What is Angioneurosis?

This group includes a number of diseases in which vascular disorders vibrate as a result of autonomic innervation disorders, Raynaud’s disease, erythromelalgia, migraine, Meniere’s disease.

Raynaud’s disease belongs to the group of angiotrophneuroses (syn: vasomotor trophic neurosis, vascular trophic neuropathy). This is the general name for a number of diseases that develop as a result of disorders of vasomotor and trophic innervation of organs and tissues.

Causes of Angioneurosis

M. Raynaud, who described the disease in 1862, believed that it was a neurosis, due to the increased excitability of the spinal vasomotor centers. It was further established that Raynaud’s symptom complex can manifest itself as an independent disease and as a syndrome in some nosological forms.

Pathogenesis during Angioneurosis

Infectious lesions of the autonomic nervous system, endocrine disorders of the thyroid gland and adrenal glands are important. Probably plays the role of congenital failure of certain parts of the autonomic nervous system, in particular the lateral horns of the spinal cord. Damage to the vasomotor centers at different levels (cortex of the cerebral hemispheres, hypothalamus, trunk, spinal cord) occurs, resulting in increased vasoconstrictor tone. A spasm of blood vessels causes blanching of the distal parts of the arms and legs, less often the nose, ears, lips, asphyxiation, lowering the temperature of the affected area and, as a result, tissue necrosis. Pain caused by irritation of sensitive nerve fibers by toxic substances that occur in the ischemic site.

Symptoms of Angioneurosis

The disease in women occurs about 5 times more often than in men, mainly in young and middle age. The affected areas are more often marked on the fingers, less often on the legs and very rarely on the ears, the tip of the nose. A feature of the disease is the symmetry of these manifestations. In classical cases, there are three stages of the disease.

The basis of the first stage is vasospasm. Suddenly developing spasms of capillaries and arterioles of a certain site are characteristic. Usually the affected area becomes pale, cold to the touch, the sensitivity in it decreases. The duration of the attack is from several minutes to an hour or more, after which the spasm passes and the area takes on a normal appearance. Attacks can be repeated at different intervals of time, then the frequency and duration of attacks increase, pain joins.

The second stage is due to asphyxia. The spasm is manifested by a blue-violet color of the skin. There are tingling sensations, and sometimes severe pains, in places of asphyxia the sensitivity disappears. An important role in the development mechanism of this stage is dilatation of the veins. After a while these phenomena disappear. There is a transition of the first stage of the disease to the second.

The third stage develops after prolonged asphyxia. On the swollen limb, which has a violet-blue color, bubbles with bloody contents appear. After opening the bladder, tissue necrosis is found in its place, and in more severe cases, not only the skin, but also all soft tissues up to the bone. The process ends with the scarring of the formed ulcerative surface.

The disease is chronic. The process drags on for decades. In some patients, the paroxysms are repeated several times a day, in others they appear at monthly intervals. Gangrene is rare; at the same time nail phalanges are exposed to necrosis.

Diagnosis of Angioneurosis

The diagnosis is made on the basis of the clinical manifestations of the disease. First of all, it is necessary to determine whether it is an independent disease or Raynaud’s syndrome. The disease is characterized by attacks of blanching or cyanosis of the fingers (usually stage II and III), as well as protruding parts of the face under the influence of cooling, emotional and other irritations, the symmetry of the lesion, the absence of gangrene on the skin of the fingers.

For Raynaud’s syndrome, the presence of signs of the underlying disease is typical: scleroderma, vibration disease, intoxication with various chemicals, anterior scalenus muscle syndrome, additional cervical rib, pectoralis minor muscle, syringomyelia, endocrine disorders (thyrotoxicosis, menopause).

Treatment of Angioneurosis

Assign central and peripheral adrenergic blockers, aminazine, tropafen, dihydroergotamine, ganglioblokatory (pahikarpin, benzogeksony, gangleron), tranquilizers. Antispasmodic vasodilators are shown: nicotinic acid, trental, calcium ion antagonists (adalat, verapamil). Warm baths are advisable. With the failure of conservative therapy, they carry out desimpatisation and preganglionic sympathectomy.

Forecast. In relation to life, the prognosis is good, in terms of complete recovery – unfavorable. If the disease occurs during puberty, then often with age a significant improvement or complete recovery may occur.

Working capacity. Contraindicated work associated with hypothermia of the extremities, with thin and complex movements of the fingers (playing musical instruments, typing on a typewriter), with vibration, dampness, in contact with toxic chemicals. In connection with the impossibility of performing work in the main profession, depending on the severity of the disease, III or (in rare cases) disability group II can be established.