Myositis of the eye muscles. Myositis of the eye muscle: what is it, what is the diagnosis and treatment. Symptoms of muscle damage during inflammation

Ocular myositis is a disease during which one or more external eye muscles become inflamed. This is a rare disease that most often affects one eye. Young people and people in middle age get sick. Men are more often ill. Such a disease develops in people whose work is sedentary (this is the work of representatives of the musical sphere, people associated with working at computers).

Be vigilant - if the disease is not cured in time, then there may be different kind complication. No one talks about surgical intervention, but the fact that you have to go to the hospital for inpatient treatment is quite possible, especially if complications begin with areas of the body that are on the face.

Remember, everyone needs first aid. Always refer to experienced specialists for any changes on the face.

If we talk about the course of the disease, then all inflammatory processes can be acute or chronic.

Depending on the spread, myositis can be local and diffuse.

What are the symptoms of myositis of the eye muscle?

There are the main symptoms of myositis that accompany any of its forms and types. Muscles usually hurt. Increased discomfort occurs when changing weather conditions, as well as at night. There are also such symptoms: the muscle areas involved in the inflammatory process are tensed, the joints are limited in movement. Muscles hurt more.

Eye myositis can be acute exophthalmic, chronic oligosymptomatic. There are also neuromyositis. All these factors, if not dealt with, will lead to very serious sores.

The first is the most common. It is characterized by specific symptoms. The onset is acute, when the eye moves, there is prodromal soreness. Also, this form is distinguished by other symptoms, it is distinguished by a person's photophobia, tearfulness is possible. The latter are joined by exophthalmos, they appear due to the thickening of the inflamed muscles. The more muscles involved in the process, the stronger they are expressed.

The mobility of the eyeballs in the direction of diseased muscles is painful and limited. Because of the perifocal edema, it is difficult for him to move into the orbit. Eye irritation leads to chemosis, ptosis, and periorbital pain. They affect what the condition is referred to as myopathic pain exophthalmos.

Most often, the symptoms are mild. After a couple of weeks, the symptoms disappear. If the course of exophthalmic myositis is sluggish, then it can be considered an orbital tumor, since the radiograph shows orbital opacification.

In the second form, inflammation of the muscles of the eyes, the symptoms are not very pronounced (pains of a breaking nature, the presence of diplopia, paresis of the muscles of the eyes). The process is slow.

Ocular neuromyositis is characterized by acute bilateral exophthalmos, eyelid edema, chemosis, and multiple paralysis of the eye muscles.

How to cure myositis of the eye?

It is not difficult to diagnose this disease. A specialist can make an accurate diagnosis using the patient's history.

To see a detailed picture, you can undergo electromyography. Thus, the bioelectric impulses of the patient are examined. They also take a general blood test so that the inflammatory process can be detected.

Before determining the methods of therapy, in each individual situation, the specialist gets acquainted with the nature of the occurrence of the disease or unpleasant sensations of this kind.

The treatment of myositis itself is divided into pathogenetic and symptomatic. Pathogenetic treatment deals with the cure of the cause of the formation of the disease. Symptomatic treatment alleviates the patient's condition.

Among the main methods in the treatment of eye myositis are:

• physiotherapy treatment;
• physical education treatment;
• massage (suitable for any form of the disease, if the form of the disease is not purulent);
• treatment with a protein diet;
• treatment with anti-inflammatory drugs;
• medication treatment (painkillers and vascular drugs).

A good effect during the treatment of inflammatory eye diseases is given by Prednisolone, Prednisone, Triamcinolone or Dexamethasone. When the disease is severe, in addition to steroids, the use of salicylates is recommended (so that a person sweats when he is wrapped up), Amidopyrine, Butadion, physiotherapy (diathermy, diadynamics).

To avoid the re-development of myositis, it is necessary to sanitize the infectious focus and harden the body.

Summing up the disease

To prevent myositis, each person should take good care of their health. Do not forget to pay attention to the body. All this will be useful in eliminating a number of factors. These are factors that can contribute to the appearance of such inflammation. Otherwise, the disease can have very serious consequences for the body (muscles can simply atrophy).

Muscles should not be overstressed when doing any work. The same applies to the situation when physical activity takes place (sports, for example). Hypothermia must be avoided. Drafts are undesirable. Work must not be carried out in cold rooms. Optimum temperatures should be maintained.

Specialists recommend treating colds and infectious processes correctly and in a timely manner. This will also be the prevention of the disease. Do not neglect the doctor's prescriptions. By contacting specialists in time, you can begin effective treatment. Then it will be easier and easier to treat the disease. Recovery will come quickly.

Myositis is a disease of muscle tissue that has an inflammatory, traumatic, chronic character and is accompanied by painful sensations and weakness throughout the body. Most often, the disease is present in the muscles of the neck, back, shoulders, chest person.

Types of myositis

There are two main forms of myositis - local myositis and polymyositis. Local myositis is characterized by inflammation of one muscle. With polymyositis, the inflammatory process spreads to several muscles or groups of muscles.

The classification of myositis can vary. So, depending on the nature of the course of the disease, chronic, acute and subacute myositis are distinguished, and depending on the prevalence: limited and generalized.

In addition, scientists point out special forms myositis like:

Infectious non-purulent with severe pain and general malaise. This form develops during viral infections.

Acute purulent with the formation of purulent foci in the muscles, with their swelling and severe pain. This form of myositis is often a complication of existing purulent processes, or acts as a symptom of septicopyemia.

Myositis ossificans may be congenital or acquired as a result of trauma.

Polymyositis is expressed in multiple lesions of muscle tissue.

Dermatomyositis, called Wagner's disease, is a systemic disease.

Myositis in children

Myositis in children often, as in adults, occurs after hypothermia and after infectious diseases, as a result of injuries. The disease weakens the contractile function of muscles, blood circulation.

Symptoms:

• Heat body.
• Aching pain in the area of ​​the affected organ.
• Puffiness.
• The appearance of seals.
• The presence of muscle spasms.

Signs of myositis

Myositis has two stages - acute and chronic. As a rule, untreated acute myositis becomes chronic and then periodically worries the patient - the pain intensifies with hypothermia, changing weather conditions, manifesting itself at night and with a long static position of the body.

Acute myositis develops after local infection of the muscle with generalized acute infection, as well as due to injuries and muscle strain (especially in combination with hypothermia).

Myositis primarily affects the muscles of the neck, lower back, lower leg, and chest. In the event that local myositis (and not polymyositis) occurs, pain and muscle weakness apply only to a certain muscle group.

The main symptom of myositis is pain, which is aching in nature and is especially aggravated by movement and touching the muscles. On palpation, painful foci are felt - strands and nodules.

Slight swelling and hyperemia (redness) of the skin occurs in some cases. Sometimes myositis is accompanied by fever, headache.

The patient's condition without adequate therapy deteriorates sharply.

Myositis symptoms

Symptoms that indicate myositis are:

• general signs of injury, infection;
• weakness and fatigue;
• pain;
• decreased mobility;
• change in muscle consistency;
• skin changes;
• sensitivity changes;
• the appearance of contractures and abnormal positions of the limbs.

In acute myositis, which develop as a result of injuries, the first signs will be the consequences of these injuries.

In the first days appear:

• hyperemia (redness) of the skin;
• edema;
• soreness;
• subcutaneous hemorrhages;
• hematomas;
• sometimes the local temperature rises.

When infections are the trigger

viral, bacterial

), then the first symptoms will be the general signs of these infections.

When an inflammatory process develops in a muscle, muscle tone is the first to suffer. Muscle fibers lose their ability to quickly and fully contract and relax.

The patient feels a growing weakness in the affected part of the body. With myositis of the extremities, it is difficult to raise your arms above your head or move your legs.

Weakness can reach such a degree that it becomes difficult for the patient to get up from a chair or bed.

The main characteristic of myositis is pain in the affected muscle or muscle group. The inflammatory process leads to the destruction of muscle fibers and accumulation a large number active substances in the focus of inflammation, which irritate the nerve endings. Pain varies from moderate to severe, depending on the site of the lesion and the stage of the disease.

Many people experience soreness in the neck muscles. Someone writes off unpleasant sensations for overexertion, someone recalls the well-known vague concept of “pinched”, but few people think about myositis.

