Vol XXIX, No 1-2 (1997)
Articles
V.M.Bekhterev and the Kazan Neurological School
Abstract
The outstanding role in development of home and the world neurology by professor V.M. Bekhterev, having founded the basis of the modem integrative science of the nervous system is shown. The purpose of this work is to awake interest of the medical society to the personality of V.M. Bekhterev, a founder of the Kazan neurological school, a scientist and a doctor, to his works of the Kazan period of his activity.
Clinical and neurophysiologic peculiarities of epileptic syndrome in patients with ischemia of brain
Abstract
By clinico-instrumental examination in 610 patients with ischemic insult at the age of from 30 to 89 it was determined that 8.7% of them have had 3 and more epileptic fits. According to the international classification ischemic insults are one of the reasons of increasing incidence of epileptic fits in the aged people.
Information evaluation of brain imaging methods in posttraumatic epilepsy
Abstract
There given the results of brain imaging methods (CT and MRT) in posttraumatic epilepsy. On the background of complex investigation (EEG, CT and MRT) it was shown that imaging methods significantly replenish information on localization and character of focus, especially in heavy craniocerebral injury, the MRT method being more informative. Changes, reflected by CT are revealed in 68% of patients (32% — focal), while changes by MRT — in 64% of patients (52% — focal). To achieve optimal results it is necessary to complexly use EEG and imaging methods, for it is important for making a prognosis, improving conservative and surgical treatment of patients.
Eeg-analysis of the effect of combined use of carbamazepin and mexidolum on the epileptiform brain activity
Abstract
Experiments on rats with chronic epileptogenic fod in sensomotor region of cortex showed that effects of anticonvulsive agents depend on the progression phase of epileptic system. Effect of carbamasepinum in effective doses is mostly expressed during the phase of stable epileptic system with
determinant foci in limbico-hypothalamic structures. Lowering the doses of the drug brings about a decrease of anticonvulsive effect and activation of the secondary hippocampal focus. Combined use of carbamazepin and mexidolum with membra-notropic antioxidantal activity bbrings about an increase of anticonvulsive properties of carbamazepin and allows to decrease the therapeutic doses of the last.
Differential diagnosis of epilepsy and paroxysmal states of nonepileptic genesis in the early stages of the disease
Abstract
There discussed and systematized different diagnostic mistakes in patients, suffering epilepsy and nonepileptic paroxysmal conditions at early stage of disease. There given the analysis of clinical and paraclinical examination data of 525 patients. Decisive factors in diagnosis are revealing basic clinical symptocomplex and its analytical understanding in comparsion with the findings of investigation methods, conducted by special devices.
Capacities of formal methods in objectivization of epileptic severity dynamics
Abstract
There was analyzed dynamics of morbidity in 65 epileptic patients with the help of severity scale of epileptic seizures, accounting method of recovering percentage, index of quality of life. The highest value on scale was obtained during complex partial seizures, transferring into secondly generalized (15 points), the lowest — during typical absentia epileptica (1 point). When mixing some epileptic seizures the total sum of points achieved 34 points. Percentage of improvements was counted in 6 months after correction of therapy. Quality of life was evaluated by 5-point analogue scale, developed by the authors and tested in temporal epilepsy.
To the question of study of epileptogenic role of kynurenine in the epileptic pathogenesis (clinical and biochemical study)
Abstract
It was studied the content of endogenic convulsive agent, kynurenine, in the blood and liquor of 57 epileptic patients. It was revealed raising of kynurenine level in the blood of epileptic patients as compared with the level of control group, as well as more high level of kynurenine in the blood of patients with frequent seizures and lowering its level in liquor just after paroxysm. The abovesaid confirms the certain role of kynurenine in the pathogenesis of epilepsy.
