Vol XXXIII, No 1-2 (2001)
Articles
Neurosciences in the framework of the "Decade of the brain" program
Abstract
The "Decade of the Brain" - a complex of scientific research works in the field of neurosciences, carried out in 1990-2000, has come to an end. in the world and in our country. Important results were obtained during this period in the largest neurological center in Russia - the Research Institute of Neurology of the Russian Academy of Medical Sciences. The research was based on the conceptual principle, systems approach and principles of evidence-based medicine.
Peculiarities of neurologic examination of elderly and senile persons
Abstract
Changes typical for elderly persons which may be detected clinically and with the use of paraclinical investigation techniques are discussed. The significance of correct assessment of anamnesis and patient’s symptoms is emphasized. Changes in neurologic state are studied in detail. Among paraclinical methods of investigation particular attention has been given to the results of computered tomography and magnetic-resonance tomography of brain. Causes of leukoareosis are considered.
Peculiarities of frustrational tolerance and anticipational activity in patients with multiple sclerosis
Abstract
Peculiarities of the system of psychocorrection and probabilistic prediction functioning in 110 patients with multiple sclerosis with different evidence of emotional disturbances are investigated. The unbalanced system of psychocorrection impeding adequate correction of the activity was revealed in more than 50% of patients with multiple sclerosis. On this basis patients with multiple sclerosis can be assigned to psychologically unfavourable contingent, group of the so-called potential neurotics.
Collapse of syringomyelitic cavities as a compensatory mechanism of syringomyelia course
Abstract
The results of examination of 72 patients with clinical picture of syringomyelia using MRT are revealed. Images of spinal cord in sagittal and axial planes have been obtained. Deformity of cavity found in axial sections of 26 patients was considered as its spontaneous collapse.
When interpreting MRT picture drain communication between the cavity and subarachnoid space of spinal cord in 10 patients was supposed. Relation between the cavity diameter and duration of illness was determined. A decrease of cavity diameter during the long course of illness may be related to the cavity collapse, which is one of the possible compensatory mechanisms of syringomyelia course.
Treatment and prophylaxis of scarry and comissural lumbosacral radiculopathies
Abstract
Aiming at treatment of compressive-comissural radiculopathies in patients with lumbar damage with discs involvement surgical treatment was used including set of procedures, directed to minimization of scarry and comissural process and its consequences in microsurgery of lumbar disease with discs damage. Peculiarities of surgical approach to the structures of vertebral canal, reconstructive elements of surgery, and also techniques of implantation of silicon microneuroprotectors and polytetrafluoroethylenic spinal membranes into neural structures zones are discussed. The proposed complex of surgical measures provides maximal decompression of neural structures of vertebral cord, their protection from the effect of musculocutaneous scars and fibrous tissues and positive results of treatment.
Patogenetic motivation of using the calcium antagonists in treatment hypoxic intracranial hemorrhages in newborns
Abstract
The prospective observation, clinical and biochemical examination of 252 mature infants with perinatal hypoxic encephalopathy from neonatal period till 1 years old and 55 infants with intracranial hemorrhages were carried out. The role of perinatal risk factors in the pathological forming as well as the dependence of clinical manifestations from hypoxia character (acute, chronic, combined) and the disease period was determined. The interrelation of disturbances of enzyme transmembrane transport of electrolytes activity and the level of intracellular calcium in thrombocytes with the character, degree of the severity, clinical syndromes and course of pathological process was revealed. The decrease of Ca2+-ATPase activity and increase of the level of intracellular calcium in patients with the chronic and combined character of hypoxia was noted. Clinical and biochemical efficiency of calcium antagonists (nimodipine) in children with perinatal hypoxic and hemorrhagic CNS disturbances was determined.
Cervical natal trauma: neurologic symptomatology and manual therapy
Abstract
Pathology of the central nervous system in perinatal period is one of the topical problems of pediatric neurology. Numerous diseases of adolescents are the reckoning for late diagnosis and inadequate treatment in the early months of life. In the last few decades manual therapy of children has been widely distributed, but its use is very limited with infants and young children. Favourable experience of doctor H. Biderman (Germany), the leading expert actively using manual intervention in young children, is observed. The carried-out researches are the first joint experience of pediatric neurologists and manual therapists.
Transcorporal reimprinting as new conceptual structural model of integrative narcomania therapy
Abstract
New approaches for increasing the effectiveness of treating drug abusers are described. Unique in complexity and daring conception of treatment integrating the most promissing approaches applied in various fields of medicine, such as in psychiatry, neuropathology, psychotherapy, anesthesiology, is developed and presented. All the principles of therapy, that is clinical and pathogenetic reasons, complexity, correlation with the state of the patient and individuality of treatment, are respected. All the components of this method are allowed to use for therapeutic purposes. Algorithm of their use according to therapeutic purposes is given.
Organic psychic disorder and aggressiveness: some possibilities of clinical and experimental assessment
Abstract
A comparative complex clinical and experimental study of the state of vegetative nervous system in patients with organic psychic disorder having committed aggressive criminal acts and those who kept away from them is conducted. Based on the obtained results the possibilities of use of indices of destabilization of cerebral mechanisms of vegetative balance control are proved.
