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Vegetative disorders in the limbs
Last reviewed: 18.10.2021
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Vegetative disorders in the limbs are a compulsory companion of the pathology of the peripheral nervous system and are often found in submental vegetative disorders. They are manifested by vascular-trophic-algic syndrome as one of the forms of the syndrome of vegetative dystonia.
Symptoms of vegetative disorders are diverse, but they all consist of three types of syndromes: pain, vascular and trophic syndromes.
Pain sensations in the extremities are characterized by a variety, however, several types should be distinguished among them:
- radiculoalgic type - pain is dagger-sharp, shooting, paroxysmal, spreading throughout the dermatome from proximal to distal sections;
- neuralgic type - pain with nerve trunk damage aching, occasionally cutting, relatively prolonged, decreasing at rest, amplified by movement, tension or palpation of the nerve;
- myalgic type - pain is felt in the depths, amplified by pressure or stretching of muscles, gnawing or brainwashing, often localized in separate zones, very constant;
- dysesthetic type - pain in the form of burning, tingling, "ripping off", localized on the skin more distally, of different duration, is enhanced with active movements.
The intensity of pain can be different: from mild soreness, which occurs when palpation of certain areas, to intense pain, accompanied by pronounced vegetative reactions.
Vascular disorders in the limbs can also be of different intensity. They appear naturally stronger in the most distal parts of the limbs. Their characteristic component is a change in the color of the skin: pallor, "marble" skin pattern, redness, cyanosis. In some forms of pathology, these changes occur in the form of three-phase seizures, reflecting the pathophysiological stages of some pathological conditions (the Raynaud phenomenon). These disorders are manifested by subjective sensations of transient numbness, paresthesia. Often, these phenomena are accompanied by a decrease in skin temperature. The prolonged existence of vascular disorders often leads to a violation of venous outflow, which is manifested by swelling of various sites.
Trophic disorders are a frequent phenomenon of peripheral nerve damage. The severity of trophic changes in the skin, subcutaneous tissue can be different: from mild skin peeling to the formation of deep, long-term healing ulcers. Trophic skin changes are usually more noticeable in the hands and feet. Their origin is associated with the traumatic effects of excessive heat or cold, which remain unobserved by the patient due to pain or accompanying sensitivity disorders. Gradually, the skin surface becomes smooth and dense, atrophy of the subcutaneous tissue develops, pigmentation areas are detected, ulcers and fibrosis of the subcutaneous tissue are formed. Fingers can take the form of "drumsticks", the nails appear transverse striation, they thicken, sharpen, become brittle and acquire a clawlike appearance. The hair of the denervated limbs is thinned and falls out, but occasionally hypertrichosis develops, especially in the forearm area.
We can distinguish the following groups of diseases that are accompanied by the most vivid autonomic disorders in the limbs: neurovascular syndromes like neurological manifestations of spine osteochondrosis, tunnel compression-ischemic neuropathies, and polyneuropathic syndromes of various etiologies.