Problems of classification of sleep disturbance in children with cerebral paroxysms
Abstract
Questioning on sleep disturbances and polygraphic investigations of sleep and active state in 31 children with temporal epilepsy has been carried out. According to literature available and original observations, the novel classification of sleep disturbances in children is offered. Sleep disturbances are divided into permanent and paroxysmal. Paroxysms are divided into typical hypnic (non-epileptic), sleep-related "border" paroxysms and typical sleep-related epileptic attacks.
On neuroimmune mechanisms of pathogenesis of epileptic paroxisms in children
Abstract
Results of immunological investigation of antibody level to galactocerebrosides in children with paroxismal disturbances of consciousness of different severity and in children of control group, as well as in mothers of the ill and healthy children are presented. It has been determined that level of antibodies related to galactocerebrosides correlates with the severity of the course of epileptic paroxisms in children. In all children with nonepileptic paroxysms titers of antibodies related to galactocerebrosides coincide with age-dependent estimated data. Titers of antibodies related to galactocerebrosides of diagnostic value are absent in all the women whose children suffer from nonepileptic as well as benign epileptic paroxysms. The obtained results in conjunction with clinical biochemical findings allow to carry out early diagnosis of severe forms of epileptic paroxisms in children, to prognose the course of disease and promote to timely administration of pathogenetic treatment.
Morphological and functional investigation of brain tumors, followed by convulsive syndrome, when treated by lamiktal
Abstract
Taken into view factors, enfluencing the formation of destructive, reparative and compensatory processes, proceeding in brain of epileptic patients with neuroectodermal tumors. Durable clinical observation, CT examination at different stages of disease, electronic and microscopic study of perifocal zone of brain during surgery allowed to reveal a number of mechanisms, preventing realization of anticonvulsive action of lamiktal in paroxysmal conditions of such patients.
Topical electtrophysiological diagnosis of temporal epilepsy and stereotaxic therapeutic stimulation
Abstract
Results of complex clinical electrophysiological examination of 110 patients with temporal epilepsy, who underwent implantation of electrodes into different brain structures for diagnostic and therapeutic purposes, are presented. It has been found that limbico-temporal structures at the moment of sezure development are functioning as united functional system with predominant involvement of amigdala into ep. ileptogenesis. It is illustrated, that low-frequency electrostimulation of neuronal structures of temporal lobe, surrounding epileptic foci, can exert antiepileptic clinical electrophysiological effect.
State of adaptational-compensatory mechanisms in children with temporal epilepsy and their correction via transorbital electrophoresis with gamma-oxy-butyric acid
Abstract
It is shown, that in temporal epilepsy there exists dysfunction of adaptational-compensatory mechanisms, leading to intensification of epileptic process. Their optimization via transorbital electrophoresis with gamma-oxy-butyric acid promotes to activation of sanogenetic mechanisms of epilepsy.
Peculiarties of catecholamines exchange in children with febrile convulsions
Abstract
Excretion of catecholamines indiumal urine of 75 children with febrile convulsionns has been studied. It has been revealed that functional state of sympathetic adrenal system in children with febrile convulsions is characterized by a number of peculiarities. They include an increase of adrenaline and norepinephrine. In the case of transformation of febrile into afebrile seizures additional increase of dopamine excretion is observed. That’s why hypersecretion of the three mentioned amines is estimated as prognostically unfavourable factor of the course of febrile convulsions. According to our findings, progression of seizures in sleeping state is also prognostically unfavourable symptom of the course of febrile seizures. The obtained biochemical ringings together with clinical information can serve as prognostic criteria in solving the problem of variations of the course of febrile convulsions.
Peculiarities of diurnal sleep in children with absence epileptic seizures
Abstract
При полисомническом обследовании 22 детей с абсансными припадками выявлены повышенная активность таламо-кортикальной синхронизирующей системы и несостоятельность ретикулярной формации ствола головного мозга. Структуры ствола мозга, ответственные за формирование фазы быстрого сна, оказывают противоэпилептическое влияние.