The symptoms of myositis are diverse, but its main manifestation is considered to be a muscular symptom complex, expressed in muscle weakness. It can disturb a person constantly and be quite pronounced, or it can appear only after a person performs certain tests.

The loss of muscle strength occurs gradually, this process takes from several weeks to several months. Large muscles are involved in the inflammatory process - hips, neck, shoulders, back.

Muscle myositis is characterized by bilateral symmetrical inflammation. At the same time, a person is not able to lift weights, climb stairs, and sometimes even just raise his hand and get dressed on his own.

The hardest people endure is myositis of the shoulder and pelvic muscles. Such patients often suffer from gait disturbance, have difficulty getting up from the floor or from a chair, and may fall during movement.

Other symptoms of myositis may include:

The appearance of a rash.

Increase in general fatigue.

Thickening and thickening of the skin.

Aching pain that increases with movement and probing of the muscles.

Sometimes there is hyperemia of the skin and swelling in the affected area.

Perhaps an increase in body temperature, feverish conditions, headaches.

Pain in the joints appears during periods of exacerbation of myositis, but the skin over the joints does not become swollen or hot, as in arthritis or arthrosis.

With myositis, aching pains appear in the muscles of the arms, legs, torso, aggravated by movement. Often, dense nodules or strands are felt in the muscles. With an open injury, due to infection, purulent myositis may develop, which is manifested by an increase in body temperature, chills, a gradual increase in pain, swelling, thickening and muscle tension, and redness of the skin over it.

Diagnosis of myositis

The initial examination of the patient by a doctor and the compilation of the results of the examination can confirm or refute the presence of inflammation in the muscles. A study of blood, secretions that were taken in the affected area supplements the initial information.

The sequence of diagnostic measures allows you to identify the presence of the inflammatory process, the area of ​​​​distribution, the degree of damage, the cause of the formation.

To make a correct diagnosis, it is necessary to conduct certain types of examinations:

• a blood test that shows how fast red blood cells settle;
• electromyography allows you to identify the condition on the affected area of ​​\u200b\u200bthe muscles have nerve fibers;
• computed tomography allows early detection of signs of ossifying myositis;
• magnetic resonance imaging shows in detail the state of the soft tissues.

The diagnostic results will be used to determine the type of myositis and prescribe a quality treatment.

Which doctor treats myositis?

The doctor who will treat the disease may be of different competence - it all depends on the localization of myositis. Treatment of myositis can be carried out by a therapist, traumatologist, neuropathologist, orthopedist or surgeon.

At the first manifestations of pain, it is necessary to contact a rheumatologist or therapist, who, after an initial examination, will be able to refer you to a specialist for diagnosis and treatment.

The treatment of myositis is in the competence of such doctors as a neuropathologist, rheumatologist and therapist. Initially, with pain in the back, neck or legs, it is necessary to consult a therapist.

Further, depending on the etiology of the disease, the family doctor recommends a consultation with a specialist. So, with myositis due to autoimmune diseases, it is recommended to consult a rheumatologist; with myositis during colds - to the therapist; with neuro- and dermatomyositis - to a neuropathologist.

Diagnosis of myositis, in addition to questioning and examination, may include various laboratory and instrumental examinations, so the patient must be prepared in advance for significant time and material costs.

Diagnosis of myositis includes:

• survey;
• inspection;
• laboratory tests (rheumatic tests);
• instrumental research;
• biopsy.

Includes data on how the disease began and what preceded it.

The doctor may ask the following questions:

• "What is worrying you at the moment?"
• "What was the first symptom?"
• "Was there a temperature?"
• “Was the disease preceded by hypothermia, injury?”
• “What diseases does the patient still suffer from?”
• “What was the patient sick with a month or a couple of months ago?”
• "What was wrong with you as a child?" (for example, did you have rheumatic fever as a child?)
• “Are there any hereditary pathologies in the family?”

Inspection

Initially, the doctor visually examines the place of pain. His attention is attracted by the reddening of the skin over the muscle, or vice versa, their blanching. With dermatomyositis on the skin in the area of ​​the extensor surfaces (

joints

) form red, scaly nodules and plaques. Nails can attract the doctor's attention, since one of the early signs of dermatomyositis is a change in the nail bed (

redness and swelling of the skin

). Long-term myositis is accompanied by muscle atrophy. Above the atrophied muscle, the skin is pale with a meager network of blood vessels.

feeling

) of the affected muscle. This is done to assess muscle tone and identify painful points. In the acute period of the disease, the muscle is tense, as its hypertonicity develops. Hypertonicity is a kind of protective reaction of skeletal muscles, therefore, when

the muscle is always tense. For example, with cervical myositis, the muscles are so tense that it makes it difficult for the patient to move. Sometimes swallowing processes may even be disturbed if the inflammatory process has captured most neck muscles.

Muscle soreness can be both general and local. For example, with infectious purulent myositis, local tender points are revealed that correspond to purulent foci. With polyfibromyositis, pain increases towards the joint, that is, at the points of attachment of the muscle.

With polymyositis, the pain syndrome is moderately pronounced, but muscle weakness progresses. In the clinical picture of myositis ossificans, the pain is moderate, but the muscles are very dense, and dense areas are detected during their palpation. A pronounced pain syndrome is observed with neuromyositis, when nerve fibers are also affected along with muscle tissue.

Rheumatic tests

Rheumoprobes are those tests that are aimed at identifying systemic or local rheumatic diseases.

Such diseases can be:

• rheumatoid arthritis;
• systemic lupus erythematosus;
• polymyositis;
• polyfibromyositis;
• myositis with inclusions and others.

Thus, rheumatic tests help determine the etiology of myositis, confirm or exclude the autoimmune pathogenesis of the disease. Also, with the help of rheumatic tests, the intensity of the inflammatory process is determined.

In the diagnosis of myositis, rheumatic tests include the determination of the following indicators:

• C-reactive protein;
• antistreptolysin-O;
• rheumatic factor;
• antinuclear antibodies (ANA);
• myositis-specific autoantibodies.

C-reactive protein

An increased concentration of C-reactive protein is observed in various inflammatory processes in the body. C-reactive protein is a marker of the acute phase of inflammation, therefore it is determined in acute infectious myositis or in exacerbations of chronic ones.

By determining the level of this protein, one can evaluate the effectiveness of the treatment taken. However, in general, C-reactive protein is only an indicator of the infectious process and does not play a role. important role in the differential diagnosis of myositis.

Antistreptolysin-O

It is an antibody

), which is produced in response to the presence in the body

, or rather on the enzyme it produces - streptolysin (

hence the name

). It is an important diagnostic criterion for

and rheumatoid arthritis. Thus, an increased titer of these antibodies speaks in favor of rheumatic myositis.

Rheumofactor

Rheumofactor is an antibody produced by the body against its own proteins (

immunoglobulins

). Increased values ​​of the rheumatic factor are observed in autoimmune pathologies, dermatomyositis, rheumatoid seropositive arthritis. However, there are cases when the rheumatic factor is negative. This is seen in seronegative rheumatoid arthritis or in children with juvenile arthritis. An important diagnostic value is the quantitative determination of the rheumatic factor before and after treatment.

Antinuclear antibodies

A family of autoantibodies that binds to the components of its own proteins, namely, to the nuclei of cells. Observed with dermatomyositis, scleroderma and other systemic collagenoses.

Myositis-specific autoantibodies Myositis-specific autoantibodies (MSA) are markers of such idiopathic myositis as:

• dermatomyositis;
• polymyositis;
• myositis with inclusions.

MSA is a group of very different antibodies that are produced to various components of cells: mitochondria, some enzymes, cytoplasm.

The most common antibodies are:

• Anti Jo-1 - detected in 90 percent of people suffering from myositis;
• Anti-Mi-2 - seen in 95 percent of people with dermatomyositis;
• Anti-SRP - found in 4 percent of people with myositis.

Biopsy and morphological examination of muscle tissue

A biopsy is a diagnostic method in which pieces of tissue are taken in vivo (

biopsy

), followed by their study. The purpose of a biopsy in the diagnosis of myositis is to determine structural changes in the muscle tissue, as well as in the surrounding vessels and connective tissue.

The indications for a biopsy are:

• infectious myositis;
• polymyositis (and as their variety dermatomyositis);
• polyfibromyositis.

