Polyneuropathy after chemotherapy

Polyneuropathy after chemotherapy occurs due to toxic damage to nerve fibers and certain areas of the brain by the drugs used. Patients are primarily concerned about the resulting weakness.

Polyneuropathy is a lesion of the peripheral nervous system, which manifests itself in peripheral flaccid paralysis, sensory disturbances, trophic and vegetative-vascular disorders. If this symptom is ignored during chemotherapy and the necessary symptomatic treatment is not prescribed, then other signs of polyneuropathy arise. They become more intense and diverse.

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Causes polyneuropathy after chemotherapy.

The mechanism of damage to the nervous system may be as follows:

1. Induce axonal degeneration.
2. To provoke the appearance of segmental demyelination.

The degree of manifestation and frequency of symptoms of polyneuropathy after chemotherapy depend on the drug, and its single and cumulative dose also affects it. There are also other risk factors, such as hereditary and acquired neuropathies, diabetes mellitus, existing alcoholism, existing renal and/or hepatic dysfunction, previous courses of chemotherapy.

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Symptoms polyneuropathy after chemotherapy.

Experts distinguish several types of polyneuropathy after chemotherapy:

• Distal – this syndrome manifests itself in symmetrical disturbances of sensitivity and/or disturbances of motor functions in the patient.
• Sensory – manifests itself in sensations of numbness, tingling, cold or burning in different parts of the body. It also manifests itself in dysesthesia – a violation of the sensitivity of nerve fibers, as a result of which, when touching the skin, the patient experiences unpleasant, and sometimes abnormal and perverted sensations. For example, cold can be felt as warmth, a simple touch – as pain. It is possible that this type of polyneuropathy manifests itself only as pain sensations.

All of the above symptoms begin with the feet and toes, with the fingertips and hands. Gradually, these sensations spread to the arms and legs, rising to the spine.

• Motor – manifests itself in decreased muscle strength, decreased tone and atrophy, involuntary muscle movements, decreased tendon reflexes – Achilles, knee. These symptoms begin to appear in the area of the foot, fingertips and toes, hands and gradually spread to the spine. Patients cannot perform simple movements – stand, move on their heels, straighten their hands; symptoms of “drooping” feet or hands appear.
• Vegetative – manifests itself in disturbances of the heart rhythm, changes in blood pressure, dizziness, diarrhea or constipation, dry or sweaty skin, hearing and potency disorders, and urinary incontinence.
• Central - occurs in rare cases and manifests itself in encephalopathy with convulsive syndrome, as well as in disturbances of consciousness - from the appearance of drowsiness to a state of coma. There may also be sensations of an electric charge passing from the neck through the arms and along the spine to the legs after the head has involuntarily bent forward.

Forms

Neuropathy after chemotherapy

Neuropathy after chemotherapy occurs due to damage to the peripheral nervous system, and in rare cases - the central nervous system. Neuropathy manifests itself in the disruption of the patient's motor functions, as well as in decreased sensitivity of the skin, the appearance of perverted (abnormal) sensitivity, decreased vibration sensitivity, decreased tendon reflexes, the appearance of a feeling of numbness in the limbs and body parts, and so on.

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Treatment polyneuropathy after chemotherapy.

To protect against the negative consequences of polyneuropathy, patients and their relatives should adhere to the following recommendations:

Preventing burns:

• use thick rubber gloves when washing dishes and other activities with hot water; if possible, purchase a dishwasher;
• install taps and faucets in the house with automatic water temperature regulation – thermostats;
• When preparing food, always use potholders and oven mitts for pots and pans;

Fall Prevention:

• Place special rubber mats in the bathroom, shower and toilet to prevent slipping;
• temporarily hide all wires, carpets and anything else in the home that could cause a fall (if the patient trips over these objects);
• minimize independent movement on the streets outside the home;
• purchase and wear special orthopedic shoes;
• in winter, move only on paths cleared of snow and ice;
• At night, turn on night lights along the route from the bedroom to the toilet, bathroom or kitchen.

To facilitate self-service:

• purchase shoes and clothing with Velcro fasteners, because tying shoelaces and fastening buttons are difficult tasks for patients with polyneuropathy.

Prevention

To prevent worsening of polyneuropathy symptoms after chemotherapy:

• it is necessary to stop smoking;
• It is prohibited to consume alcohol;
• If you have diabetes, you need to constantly monitor your blood sugar levels;
• Take neurotropic vitamins prescribed by your doctor, which include Thiamine and Neuromultivit.

Patients undergoing therapy with the drug oxaliplatin should avoid contact with cold objects, as these sensations cause pain in patients.

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