Painful polyneuropathies
Antipenko E.A.¹, Sedyshev D.V.<sup>2

1</sup> Nizhny Novgorod State Medical Academy
² Nizhny Novgorod Regional Clinical Hospital named after N.A. Semashko 

Polyneuropathies (PNP) are among the most common diseases of the peripheral nervous system and account for 60% of their total number, according to statistics of the Russian Federation. The article discusses the issues of etiology, pathogenesis, clinical variants, manifestations of the pain syndrome in PNP. The etiotropic and pathogenetic therapy is discussed in detail, as well as the use of B vitamins complexes which effectively reduce pain, normalize reflex reactions, and eliminate sensitivity disorders in patients with alcoholic PNP.
The aim of the study was to assess the analgesic effect of the complex of В vitamins in the treatment of alcoholic and diabetic PNP.
Patients and Methods: 41 patients (34-56 years) with chronic distal sensory diabetic and alcoholic axonal sensorimotor PNP were treated. The diagnosis was confirmed clinically and by electroneuromyography. Before treatment the level of neuropathic pain according to the DN4 questionnaire averaged 7 points, according to a 10-point visual analog scale - 6.8 points. Patients received conventional etiopathogenetic therapy in accordance with the standards of medical care and national guidelines for the treatment of PNP. The main group of 13 patients with diabetic PNP and 10 patients with alcoholic PNP received an additional complex of B vitamins in the form of a drug Neurobionum intramuscularly 1 ampoule daily for 9 days, then orally one tablet 3 times a day for 3 weeks. 
Results: patients of the main group noticed a more pronounced analgesic effect within 9 days. The greatest effect was noted for burning and paroxysmal pains. At the same time, the number of patients who experienced pain reduction of at least 50% was significantly higher in the main group. A month later, the main group experienced an increase in the therapeutic effect.
Conclusion: the use of a complex drug Neurobion in addition to the conventional therapy of painful PNP significantly reduces pain syndrome.

Key words: polyneuropathy, pain syndrome, diabetic polyneuropathy, alcoholic polyneuropathy, B vitamins complexes, electroneuromyographic study.
For citation: Antipenko E.A., Sedyshev D.V. Painful polyneuropathies // RMJ. 2017. № 21. P. 1543–1547.