For polymyositis and its variants (

dermatomyositis, polymyositis with

) are characterized by inflammatory and degenerative changes: cell infiltration, necrosis of muscle fibers with loss of transverse striation. In polyfibromyositis, muscle tissue is replaced by connective tissue with the development of fibrosis. In infectious myositis, cellular infiltration of the interstitial tissue and small vessels predominates.

Myositis treatment

To avoid complications, it is necessary to start treatment under the supervision of a doctor immediately after confirming the diagnosis.

Medical treatment

Drug treatment is prescribed by a doctor in order to eliminate the symptoms and the inflammatory process.

For the treatment of the disease, drugs of different pharmaceutical groups can be prescribed:

• Drugs of the NSAID group in tablets (Nimesulide, Ibuprofen, Movalis, Peroxicam, etc.).
• Non-steroidal drugs for injection (Meloxicam, Diclofenac, Mydocalm).
• Analgesics (Antipyrine, Analgin, Paracetomol).
• Ointments (Turpentine ointment, Traumeel S, Dolaren-gel, Roztiran, etc.).

Physiotherapy

Physiotherapy for myositis restores muscle contraction and significantly increases blood circulation.

• Warming and wrapping the inflamed area.
• Manual therapy - a set of techniques, carried out by means of statistical tension, muscle stretching, the main purpose of which is the diagnosis and treatment of the disease.
• Massage - normalizes blood circulation, relieves pain in the muscles, eliminates swelling. The main goal of such therapy is to start the recovery process, to start the work of all limbs. The massage is carried out with increasing effect using a thermal procedure, which allows you to completely relax the inflamed muscles.

Magnetotherapy

Magnetotherapy is an effective method of treatment that reduces muscle weakness, inflammation, redness of the skin, improves blood circulation, increases immunity, reduces pain occurs after the first procedure. With the help magnetic field you can strengthen the therapy prescribed by the doctor.

Often a drug such as Almag-01 is used, it relieves swelling, stabilizes metabolic processes, and relieves inflammation. There are contraindications for treatment with an electromagnetic field - a purulent form of the disease.

Physiotherapy

Therapeutic exercise is not a very specific type of rehabilitation therapy, which consists of a set of physical exercises (sports, games, gymnastics) that restore physiological and psychological health.

Significant improvements are observed after exercise therapy:

• improves mobility in the limbs, joints;
• blood supply and general hemodynamics are activated;
• swelling is reduced and pain is reduced.

Folk remedies can also be used to treat myositis, combined with medications prescribed by a doctor. The basic principle of home treatment is to maintain heat in the affected area with the help of warming ointments, massage using essential oil.

Effective and proven traditional medicine recipes:

• Horsetail Elixir. 4 tsp butter mixed with 1 tsp. horsetail powder, the resulting mixture must be rubbed onto the affected area of ​​\u200b\u200bthe joint or back.
• Cabbage leaf compress. Sprinkle two leaves of cabbage with soda and apply to the sore spot.
• Bodyagi ointment. Mix butter (1 tsp) with ¼ spoon of bodyaga. Rub in before going to bed using heat.
• Burdock compress. Scald burdock leaves with boiling water and apply to the affected area of ​​the muscle.
• Potato recipe. Boil potatoes in uniforms, mash and apply on the neck or back.
• Infusion of Adonis. Pour 2 teaspoons of chopped herbs with boiling water (200 ml), strain and infuse for one hour. Use three times a day for a tablespoon. This infusion will perfectly reduce the pain.

Inpatient treatment of myositis can be prescribed for an acute form of the disease or for periodic exacerbations.

Treatment of myositis depends on the cause that caused this disease. With purulent infectious myositis, antibacterial agents are prescribed, with hypothermia -

With myositis due to hypothermia or stress (

most often it is cervical or lumbar myositis

), local treatment is prescribed in the form of ointments.

Ointments for the treatment of non-purulent infectious myositis

With extensive myositis that affects several muscle groups and which is accompanied by fever and other symptoms of a cold, treatment is prescribed in an injection form (

Injections for the treatment of non-suppurative infectious myositis

Tablets for the treatment of non-purulent infectious myositis

Most often, the treatment of myositis is combined, that is, medicines are prescribed locally (

in the form of an ointment

) and systemically (

in the form of tablets or injections

Treatment of polymyositis and its forms (dermatomyositis)

The main drugs in the treatment of polymyositis and its form of dermatomyositis are glucocorticosteroids. The drug of choice is prednisolone, which is prescribed in the form of injections in the acute period of the disease.

Injections for the treatment of polymyositis and its form of dermatomyositis

With the ineffectiveness of the therapy, the so-called puls-therapy is carried out, which consists in the introduction of ultra-high doses of glucocorticoids (

1 - 2 grams

) intravenously for a short period (

3 – 5 days

). This therapy is carried out exclusively in a hospital.

Prednisolone tablets are prescribed as maintenance therapy after remission is achieved. Methotrexate and azathioprine are also prescribed in tablet form. These drugs belong to the group of immunosuppressants and are prescribed in the most severe cases and when prednisolone is ineffective.

Tablets for the treatment of polymyositis and its form of dermatomyositis

Since diffuse inflammation of the muscles is observed in poliomyositis, the appointment of ointments is impractical.

Treatment of ossifying myositis

With ossifying myositis, conservative treatment is effective only at the beginning of the disease, when resorption of calcification is still possible. Basically, the treatment of this type of myositis is reduced to surgical intervention.

Massage and rubbing ointments are contraindicated.

Treatment of polyfibromyositis

Treatment for polyfibromyositis includes anti-inflammatory drugs, lidase injections, massage, and physiotherapy.

Ointments for the treatment of polyfibromyositis

Injections for the treatment of polyfibromyositis

In the form of tablets, anti-inflammatory drugs are prescribed, which are advisable only in the acute phase of the disease.

Tablets for the treatment of polyfibromyositis

Treatment of purulent infectious myositis

Includes application

Painkillers and

funds. In some cases, surgery is indicated.

Ointments with their subsequent rubbing over the affected surface are contraindicated, as they can contribute to the spread of the purulent process to healthy tissues.

Injections for the treatment of purulent infectious myositis

Tablets for the treatment of purulent infectious myositis

Treatment of myositis in autoimmune diseases

In parallel with the treatment of the underlying disease, which is accompanied by myositis (

systemic lupus erythematosus, scleroderma

) symptomatic therapy of myositis is carried out. It consists in taking painkillers and anti-inflammatory drugs; in the acute phase, a pastel regimen is observed.

Ointments for the treatment of myositis in autoimmune diseases

Injections for the treatment of myositis in autoimmune diseases

Tablets for the treatment of myositis in autoimmune diseases

Therapy of myositis with folk remedies consists in the use of ointments, oils, solutions and tinctures for alcohol for rubbing. Anti-inflammatory compresses and heat isolation of the affected muscle area are widely used.

These manipulations require restrictions motor activity and maximum peace of mind. With pain syndrome with myositis help to cope herbal infusions before using which you should consult your doctor.

Therapy for myofasciculitis is selected individually for each patient after a thorough diagnosis.

Symptom-by-symptom treatment is as follows - dental correction (correction of functional mandibular disorders, occlusion); elimination of stress factors with the appointment of antipsychogenic and sedative drugs (persen, diazepam). Correction of vertebrogenic triggers is necessary (correction of the pathology of the spinal column).

Injection blockades with anesthetic drugs at trigger points may be used.

When pain or swelling appears, one should not rush to be treated with any, even popular, medicines or folk remedies, but one should immediately consult a doctor. At the very beginning, as soon as the patient seeks medical help, he is examined, and then an examination, which may require an X-ray or MRI, moreover, resonance therapy will give more data on the course of the disease, which will allow the correct treatment to be prescribed.

In addition, a blood test is needed to determine the inflammatory process in the body, and rheumatic tests are also done. Rarely, tissue biopsy is required.

Myositis of the neck is an inflammatory disease of the muscles of the neck, due to the action of many causes. Among other forms of this disease, it is the cervical variant that is widespread and poses the greatest danger.

The disease affects people of any age and gender. The risk group especially includes people (a social being with reason and consciousness, as well as a subject of socio-historical activity and culture) who have other problems with the musculoskeletal system.

Symptoms of the disease are experienced by almost every person during his life. This disease can be treated with conservative methods using alternative therapy.