Anti cytokine therapy of secondarily-progressing multiple sclerosis (ms)
Abstract
For treating active forms of secondarily-progressing multiple sclerosis a preliminary clinical trial was performed by two courses: antibody-to-cytokine course (γINT, αINT and TNFα) and cyclosporin А-course (sandimmun). Data of preliminary test of antibodies to cytokines evidence to possibility of performing further clinical trials "antibodies to γINT and to TNFα (to a lesser degree)" during active forms of progressive MS. Were obtained the results, evidencing to a possible use of sandimmun in constantly progressive forms of secondarily progressing disease, when favourable clinical effect coincided with supression of cytokine IL-2 production and lowering of activeness of immunocytes.
Experience of use of human leukocyte interferon in remittent course of multiple sclerosis
Abstract
Results of follow up of 58 patients with remittent type of course of multiple sclerosis, who were treated with human leukocyte interferon for 3 years are presented. Improvement in the course of disease of incidence of aggravation and neurological deficite, normalization of cytokines allows to recommend human leucocyte interferon for treatment of multiple sclerosis.
Peculiarities of clinics and pathogenesis of Diphtheria polyneuropathies in children
Abstract
85 children with diphtheria complicated by diphtheric polyneuropathy (DPN) underwent clinical-instrumental examination. The dependence of incidence of DPN progression on the degree of primary intoxication has been determined. In toxic forms characterized by prolonged immunosuppression, multiwave course and in local forms onewave course of DPN takes place.
Present-day professional lead polyneuropathy — chronic demyelinating disease of peripheral nervous system
Abstract
Relatively high positive correlation between lead content in biologic environment and indices of porphyrinic exchange in patients with neurogenic form of chronic polyneuropathy has been determined. In risk group such correlation was absent. Clinical symptoms, change in electric neuromyography, indices of porphyrinic exchange and lead content in biologic environment has been studied in 92 workers engaged in making lead and exposed to small average concentrations of it close to the limiting permissible concentration during the working day. Progression of chronic lead intoxication, the initial form of which clinically reveals in 12—4 years by vegetosensoric polyneuropathy of upper and lower extremities and intrinsic changes in electric neuromyography indices has been determined. Isolated symptoms of polyneuropathy and lowering of the indicated parameters of electric neuromyography by 5—10% are revealed in preclinical stage (risk signs). The nature of electric neuromyography changes points to segmental myelinopathy.
Diagnostic significance of electroneuromyographic (enmg) indices in diphtheria polyneuropathy
Abstract
There studied changes of electroneuiomyographical indices for evaluation of incidence and dynamics of lesion of peripheral nervous system during diphtheria. For this purpose 37 patients with diphtheria polyneuropathy at the age of 2—14 years at different terms of disease were examined. It was shown that during diphtheria most often the nerves of lower extremities are damaged: fibular and tibial. Information of ENMG indices of the latter is more significant. For revealing the initial symptoms of the nervous system lesion it is useful to investigate the state of myelinization of proximal parts of peripheral nerves according to F-wave latency.
Paroxysmal hypokinetic conditions DURING MYASTHENIA
Abstract
There determined basic factors, inducing paroxysmal hypokinetic conditios. There given clinical characteristics of generalized and partial miasthenic crises of different severity. It was observed extremely divergent course of myasthenic crisis. It was developed a scheme of urgent measures, directed at supporting an adequate pulmonary ventilation and stabilizing of hemodynamical disorders.
A case of a combination of Duchenne muscular dystrophy with chromosomal mosaicism 45.X / 46.XX
Abstract
The paper is concerned with a case history of a girl with a rare combination of 2 rare anomalies — monosomia by X chromosome and Duchenne's muscular dystrophy. Mosaicism 45,X/46,XX in a girl with a mild picture of Duchenne's muscular dystrophy was confirmed by a study of the kariotype in lymphocytes of the peripheral blood.
Presymptomatic dna-diagnosis of proximal spinal muscle atrophy
Abstract
Case of preclinical DNA-diagnosis in a family with the use of polymorphous markers in the region 5gll.2-gl3.3 and search of the SMN gene deletion is presented. It has been suggested to perform DNA-study in all the members of families in which patients with spinal muscle atrophy were revealed.
