets and Rhododendroneel S drops can be used to relieve pain and inflammation in neuropathies.

The German company Heel produces many homeopathic preparations useful for ischemic neuropathy. Its products have occupied a place of honor on the shelves of homeopathic pharmacies in Ukraine for more than 20 years, which has allowed many patients to see their high effectiveness.