Treatment will primarily depend on the severity of the symptoms of the disease. It can be reduced to taking antibacterial drugs, antiviral agents, immunosuppressants, etc.

The treatment regimen for myositis should be selected on an individual basis, taking into account all the clinical manifestations of the disease.

To eliminate the inflammatory phenomena that provoked myositis, it is possible to use immunosuppressive drugs, for example, Methotrexate, Prednisolone, Azathioprine.

If myositis is of a viral nature, then treatment should be aimed at maintaining the body's immune forces and fighting the infection, since there is no etiological therapy. If a bacterial infection has become the cause of muscle inflammation, then antibiotics are advisable.

Treatment of myositis is carried out under the supervision of a doctor and consists in the fight against infection and the proper organization of work, sports and recreation. Treatment of myositis is pathogenetic and symptomatic.

Despite the terrible pain, cervical myositis is treated quite easily (in the event that the treatment is started immediately and the attack has not taken on a protracted character).

Firstly, an experienced doctor will advise the sick person to be as completely at rest as possible. The affected area should be lubricated with a warming ointment, and an anti-inflammatory drug should be taken inside.

The best effect is given by novocaine blockade - chipping the most painful areas of the affected muscles with novocaine with the addition of corticosteroid hormone. Therapeutic effect from carrying out novocaine blockade manifests itself almost immediately after the procedure: muscle inflammation decreases and pain disappears.

PIR (stretching muscles and ligaments) is a relatively new therapeutic method of manual therapy, which involves the active interaction of the patient and the doctor. The patient is not passive during the procedure, he tenses and relaxes certain muscles.

And the doctor during relaxation stretches his muscles. During the procedure, the patient notices with surprise that tension and pain disappear right before their eyes.

The number of PIR procedures is prescribed depending on the patient's condition.

Prevention of myositis

What do we have to do?

For the prevention of myositis, it is necessary:

• follow a balanced diet;
• observe the water regime;
• lead an active lifestyle, but at the same time avoid excessive physical exertion;
• treat colds and other infectious diseases in a timely manner (it is impossible to carry diseases on the legs and allow their complications).

Diet

Fatty polyunsaturated acids help to prevent the inflammatory process in the muscles.

A sufficient amount of polyunsaturated acids is found in:

• salmon species of fish (salmon, pink salmon, chum salmon);
• herring;
• halibut;
• tuna.

For the prevention of myositis, foods with a high content of salicylates are also useful.

These products include:

• carrot;
• beet;
• potato.

Easily digestible proteins help to increase the resistance of the body, for which you should include soy, chicken, almonds in the diet. Also on the menu should be foods with a high content of calcium (

Myositis of the eye muscle: what is it, what is the diagnosis and treatment

Ocular myositis is a disease during which one or more external eye muscles become inflamed. This is a rare disease that most often affects one eye. Young people and people in middle age get sick. Men are more often ill. Such a disease develops in people whose work is sedentary (this is the work of representatives of the musical sphere, people associated with working at computers).

Be vigilant - if the disease is not cured in time, then there may be various kinds of complication. No one talks about surgical intervention, but the fact that you have to go to the hospital for inpatient treatment is quite possible, especially if complications begin with areas of the body that are on the face.

Remember, everyone needs first aid. Always refer to experienced specialists for any changes on the face.

Myositis of the eye - what affects and how?

The occurrence of muscle inflammation is affected by the presence of:

If we talk about the course of the disease, then all inflammatory processes can be acute or chronic.

Depending on the spread, myositis can be local and diffuse.

Diffuse forms of the disease or polymyositis usually do not differ in the intense manifestation of the pain syndrome. It is more distinguished by a gradual increase in weakness, it is accompanied by swelling of the affected areas. Also, the joints that are nearby may be involved in the process. This can lead to arthritis.

What are the symptoms of myositis of the eye muscle?

There are the main symptoms of myositis that accompany any of its forms and types. Muscles usually hurt. Increased discomfort occurs when changing weather conditions, as well as at night. There are also such symptoms: the muscle areas involved in the inflammatory process are tensed, the joints are limited in movement. Muscles hurt more.

Eye myositis can be acute exophthalmic, chronic oligosymptomatic. There are also neuromyositis. All these factors, if not dealt with, will lead to very serious sores.

The first is the most common. It is characterized by specific symptoms. The onset is acute, when the eye moves, there is prodromal soreness. Also, this form is distinguished by other symptoms, it is distinguished by a person's photophobia, tearfulness is possible. The latter are joined by exophthalmos, they appear due to the thickening of the inflamed muscles. The more muscles involved in the process, the stronger they are expressed.

The mobility of the eyeballs in the direction of diseased muscles is painful and limited. Because of the perifocal edema, it is difficult for him to move into the orbit. Eye irritation leads to chemosis, ptosis, and periorbital pain. They affect what the condition is referred to as myopathic pain exophthalmos.

Most often, the symptoms are mild. After a couple of weeks, the symptoms disappear. If the course of exophthalmic myositis is sluggish, then it can be considered an orbital tumor, since the radiograph shows orbital opacification.

In the second form, inflammation of the muscles of the eyes, the symptoms are not very pronounced (pains of a breaking nature, the presence of diplopia, paresis of the muscles of the eyes). The process is slow.

Ocular neuromyositis is characterized by acute bilateral exophthalmos, eyelid edema, chemosis, and multiple paralysis of the eye muscles.

How to cure myositis of the eye?

It is not difficult to diagnose this disease. A specialist can make an accurate diagnosis using the patient's history.

To see a detailed picture, you can undergo electromyography. Thus, the bioelectric impulses of the patient are examined. They also take a general blood test so that the inflammatory process can be detected.

Before determining the methods of therapy, in each individual situation, the specialist gets acquainted with the nature of the occurrence of the disease or unpleasant sensations of this kind.

The treatment of myositis itself is divided into pathogenetic and symptomatic. Pathogenetic treatment deals with the cure of the cause of the formation of the disease. Symptomatic treatment alleviates the patient's condition.

Among the main methods in the treatment of eye myositis are:

• physiotherapy treatment;
• physical education treatment;
• massage (suitable for any form of the disease, if the form of the disease is not purulent);
• treatment with a protein diet;
• treatment with anti-inflammatory drugs;
• medication treatment (painkillers and vascular drugs).

A good effect during the treatment of inflammatory eye diseases is given by Prednisolone, Prednisone, Triamcinolone or Dexamethasone. When the disease is severe, in addition to steroids, the use of salicylates is recommended (so that a person sweats when he is wrapped up), Amidopyrine, Butadion, physiotherapy (diathermy, diadynamics).

To avoid the re-development of myositis, it is necessary to sanitize the infectious focus and harden the body.

Summing up the disease

To prevent myositis, each person should take good care of their health. Do not forget to pay attention to the body. All this will be useful in eliminating a number of factors. These are factors that can contribute to the appearance of such inflammation. Otherwise, the disease can have very serious consequences for the body (muscles can simply atrophy).

Muscles should not be overstressed when doing any work. The same applies to the situation when physical activity takes place (sports, for example). Hypothermia must be avoided. Drafts are undesirable. Work must not be carried out in cold rooms. Optimum temperatures should be maintained.

Specialists recommend treating colds and infectious processes correctly and in a timely manner. This will also be the prevention of the disease. Do not neglect the doctor's prescriptions. By contacting specialists in time, you can begin effective treatment. Then it will be easier and easier to treat the disease. Recovery will come quickly.

Myositis of the orbit

Myositis of the orbit- acute or chronic inflammation of the oculomotor muscles. The main symptoms of the disease are bursting pain in the periorbital region, muscle weakness, diplopia, and limited mobility of the eyeball. The palpebral fissure is narrowed, the eyelids are swollen. Ophthalmoscopy, biomicroscopy, ultrasound, tonometry, gonioscopy, CT of the orbits and brain are used to make a diagnosis. The tactics of treatment is reduced to the appointment of antibiotics, angioprotectors, NSAIDs, antihistamines, hormonal drugs and radiotherapy. After stopping the acute process, electrophoresis is applied.