The principles of organizing social and psychiatric care for children in modern Russia
Abstract
The goal of the state social policy in relation to the situation of children in the Russian Federation is to overcome the negative trends caused by the influence of economic and political factors, to stabilize the situation in protecting the health of the younger generation and to create real conditions for consolidating positive dynamics in the life support of children. The reaction of society and the state mainly to negative consequences in the children's environment is suboptimal and ineffective. The need arose to define new conceptual approaches to protecting the health and development of children.
Neurological symptoms caused by the subspecies borrelia burgdorferi
Abstract
Borreliosis is characterized by a variety of clinical symptoms affecting the skin (erythema chronicum migrans, lymphadenopathia cutis benigna, acrodermatitis chronica atrophicans), eyes (conjunctivitis, iritis, uveitis), muscles (myositis), nervous system (neuritis, radiculitis, polyradiculitis, meningopolyralitis ), joints (arthritis, arthralgia) and heart (carditis). The variety of symptoms is explained by the difference in the subspecies Borrelia burgdorferi sensu lato in virulence and organotropism and changes in the patient's immune response. The main subspecies Borrelia burgdorferi sensu lato (B.b.s.l.) are Borrelia burgdorferi sensu stricto (B.b.s.s.), Borrelia burgdorferi garinii (B.b.g.) and Borrelia burgdorferi afzelii (B.b.a.). In North America, only B.b.s.s. has been found, while all 3 species can be found in Europe. Epidemiological studies have shown that the number of patients with borreliosis is still increasing, which is associated with an increase in the density of distribution of tick vectors, which are carriers of the disease, and with the degree of awareness of people.
On the pathogenesis of true trigeminal neuralgia
Abstract
Among the pain syndromes of the face, trigeminal neuralgia ranks first in frequency. However, despite the fact that the disease has been known for more than 2000 years [14] and was isolated as a separate nosological form more than 200 years ago [7], the issues of etiology and pathogenesis, and, consequently, treatment, cannot be considered resolved. At the same time, knowledge of the mechanism of trigeminal neuralgia is of great importance for the treatment of patients.
The state of emergency care for patients with acute cerebrovascular accident
Abstract
At the turn of the second and third millennia, one of the main health problems was acute cerebrovascular accident - cerebral stroke (CS), which is the second leading cause of death in the industrially developed countries of the world and the main cause of disability in the adult population of the most working age. The social costs associated with the cost of treating stroke patients are a major source of depletion of scarce health resources in every country.
Towards the results of ten years of cooperation between scientists from Germany and Russia
Abstract
The fruitful collaboration between German and Russian neurologists has its roots in the last century. In the formation of neurological science in both countries, such outstanding Russian scientists as V.M. Bekhterev, L.O. Darkshevich, Korsakov, Minor, Krol, as well as German neurologists Grisinger, Strumpel, Oppenheim. As a result of well-known historical events, this creative connection, mutually beneficial for both scientists and patients, was interrupted for 60 years. Only after the fall of the “Iron Curtain”, both on the one and on the other side, there was a desire to end the “Ice Age” and begin the path to rapprochement. The first meetings between scientists from both countries and the exchange of views on issues of interest to them served as the impetus for the first scientific conference dedicated to a wide range of neurological diseases, the diagnosis and treatment of which leave much to be desired.
Integral health improvement system for adolescent patients with paroxysmal conditions
Abstract
The development of pathological mechanisms of paroxysmal states of epileptic and non-epileptic nature of the pubertal period was studied. A systematic approach to identifying the interest of many body systems that provide homeostasis (mental, autonomic, immune) revealed their inconsistency. Taking into account the dominant role of the central nervous system in the implementation of adaptive, adaptive functions of the body, the formation of a paroxysmal state (PS) is considered as one of the manifestations of central nervous system dysadaptation in the period of hormonal imbalance.
Information on familial cases of syringomyelia, basilar impression, and Chiari malformation
Abstract
The presence of familial cases of syringomyelia, basilar impression (intussusception) and Chiari malformation (MC) indicates the role of heredity in the occurrence of these diseases. Studies by a number of authors [32, 44] show that the primary pathology in this case is bone anomalies of the craniovertebral region (CVR), which contribute to the formation of the posterior cranial fossa (PCF) of reduced volume. As a result of this, the caudal parts of the cerebellum and the medulla oblongata descend through the foramen magnum (foramen magnum), i.e. formation of type I MC. In the presence of bone anomalies of KVO and MV type I, in some cases, a violation of CSF dynamics can occur at the level of the BVO, which will lead to the development and progression of syringomyelia. CVD abnormalities are, in turn, the result of defective development of the cartilaginous tissue of the bones of the skull and adjacent parts of the spine during the first weeks of embryonic development [34, 43]. Such dysembryogenesis may be due to dysfunction of genes that control the formation of the fifth occipital somite in the human body [49]. Literature data on familial cases of syringomyelia, basilar impression and MC confirm their common heredity basis.