Clinical genetic analysis of myotonia dystrophica in the republic of bashkortostan
Abstract
In the Republic of Bashkortostan computer data bank on myotonia dystrophica (MD) was created where information on all diagnosed patients and members of their families was entered. For the first time in the republic qualitative molecular genetic RNA-diagnosis of MD started, with the help of which one phenotypically healthy mutation carrier is revealed. Clinical genetic characteristic of MD in Bashkortostan and main subpopulation of the republic is presented. Besides neuromuscular symptoms cerebral and extraneural symptoms are analyzed.
Differential diagnosis of hypokinetic disorders in hereditary neuromuscular diseases
Abstract
For determination criteria of differential diagnosis analysis of clinical manifestations and indices of additional research methods (EMG, ENMY, biochemical, histomorphological) of paroxysmal hypokinetic conditions in myoplegia, myopathic syndromes, glycogenosis and Mc Ardl syndrome in polymyositis, Eulenburg-Lewandowsky paramyotoxia, remittent form of neural amyotrophy, some forms of congenital myopathies was carried out.
Recovery of locomotor functions in patients with amyostatic syndrome by method of referential bioadaptation
Abstract
Time parameters of locomotor functions are studied by computer analysis of walking phase with the aim of correcting pace-rhythmic structure of locomotor act, disturbed in conditions of organic brain pathology. As a result of comparison with average statistical norm, time frequency was selected and 83 offered to patient by functioning of portable photophonostimulator as the main walking speed. As a result of using this method (referential bioadaptation) in 7 patients parameters of locomotor functions significantly approximated to the norm. This approach is considered promising for locomotor rehabilitation in neurology.
Psychological characteristics of patients with myotonia dystrophica and principles of their rehabilitation
Abstract
When testing psychological characteristics of personality in 20 patients with myotonia dystrophica using MMPI test, it was revealed forming of anxious-asthenic syndrome, typical for initial clinical symptons of the disease. With the main disease progression tendency to hypochondriac and depressive states is observed. Complex of medicamental and psychotherapeutic rehabilitation is offered.
Exteroceptive suppression in facial hyperkineses and dystonias
Abstract
On the basis of study of results of exteroceptive suppression parameters in 140 patients with different variants of facial hyperkineses the state of reflex inhibitory neuronal chains was defined more precisely. Received data may be used in process selection and monitoring of therapy and promote to understanding of facial musculature dyskinesia forming mechanisms.
Sensor interaction in mechanisms of puncture analgesia in treatment of myofascial pain syndromes
Abstract
Problems of interaction of two afferent flows: nociceptive and artificial, made with neurophysiological complex (somatosensor generated potentials) are discussed. Somato-sensor potentials were registered on standard methods before and after medical influence on acupuncture points, used for analgesia. Possible mechanisms of rapid phase of analgesia by activation of recurrent inhibition of nociceptive flow are considered.
Basic principles of treatment of epilepsy in children
Abstract
Currently, epilepsy is one of the most pressing problems in pediatric neurology. The incidence of epilepsy in the pediatric population ranges from 0.5 to 0.75%. The problem of epilepsy is a problem of accurate syndromological diagnosis and treatment. The modern classification of epilepsy, epileptic syndromes and similar disorders distinguishes about 40 different forms of epilepsy, differing in clinical symptoms, principles of therapy, prognosis.
About some unused reserves of the scientific heritage of V.M. Ankylosing spondylitis
Abstract
In the choice of the topic and direction of scientific research, along with many objective factors, the psychological attitude of the researcher, his current interests and attitude to this topic play an important role. At the same time, the results of the works of famous scientists often pass by the attention of contemporaries and remain unclaimed. Suffice it to refer to the discoveries of GI Mendel, made in 1865-1866. and which attracted attention only in 1900. The scientific heritage of our great compatriot VM Bekhterev is being developed very intensively with a few exceptions.