Myositis of the orbit

Myositis of the orbit is a disease in which one or more external muscles of the eye are affected. The pathology was first described in 1903 by the American scientist G. Gleason. According to statistics, the primary idiopathic variant occurs in 33% of patients suffering from myositis. The secondary form accounts for 67% of cases. Often, pathology is considered in the general structure of the pseudotumor of the orbit. The development of modern diagnostic methods in ophthalmology has reduced the frequency of enucleation by 27%. The idiopathic variant of the disease is more often diagnosed in males after 40 years of age. Secondary damage to the muscles of the orbit occurs in all age groups.

Causes of myositis of the orbit

Etiology this disease not fully explored. Scientists believe that the primary form is based on an autoimmune process in which skeletal muscles are damaged. At the same time, it remains unknown why exactly the external muscles of the eyeball are involved in this process. The main causes of secondary inflammation of the oculomotor muscles are:

• Traumatic injuries. Direct trauma to the muscles or bone walls of the orbit is complicated by secondary myositis, which is due to local damage to muscle fibers. Pathology can occur against the background of contusion of the eye.
• Infectious diseases. The starting factor is the flu, tonsillitis, rheumatism. Toxins or decay products formed during syphilis and toxoplasmosis of the eye have tropism for myocytes. After etiotropic treatment, all symptoms of pathology disappear.
• Impact of physical factors. The onset of symptoms of myositis is often preceded by hypothermia or a burn. With the formation of post-burn scars, symptoms cannot be eliminated.
• Body intoxication. Transient myositis is one of the frequent manifestations of drug or alcohol poisoning. Intoxication with pesticides under production conditions (mercury vapor, lead) also potentiates the development of the disease.
• Non-observance of hygiene rules. Neglect of eye hygiene contributes to the penetration of pathological agents into the orbital cavity. Cosmetical tools, remaining on the skin with untimely removal of makeup, toxic effect on the structure of the eyeball.
• Iatrogenic effect. The clinical picture develops in early or late postoperative period. Surgical intervention for the correction of strabismus is often complicated by inflammation of the oculomotor muscles.

Pathogenesis

The mechanism of development of primary idiopathic myositis has not been elucidated. In the pathogenesis of the secondary form, the type of triggering factor directly depends on the etiology. In case of injuries or intraoperative muscle damage, the pathological process is triggered by pro-inflammatory agents (interleukins 1, 2, 6, 8, interferon gamma, tumor necrosis factor a). The external muscles of the eye during the infectious genesis of the disease are affected by the toxins of the pathogen and the decay products of the surrounding tissues. Acute intoxication with ethanol and narcotic substances leads to a decrease in skeletal muscle tone. Over time, atony is replaced by spasm, convulsive twitches, which potentiate the development of myositis. The basis of inflammation of the muscles of the orbit during hypothermia is a neurogenic mechanism.

Classification

Taking into account the cause of development, primary idiopathic and secondary myositis are distinguished. The etiology of the primary form remains unknown, the secondary variant occurs against the background of other pathological conditions and diseases of intraorbital localization. According to the clinical classification, the following types of the disease are distinguished:

• Acute. It is distinguished by a sudden onset and positive dynamics with timely treatment. Clinical symptoms are leveled independently for 6 weeks. Relapses are not observed.
• Chronic. The duration of the course is more than 2 months. Patients often claim that symptoms have been present for many years. Periods of exacerbations alternate with short-term remissions. The chronic course is most characteristic of the idiopathic form of the disease.

Symptoms of myositis of the orbit

In the idiopathic form, the first manifestations occur against the background of complete well-being. Patients complain about sharp pain in the region of the orbit, a feeling of pronounced muscle weakness. Visually determined swelling of the eyelids. The orbital fissure narrows due to secondary ptosis. The mobility of the eyelids and the eyeball is sharply limited or impossible. With a unilateral lesion, patients note double vision. The pain syndrome increases with the movement of the eyes in the direction of the lesion. The phenomenon of exophthalmos progresses very quickly. An increase in eye muscles in volume is accompanied by a feeling of bursting pain in the orbit.

Appears on the affected side headache, which increases when you try to make movements with the eyeballs. The conjunctiva is hyperemic. The line of transition of the orbital conjunctiva into the palpebral conjunctiva is smoothed due to edema. Visual impairment occurs only with compression of the ONH in patients with a high degree of exophthalmos. Clinical manifestations increase with general hypothermia of the body, emotional overstrain. In severe cases, a slight increase in body temperature, swelling of the entire periorbital zone is possible.

In secondary myositis of the orbit, there is a clear relationship between the development of symptoms of the disease and the action of certain factors (hypothermia, correction of strabismus, intoxication). With a traumatic or iatrogenic genesis of the pathology, the reposition of the eye is practically impossible. In patients with intoxication, the symptoms are temporary, and the elimination of the action of the etiological factor makes it possible to achieve stable clinical remission. For secondary myositis that occurs against the background of hypothermia, a recurrent course is often characteristic.

Complications

In the absence of timely treatment, cicatricial-atrophic changes occur, which practically do not undergo reverse development. Most patients develop ophthalmohypertension resistant to antihypertensive therapy. With a high degree of severity, signs of stagnation of the optic nerve head are observed, a subsequent transition to total atrophy is possible. A progressive decrease in visual acuity causes amaurosis. The chronic form is complicated by restrictive myopathy. Retrobulbar fiber can be replaced by fibrous or cartilaginous tissue.

Diagnostics

The first step in the diagnosis is a physical examination of the patient. Visually, exophthalmos is determined in combination with swelling of the periorbital zone. Exophthalmometry can be used to measure the degree of protrusion of the eyeball. In infectious myositis, the causative agent of the pathology is identified using serological methods. Specific research methods include:

• Ultrasound of the eye. When conducting ultrasound in B-mode, an increase in the volume of the eyeball is determined. The echogenicity of the affected muscle is reduced. Splitting of echo signals from the fundus is noted.
• CT scan of the brain and orbits. The affected muscle is spindle-shaped thickened. When examining the orbit in the axial projection, exophthalmos of moderate severity is detected. The volume of muscle tissue and eyelids is increased. The retrobulbar space is not changed.
• Contactless tonometry. Intraocular pressure is increased. With additional electronic tonography, there are no changes in the circulation of intraocular fluid.
• Biomicroscopy of the eye. When examining the anterior segment of the eyeball, reporting and injection of conjunctival vessels are revealed. The transparency of the cornea is not reduced. The relief of the iris is preserved.
• Gonioscopy. The anterior chamber of the eyes is medium in size. The transparency of aqueous humor is complete. With the traumatic nature of the disease, an admixture of blood is determined in the intraocular fluid.
• Ophthalmoscopy. When examining the fundus, a pale pink optic disc with clear boundaries is visualized. The arteries are constricted. Macular reflexes are preserved. A "transverse band" is found on the retina.

Differential diagnosis is carried out with neoplasms of the orbit and endocrine ophthalmopathy. With a progressive tumor of the orbit, the pain syndrome is less pronounced, the relationship with eye movements is practically not traced. With myositis, the muscles are affected along the entire length, while with endocrine ophthalmopathy this occurs only in limited areas.

Treatment of myositis of the orbit

Therapeutic tactics depend on the causes of the disease. Etiotropic therapy is used only when myositis occurs against the background of an infectious pathology. In case of traumatic genesis, surgical intervention is performed, aimed at restoring the integrity of the affected muscle. Conservative therapy of the disease includes:

• Antibiotics. In the treatment of myositis, broad-spectrum antibacterial drugs are used. Medicines are administered retrobulbarno. A short course of antibiotic therapy lasting 5-7 days is recommended.
• Non-steroidal anti-inflammatory drugs. Medicines of this group are highly effective with mild severity of pathology. NSAIDs are prescribed for acute course or during exacerbations.
• Hormonal drugs. Shown in severe or complicated course and a tendency to frequent relapses. Glucocorticosteroids are often used in the treatment of idiopathic myositis in the absence of the effect of NSAIDs.
• Angioprotectors. A vasoconstrictor prevents excessive exudation and increased edema. Strengthening the vascular wall avoids the development of retinal complications.
• radiotherapy. It is used for the treatment of resistant forms of the disease and for the prevention of relapses in case of insufficient effectiveness of the classical treatment regimen. Irradiation is carried out with a dose of 20 Gy on the lateral wall of the orbit.

After the elimination of the acute inflammatory process, physiotherapy is prescribed. Alternately, electrophoresis of antibacterial drugs is used in combination with antihistamines and glucocorticosteroids. In parallel, osmotherapy is carried out. Antihypertensive drugs are ineffective.