Integrative activity of the brain in health and disease of the nervous system
Abstract
Attempts to link human mental and mental activity with the brain were made in the days of Hippocrates (460-370 BC) and Galen (131-201). At the same time, a connection between the brain and movements on the opposite half of the body was noticed. This was judged by the occurrence of seizures in the half of the body opposite to the lesion of the head [44]. The origin of this fact was associated with a general disruption of the brain. The pathogenesis of all disease states was explained by the humoral theory. In accordance with it, the balance of four fluids - phlegm, blood, black and yellow bile - ensures the normal development and activity of the body. When the balance of these components is disturbed, a disease occurs [39]. In the 17th century, Thomas Willis, the author of the term "neurology", somewhat modernized the humoral theory [45]. He believed that general sensitivity is represented in the striatum, his own feelings in the corpus callosum, and memory in the cortex. This marked the beginning of the development of localization as a direction in the study of brain function. At the extreme pole of this scientific worldview is the phrenological teaching of Franz-Joseph Gall and his students [36]. They assumed that mental and moral qualities are localized in certain areas of the brain surface. At the same time, there is a direct relationship between the degree of development of a particular ability and the volume of its cortical representation. By the shape of the skull, its "tubercles" and "bumps, Gall tried to unravel the professional abilities of a person and characterological features. In 1842, Flurance and Haller put forward the thesis of the physiological equivalence of the cortex. The dogma of the equipotentiality of parts of the brain arose, and then the theory of universalism appeared.
Historical milestones in the development of the Kazan neurological school
Abstract
The oldest Russian centers of progressive thought greatly influenced the scientific and social life of Russia and European countries. For a long time, the leading centers of Russian neuropathology were created for the first time in the world, the departments of nervous diseases of the medical faculties of Moscow and Kazan universities, which nurtured a galaxy of world-renowned neurologists. Within the walls of such famous educational institutions, domestic clinical medicine reached the highest development, original directions and schools appeared, the foundation of modern clinical neurology was laid.
100 years of the Department of Nervous and Mental Diseases of the Women's Medical Institute of St. Petersburg State Medical University named after acad. I.P. Pavlov
Abstract
In the fall of 2000, jubilee celebrations were held dedicated to the centenary of the Department of Nervous and Mental Diseases at the current St. Petersburg State Medical University named after acad. I.P. Pavlov (until 1994 it was the 1st Leningrad Medical Institute named after Academician I.P. Pavlov).
About the history of the Moscow Clinic of Nervous Diseases named after A.Ya. Kozhevnikov
Abstract
The history of the development of the Moscow neurological school in the late 19th - early 20th centuries. is, in essence, the history of the clinic of nervous diseases named after A.Ya. Kozhevnikov Moscow Medical Academy named after I.M. Sechenov. The teaching of nervous and mental diseases began at the departments of pathology and therapy of Moscow University, headed by the most prominent clinicians M.Ya. Mudrov, I.E. Dyadkovsky, I.V. Varvinsky, I.T. Glebov and A.I. Polunin long before the creation of a neurological clinic. The new university charter of 1863, among others, provided for the organization of a clinic for nervous and mental diseases, and therefore in the same year the medical faculty recommended A.Ya. Kozhevnikov as a worthy candidate for heading a new department or course of nervous and mental diseases. According to the traditions of A.Ya. Kozhevnikov in 1866 was sent abroad for 3 years. He worked in clinics and laboratories headed by the largest specialists in neuropsychiatry and physiologists (J.-M. Charcot, V. Grisinger, E. Dubois-Raymond, etc.). During this period A.Ya. Kozhevnikov performed several independent histological studies. In 1869, the university council elected A.Ya. Kozhevnikov for the position of Associate Professor of Nervous Diseases and Psychiatry. In the summer of 1869, after returning from an overseas business trip, he headed the independent department of nervous and mental diseases created for the first time in the world and already in December submitted to the dean A.I. Polunin, a curriculum for teaching nervous diseases and psychiatry, began to give a course of lectures on nervous and mental diseases and to conduct practical classes on nervous diseases.
To the 80th anniversary of the Nizhny Novgorod School of Neurologists
Abstract
Scientists in Nizhny Novgorod have been actively working on the problems of physiology and pathology of the nervous system for 80 years. The Nizhny Novgorod scientific school of neurologists was formed thanks to the efforts of academicians P.K. Anokhina, N.Yu. Belenkov, professors G. Ya. Gorodisskaya, N.V. Ivanova, H.I. Harkavi, F.A. Poemnogo, E.P. Semenova, E.M. Khvatova, A.G. Greten et al. Scientists from Nizhny Novgorod obtained original data on neurobiological and neuroclinical problems. The theory of functional systems by P.K. Anokhina - K.V. Sudakov. Proceeding from the theory of functional systems, the clinic develops concepts of dynamic correlations of patho- and sanogenesis of diseases of the nervous system, harmony of health, informational mechanisms of pain, etc.