Forecast and prevention

The prognosis for acute orbital myositis is favorable. In a chronic course, relapses of the disease are possible. Specific preventive measures have not been developed. Non-specific prevention is reduced to observing safety precautions (use of glasses, masks) when working in a production environment, timely removal of decorative cosmetics. The patient should be under dynamic observation by an ophthalmologist for three months after the relief of symptoms. The development of repeated attacks requires the appointment of anti-relapse therapy with radio wave methods.

Neuralgia of the eye localization

Sluder (Sluder G., 1908) syndrome of neuralgia of the pterygopalatine node. This node is located under the mucous membrane of the outer wall of the nose at the posterior end of its middle shell. It is associated with branches of the trigeminal and facial nerves, the sympathetic plexus of the internal carotid artery, and the ciliary ganglion. Through it pass fibers that innervate the lacrimal gland. It is affected as a result of inflammatory and tumor processes developing in the main or ethmoid sinuses, tonsillitis and odontogenic infection. The main symptoms: paroxysmal oculo-orbital pain, as well as secretory and vasomotor disorders that involve the organ of vision. Pain is usually sharp, "shooting" character. Accompanied by blepharospasm, photophobia, lacrimation, edema of the upper eyelid, conjunctival hyperemia, corneal hyperesthesia, mydriasis, and sometimes transient increase in IOP. Treatment: cocaine blockade of the nasal mucosa in the area of ​​the node (during an attack of pain), etiological therapy.

Hageman-Pochtman (Hageman, 1959-Pochtman SM., 1958) syndrome of the ciliary (ciliary) node. This node is located

20 mm behind the posterior pole of the eye under the external rectus muscle, adjacent in this zone to the surface of the optic nerve. The syndrome occurs as a result of inflammatory processes that develop in the paranasal sinuses or in the orbit, as well as on the basis of infectious diseases, especially influenza and herpes. The main symptoms: unilateral mydriasis with no pupillary reactions to light and convergence, corneal hypoesthesia, weakening or paralysis of accommodation. These changes can be combined with pain in the depth of the orbit and headaches. Treatment is etiological and symptomatic.

Charlina (Charlina C, 1931) syndrome of neuralgia of the nasociliary nerve. This nerve, through its branches, takes part in the innervation of the anterior part of the eye, the anterior third of the nasal cavity, as well as the skin surface of the eyelids at the upper inner corner of the orbit, forehead, root and tip of the nose. The syndrome in full or partial form occurs due to sinusitis, nasopharyngeal adenoids, facial injuries and some other reasons. It develops acutely, with the appearance of oculo-orbital pains. They are accompanied by blepharospasm, photophobia and lacrimation. Changes in the anterior part of the eye can be represented by epithelial, ulcerative and even hypopyon-keratitis, as well as iridocyclitis with precipitates. From the corresponding nasal passage, the mucous membrane of which is edematous and hyperemic, a secret is abundantly and paroxysmal. Treatment is etiological and symptomatic.

Neuralgia of the eye localization

Slyudera syndrome - neuralgia of the pterygopalatine node. This node is located under the mucous membrane of the outer wall of the nose at the posterior end of its middle shell. It is associated with branches of the trigeminal and facial nerves, the sympathetic plexus of the internal carotid artery, and the ciliary ganglion. Through it pass fibers that innervate the lacrimal gland. It is affected as a result of inflammatory and neoplastic processes developing in the main and ethmoid sinuses, tosillitis and odontogenic infection.

The main symptoms: paroxysmal oculo-orbital pains, secretory and vasomotor disturbances that involve the organ of vision. The pains are acute, shooting character, accompanied by blepharospasm, photophobia, lacrimation, swelling of the upper eyelid, conjunctival hyperemia, corneal hyperesthesia, mydriasis, and sometimes a transient increase in IOP.

Treatment: novocaine blockade of the nasal mucosa and the site of the node (during an attack of pain), etiological therapy.

Hageman-Pochtman syndrome - syndrome of the ciliary (ciliary) node. This node is located 20 cm behind the posterior pole of the eye under the external rectus muscle, adjacent in this zone to the surface of the optic nerve. The syndrome occurs as a result of inflammatory processes that develop in the paranasal sinuses or in the eye socket, due to infectious diseases, especially influenza and herpes.

The main symptoms: unilateral mydriasis with no pupillary reactions to light and convergence, corneal hypoesthesia, weakening or paralysis of accommodation. These changes can be combined with pain in the depth of the orbit and headaches.

Treatment is etiological and symptomatic.

Charlin's syndrome of neuralgia of the nasociliary nerve. This nerve, through its branches, takes part in the innervation of the anterior part of the eye, the anterior third of the nasal cavity, as well as the skin surface of the eyelids at the upper inner corner of the orbit, forehead, root and tip of the nose. The syndrome in full or partial form occurs due to sinusitis, nasopharyngeal adenoids, facial injuries and other causes.

It develops acutely, with the appearance of oculo-orbital pains. They are accompanied by blepharospasm, photophobia and lacrimation. Changes in the anterior part of the eye can be represented by epithelial, ulcerative and even hypopyon-keratitis, as well as iridocyclitis with precipitates. From the corresponding nasal passage, the mucous membrane of which is edematous and hyperemic, a secret is abundantly and paroxysmal.

Neuralgia of the facial nerve: causes, symptoms and treatment

The facial nerve is the 7th pair of cranial nerves and consists mainly of motor fibers that are responsible for the movement of facial muscles. Each half of the face is innervated by its own facial nerve. When the nerve is damaged, paresis (muscle weakness) or plegia (lack of movement) occurs in the facial muscles. The term "neuralgia of the facial nerve" is not entirely correct, since neuralgia refers to nerve damage, which is accompanied by a pronounced pain syndrome, because the sensory fibers in the nerve are affected. The facial nerve contains a small amount of taste, pain and secretory fibers, so the term "neuropathy" would be more accurate.

Neuropathy of the facial nerve or, in other words, "Bell's palsy" occurs in 25 people per 100 thousand of the population. Men and women are affected equally often.

Causes

In 80% of cases, it is not possible to identify the cause of the disease. In other cases, there are a number of predisposing and provoking factors:

The peak incidence occurs in the autumn and spring, when windy weather sets in and people do not wear hats.

• Compression of the facial nerve by a tumor.
• Infectious and inflammatory processes (otitis, parotitis) of a viral and bacterial nature.
• Traumatic nerve damage (wounds, skull fractures).
• Diabetes.
• Pregnancy.

Under the influence of various factors, there is a violation of microcirculation and the development of edema, which leads to compression of the nerve and a violation of the conduction of excitation in it.

Symptoms

To understand what makes up the clinical picture of damage to the facial nerve, consider where it is located and what it is responsible for.

Between the bridge and the medulla oblongata are the nuclei of the facial nerve. The processes of the cells that form the nuclei go to the base of the brain, where they approach the temporal bone. In the temporal bone there is a canal of the facial nerve, through which the nerve passes, then it exits to the surface of the face through the stylomastoid foramen, penetrating the parotid salivary gland, next to the external auditory meatus. In the canal of the temporal bone, branches depart from it, which innervate the taste buds on the tongue, the lacrimal glands and the tympanic membrane. On the face, it is divided into several branches that innervate the muscles of the face.

Thanks to the facial nerve, we can smile, close our eyes, wrinkle our forehead, puff out our cheeks, make faces, show an angry or joyful face, we can cry with tears, taste the tip of the tongue.

Levels of damage to the facial nerve can be different, most lesions occur in the narrow canal of the temporal bone. As a rule, neuropathy of the facial nerve develops acutely within a couple of hours, less than a day. A person has a smoothness of the skin folds on the face, the face "sags" on the side of the lesion. A person cannot wrinkle his forehead, close his eyes (he remains open - Bell's symptom), cannot hold food in his mouth, as the muscles of the cheeks and lips become weak, lose the ability to raise an eyebrow. If you ask a person to curl his lips or whistle, then he will not be able to do it. The cheek swells when talking (a symptom of the "sail"), speech becomes slurred, the corner of the mouth is lowered down. Due to the weakness of the orbicular muscle of the eye, tear fluid accumulates, causing lacrimation.

If the fibers responsible for the work of the lacrimal gland are damaged, dry eyes develop. Taste sensitivity on the tongue may change, pain in the parotid gland may appear.

Allocate the degree of damage to the facial nerve:

Paresis (weakness) of the mimic muscles is weakly expressed, it is detected upon careful examination. A slight drooping of the corner of the mouth, closing the eyelids with effort may be detected. The expression has been saved.

Paresis of facial muscles is noticeable, but does not disfigure the face. The eye closes with effort, the forehead can be wrinkled.

There is a disfiguring asymmetry of the face. The forehead cannot be wrinkled, the eye is partially closed.

Movements in the muscles of the face are barely noticeable. The eye practically does not close, the forehead does not move.

• Extremely severe degree of total plegia.

Completely absent movement on the affected side of the face. The most unfavorable prognosis in terms of the restoration of facial expressions.

Diagnostics

Diagnostic measures include a number of laboratory and instrumental studies that are aimed at establishing the cause of the disease:

• Examination by a neurologist.
• General blood analysis.
• ENMG (electromyography). The method allows you to accurately determine the level of damage to the facial nerve.
• X-ray of the temporal bone, paranasal sinuses (search for pathology of ENT organs).
• MRI of the brain (search for a brain tumor, stroke or other processes).

Treatment

Timely treatment in half of the cases leads to a complete recovery of the person. The later treatment is started, the worse the prognosis. Treatment only in a hospital; includes several areas:

1. Medical treatment.

• Glucocorticosteroids (Prednisolone). The main treatment is aimed at removing edema in the temporal bone canal and improving microcirculation, so hormones are prescribed from the first days of the disease.
• Non-steroidal anti-inflammatory drugs (Meloxicam, Nise). Used to relieve inflammation, reduce pain in the parotid region.
• B vitamins (Combilipen, Neurobion). Thanks to B vitamins, nervous tissue recovers much better and faster.
• Vasoactive drugs (Pentoxifylline). Improve microcirculation in the lesion.
• Metabolic agents (Actovegin). Preparations of this group improve the trophism of the nerve fiber, contribute to the rapid restoration of the myelin sheath of the nerve.
• Eye drops and ointments. They are prescribed for dry eyes, prevent the development of inflammation of the cornea or ulceration.
• Antiviral drugs (Acyclovir). With the proven role of viruses in the development of facial neuralgia, these drugs are prescribed from the first days of the disease.
• Antibacterial drugs (Ceftriaxone). They are used if the role of a bacterial infection in the development of the disease is proven.
• Anticholinesterase drugs (Neuromidin). They provide better impulse conduction from the nerve to the muscle. Appointed during the recovery period.

1. Physiotherapy (electrophoresis). Well proven physiotherapy, especially in the early recovery period.
2. Band-aid traction is used to prevent the muscles from getting used to the new position.
3. exercise therapy. Gymnastics of mimic muscles should be carried out several times a day, regularly. To restore speech, articulatory gymnastics is necessary.
4. Surgery. These are plastic surgeries that are aimed at replacing the facial nerve with another nerve fiber in the absence of results from other methods of treatment.

Forecast

Complete recovery occurs in most cases (70%). In other cases, incomplete restoration of the work of facial muscles remains. Total plegia and severe degree have a low percentage of positive results after treatment. Some people develop muscle contractures, which are spasmodic muscles with involuntary twitches and are accompanied by severe pain in these muscles.

There are a number of unfavorable prognostic factors:

• Combination of neuropathy of the facial nerve with diabetes mellitus.
• development of dry eye.
• Elderly age.
• Hypertonic disease.
• Deep damage to the facial nerve according to ENMG.

Neuropathy of the facial nerve does not affect the general condition of the body, but it affects the social and psychological aspects of a person's life, disfiguring the face. Timely diagnosis and treatment in most cases lead to a complete recovery of a person and his return to normal activities.

Neurologist E. Lyakhova talks about neuropathy of the facial nerve.

With myositis of the eye, one or more external muscles become inflamed. The disease is quite rare and often treated quickly, but severe forms of inflammation can lead to atrophy of the eye muscle and complete loss of vision. We will find out what causes this pathology and how it is treated.

Inflammation of the eye muscle: features of the disease

Ocular myositis occurs mainly in men over 30 years of age who lead a sedentary lifestyle and whose professional activities are associated with a large load on the organs of vision. Takes inflammation most often unilateral form. Myositis of the oculomotor muscles is primary and secondary. The first occurs as a result of autoimmune diseases, when the cells of the body attack their own tissues, and not just harmful ones. Because of this, the muscles of the eye increase in size and thicken. This leads to swelling of the eyelids. Symptoms of secondary myositis can be different. They depend on the factors that provoked the disease.

The main causes of ocular myositis

Inflammation of the eye muscle of the secondary type occurs due to exposure to toxic substances and other adverse factors on the eyes. The most common causes of pathology:

• mechanical injuries of the eyeballs, including burns;
• constant load on the eyes in the absence of therapeutic exercises to relax the eye muscles;
• infectious ophthalmic diseases of viral, fungal or bacterial etiology;
• eye surgery;
• alcohol abuse, intoxication with narcotic substances and industrial poisons;
• hypothermia.

Other factors can also provoke inflammation of the eye muscles. There are cases when myositis becomes the result of a stressful situation, mental overstrain.

How does myositis manifest itself?

This disease can occur in acute and chronic form, take one-sided and two-sided character. The intensity of manifestation of signs is different. Symptoms are determined by the causes of the pathology, the state of immunity, the age of the patient. Characteristic symptoms ocular myositis:

• arching pain in the eyeball, aggravated by movement;
• swelling of the eyelids and conjunctiva, which leads to narrowing of the palpebral fissure;
• tearing;
• increased photosensitivity;
• exophthalmos - displacement of the eye outward;
• poor mobility of the eyeball;
• headache from the inflammatory process;
• increase in body temperature.

The disease is acute in infectious eye diseases. If inflammation occurs due to hypothermia, problems with immunity, then its signs are not so intense.

Modern methods for diagnosing myositis

The doctor must accurately determine the nature of the disease, its degree and form of flow. For this, several diagnostic procedures are assigned:

• checking visual acuity;
• a serological blood test used to detect viruses and bacteria;
• computed tomography and/or MRI;
• tonometry;
• examination of the anterior chamber of the eye - gonioscopy;
• biomicroscopy;
• ophthalmoscopy;
• electromyography.

After carrying out all these procedures and making an accurate diagnosis, the doctor determines the method of treating ocular myositis. What methods of treatment of this pathology are used today?

Modern methods of treatment of inflammation of the eye muscle

The disease is treated with conservative methods. The patient is prescribed medication and physiotherapy. Etiotropic treatment aimed at the destruction of viruses or bacteria is used only for the infectious origin of the disease.

Depending on one or another form of the disease, the following types are used medicines and procedures:

• antibiotics injected subcutaneously into the lower eyelid area;

• non-steroidal anti-inflammatory drugs to help eliminate pain and inflammation;

• angioprotectors that strengthen blood vessels, which helps prevent the development of pathologies of the retina;

• radiotherapy and physiotherapy are prescribed courses in the absence of the effect of medications.

Injuries to the eye that result in damage to the eye muscles are sometimes treated with surgery. During the operation, the structure of injured muscle fibers is restored. The acute form of myositis is treated for about 4-6 weeks. If it is chronic, treatment is delayed. It is possible to completely get rid of it in 2 months. At the same time, the patient is recommended to visit an ophthalmologist at least once every 2 months after recovery for the first six months.

Prevention of ocular myositis

How to prevent the development of this pathology? You need to monitor your health, temper yourself, strengthen your immune system, do exercises for your eyes several times a day, especially with increased visual stress, play sports. If you work in adverse conditions, wear a protective mask or goggles.

Don't start the disease. At the first of its symptoms, consult a doctor. Due to the lack of treatment, myositis can cause complete loss of vision.

Do you work in an office and spend a lot of time at the computer? You may have an unpleasant acquaintance with myositis!

Myositis is the general name for a group of diseases that are accompanied by the development of an inflammatory process in skeletal muscles.

The International Classification of Diseases of the 10th revision (abbreviated ICD-10) defines myositis as inflammation of the muscles, but everything is not so simple. Myositis is included in the class "Diseases of the musculoskeletal system and connective tissue", which includes blocks M60-M63 (myositis code M60). This code hides 55 (!) Varieties of the disease. Most diseases have their own causes, signs, localization and methods of treatment. About everything in order.

Causes of the disease

Myositis often accompanies professions, whose representatives are forced to take a static posture for a long time and use the same muscle group. This is a significant factor, but far from the only one. Here is what else contributes to the development of myositis:

Myositis symptoms

Such an insidious disease has enough direct and indirect signs:

1. aching dull pain;
2. muscle inflammation;
3. swelling and redness of the area affected by the disease;
4. increase in body temperature;
5. muscle weakness (up to atrophy);
6. persistence of pain even at rest and after rest;
7. difficult movements;
8. rash.

Types and localization

Firstly, when establishing a diagnosis, it is necessary to answer a simple question: “Where does it hurt?” Depending on the localization of pain, myositis is:

• cervical. The most common type. Most adults have experienced morning neck pain at some point;
• chest myositis. Accompanied by cough, shortness of breath;
• intercostal. Pain on palpation intensifies;
• myositis of the lumbar muscles. Accompanied by aching pain, aggravated after physical exertion;
• limb myositis. This is myositis of the elbow, hip, knee joint;
• myositis of the abdominal muscles. Causes pain in the peritoneum;
• eye. It hinders the activity of the muscles responsible for the movement of the eyeball.

Secondly, it is necessary to understand what stage the disease is in - chronic or acute. It matters how local the disease is and how many muscles are affected - one or several (polymyositis).

Third, the accuracy of diagnosis depends on the causes of the disease. By genesis, myositis can be:

Women living in anticipation of the appearance of a baby often face an unpleasant surprise. They can become lumbar myositis or myositis of the back muscles. There are enough reasons for the development of the disease:

• the center of gravity of the body shifts;
• the body of the expectant mother for a long time is in a static non-physiological position;
• ligaments relax under the influence of the hormone relaxin;
• autoimmune processes start in the body;
• convulsions may occur;
• the body is more stressed.

Medicine can help a pregnant woman, but before contacting a direct specialist, the expectant mother should consult a gynecologist. No self-medication, mothers! Remember that during pregnancy, the use of many drugs is strictly prohibited.

Obviously, muscle myositis is a really serious ailment that can lead to complications, but you should not panic.

How to start the treatment of myositis? We need to find out which doctor treats him. Therapist, surgeon, neurologist and rheumatologist - team for muscle and joint rescue in adults and children. Required tests prompt the causes of the disease and further actions in the treatment of myositis.

Tests for myositis

Analyzes will give an idea of ​​the processes occurring in the body:

For a complete diagnosis, the patient will be sent for instrumental studies:

• biopsy. A small piece of muscle tissue is taken through a small incision, which is then examined under a microscope. This study is carried out in difficult cases with suspected autoimmune myositis;
• Magnetic resonance imaging . Identifies areas damaged by the disease;
• electromyography. Finds weak and affected by myositis muscles.

Myositis treatment

The list of procedures that will save muscles is also quite voluminous:

1. wave therapy;
2. kinesiotherapy (special gymnastic exercises);
3. oxygen therapy;
4. treatment with leeches;
5. bee treatment;
6. lymphatic drainage massage;
7. magnetic therapy;
8. manual therapy;
9. plasma therapy;
10. mud therapy.

In autoimmune myositis, treatment involves complex drug therapy, including glucocorticoid hormones, sometimes for life.

Medical treatment of myositis

Effectively relieve pain, relieve inflammation, swelling and hyperemia of the skin - non-steroidal anti-inflammatory drugs (NSAIDs). These include the following drugs and their analogues:

• • Diclofenac (Diklak, Naklofen, Dicloberl, Voltaren, Olfen, Diclobene, Feloran, Diklonat P, Optofen, Diklovit).
  • Pipoksikam (Revmador, Sanikam).
  • Ibuprofen (Nurofen, Pedea, Brufen, Advil, Cefecon, Ibufen).
  • Naproxen (Apranax, Halgezin, Sanaprox, Naprobene, Aliv).
  • Nimesulide (Nise, Nimegezik, Aulin, Nimid, Nimesil, Remesulid, Sulaidin).
  • Aceclofenac (Aertal, Acinac).
  • Dexketoprofen (Dexalgin, Flamadex).
  • Meloxicam (Movalis, Revmoxicam, Mataren, Oxicamox, Melbek, Melox, Meoflam).
  • Pofekoktsib (Denebol).
  • Celecoxib (Zicel, Celebrex).
  • Indomethacin (Metindol).

Therapy with NSAIDs often combines taking tablets together with topical agents of the same pharmaceutical group:

• • Fastum gel.
  • Diclofenac gel.
  • Dolobene gel.
  • Diplife.
  • Voltaren emulgel.
  • Long.
  • Nize gel.
  • Dolaren gel.
  • Finalgel.
  • Diclopan.
  • Bystrumgel.
  • Aptoselen.
  • Indomethacin gel, etc.

For the treatment of infectious myositis, antibiotics of various classes are used:

• • penicillin (Benzylpenicillin, Bicilin);
  • tetracycline and cephalosporin (Ceftriaxone, Cephalexin, Tercef, Cefotoxin).

In some situations, when the symptoms of the disease are complicated by muscle spasm, doctors prescribe muscle relaxants (Sirdalud, Myokalm). Preparations of this group relax skeletal muscles, stabilize blood circulation and the system of replenishing the injured area with essential trace elements.

Under the condition of treatment of myositis in a hospital, the so-called puls-therapy can be used. During such therapy, the patient is given injections of glucocorticosteroids, and mainly prednisone. A dose of 1-2 grams of the drug is administered for 3-5 days. Such treatment has an immunosuppressive and antiallergic effect.

Treatment of myositis at home

Recipes proven by our ancestors will allow you to get rid of the unpleasant symptoms of myositis at home. The basis of the folk treatment of myositis are ointments:

• • Such a recipe will relieve inflammation. Take dry flowers of pharmaceutical chamomile. Grind them into powder. Next, vegetable raw materials are mixed with olive oil 1:1. Rub the remedy into the sore muscle, wrap it up and leave it until the morning.
  • With myositis, ordinary lard will help. You need to take 4 parts of unsalted suet and grind it with 1 part of powdered horsetail. The resulting mass is carefully rubbed into the sore spot, and a gauze bandage with the same composition is applied at night. From above, the area must be covered with cellophane film and wrapped with a warm scarf. The minimum course of treatment is seven days.
  • With muscle disease, such a natural ointment is recommended. Take one chicken yolk, grind it and add one full teaspoon of gum turpentine. Next, one tablespoon of vinegar (apple) is poured into the mixture. Beat the mass until the density of jelly and rub into the sore spot.
  • Not bad eliminates pain and inflammation in myositis - bodyaga. It is necessary to prepare such an ointment: for half a teaspoon of sponge powder (you can buy it at a pharmacy), take a little cow's butter (vegetable is also suitable). Mix. The mixture is rubbed into the muscle at bedtime only once every 5 days. Then be sure to warmly wrap the muscle and leave the composition on the skin until morning.

Another important component in the treatment of myositis at home is considered a potato compress. To prepare it, it is necessary to boil the potatoes, mash and fold the resulting mass into gauze. The compress is applied to the affected area and covered with warm clothes or a blanket. The compress is removed after the potato mass in it completely gives up its heat. The procedure is repeated for 5 days. Such a medicine anesthetizes and neutralizes inflammation.

The general tonic and strengthening effect on the body in the treatment of myositis at home is provided by home-made tinctures:

• • Cucumber grass is poured with boiling water and infused in a thermos for 5 hours. For 1 teaspoon of grass, take 200 milliliters of boiling water. Drink 1 dessert spoon of infusion every hour during the day. The course of treatment takes 1 month. It should be repeated after two weeks.
  • With myositis, you need to drink a tincture of barberry. For its preparation, only the bark of the plant is taken. For 8-10 g of raw materials, 80-100 ml of vodka will be required. Infuse the mixture for 8-10 days. Use tincture of 30 drops 45 minutes before meals. The course of treatment, if necessary, can be repeated after a month.

With myositis of the cervical region, bay oil will help. 12 drops of this ingredient are diluted with warm water, and then any matter is dipped into this composition. The resulting compress is applied to the neck slightly below the back of the head for half an hour. From above, the compress is wrapped with a warm scarf or shawl.