Vol XXXIII, No 3-4 (2001)
Articles
Clinico-electrophysiological analysis of family cases with heredited neuropathy and predisposition to compression paralyses
Abstract
Clinico-electrophysiological analysis of the most common in Russia family selection, having a particular form of demyelinization neuropathy — hereditary neuropathy with predisposition to compression paralyses (HNPCP) has been presented. In all the families the diagnosis has been confirmed with the help of DNA diagnostics, based upon revealing of typical deletion in chromosome field 17.p.11.2. Besides a classical recurrent variant some other phenotypes of the disease have been described: recurrent positional sensoric symtoms, progressing mononeuropathy, progressing polyneuropathy. Electrophysiological signs have been determined, which are the most informative for HNPCP. These signs can used for clinical diagnostics of the disease followed by DNA diagnostics. Relative incidence of this special form of neuropathy among acquired compression mononeuropathies (6%) and their recurrent variants (50%) has been counted.
Coorelations between CT brain parameters and variants of clinico-social outcomes of acute period in supratentorial hemorrhagic insult
Abstract
The purrpose of the investigation was to make a correlation analysis between computed tomography (CT) of brain and variants of disease course as well as clinico-social outcomes of acute period in brain hemorrhagic insult with the aid of applied mathematical statistics. There was performed a clinico-neurological examination and CT of brain in 49 patients. Reading of statistical results has been done with the help of applied mathematical statistics. It was revealed that expressiveness of tentotorial shifting and brain edema have the largest diagnostic significance at acute period of the brain hemorrhagic insult and characterize lever of lesion of nonspecific brain systems. Hemorrhagic insult is characterized by polymorphism of lesion focus and accompanyning CT-symptoms, which determine level of disease severity in patients.
Correction results of dysploproteidemy in patients with vertebrobasilar insufficiency syndrome
Abstract
Enfluence of tanakan, intravenous quantum bemotberapy, fishant and their combination on manifestation of major clinical signs, state of lipid exchange and rheologic blood properties in patients with vertebrobasilar insufficiency syndrome has been studied. Hyperlipoproteinemia mainly due to atherogenic lipoproteids and encreased blood viscosity in patients With this syndrome have been determined. The above mentioned makes reasonable to perform a correction of the revealed alterations. The maximum therapeutic effect in the form of reliable descrease of atherogenic lipoproteids and normalizing blood viscosity has been recorded on the background of blockade in enterohepatic circulation of bile accids and also of combination of fishant and quantum irradiation of blood.
State of cerebral hemodynamics in patients with Chiari I malformation
Abstract
The special features of the cerebral hemodynamics were studied in 138 patients with Chiari I malformation (CM) with a help of magnetic resonance angiography (MRA) and transcranial dopplerography (TCD). MRA data analysis (58) revealed the frequent presence of vertebrobasilar system (VBS) maldevelopment and embryonic type of the circle of Willis. TCD data analysis (100) discovered vertebrobasilar insufficiency and bilateral blood flow increase in the intracranial part of the internal carotid arteries giving evidence of the compensated blood flow from the carotid system to the VBS. 21,0% of patients with CM and communicating hydrocephalia had TCD signs of intracranial hypertension. The most significant changes in cerebral hemodynamics were found in patients with marked pathology and elder than 30 years old.
Clinico-epidemiologic aspects of cerebrovascular discases among population of the Mary El Republic
Abstract
Spread of cerebrovascular lesions among population of city of Joshkar-Ola and rural regions of the Republic of Mary El has been studied. A special screening map has been developed, which includes 50 grades, united into four sections: social and hygienic conditions, manufacture conditions, behavioral factors and medico-clinical factors. Practically all the forms of cerebrovascular diseases were developing in most cases on the background of combination of cerebral atherosclerosis with hypertonic disease. It should be noted that while disease forms were aggravating, its incidence was increasing both in the city and in the villages. It is recommended to use the obtained results when solving the problems of early preinsult diagnostics as well as prophylaxis of cerebrovascular diseases.
Hypoxytherapy and epileptic process
Abstract
Experimental investigation results, evidencing presence of coorelation between hypoxia resistance and convulsive stability, were given on the basis of pharmacology. It had been shown that the animals, highly resistant to hypoxia, were more stable to effect of convulsive agents. Possible mechanisms of this stability can be supposed, taking into account EEG results. Some clinical material, showing effectiveness of usage of adaptation to hypoxia had been presented in complex treatment of epileptic patients.
Generated potentials of brain in patients with intermittent torticollis
Abstract
For finding out a role of different afferent systems in processing a sensory signal it was performed an investigation of brain generated potentials in patients with intermittent torticollis. There had been studied acoustic truncus cerebri generated potentials and somato-sensory generated potentials. The acoustic truncus cerebri generated potentials were characterized by amplitude decrease, peak flatenning and by interpeak interval assymetry, while somato-sensory generated potentials - by amplitude increase of main peaks, peak latency assymetry. The obtained results give an opportunity to determine a functional activity of different sensory systems of brain in the structure of hyperkinesis.
Peculiarities of neurovegetative sphere in patients, born with a large body mass
Abstract
Some clinico-paraclinical characteristics have been made for persons, who had been born with the large and medium body mass. These characteristics were observed at the age of 6 years and 20-24 years old for revealing peculiarities of functions in neurovegetative sphere. It was determined, that large birth body mass is a risk factor for developing perinatal encellopathy and natal spinal trauma of cervical department in vertebral column, as well as some other neurology disorders, which character has been changing due to age of a person. Diagnostically significant clinico-paraclinical parameters, reflecting a functional state of neurovegetative sphere when having a large weight at birth were determined. A necessity of developing and using individual schemes of primary and secondary prophylaxis of the revealed peculiarities of the neuro vegetative functions has been proved.
Sex and age aspects of neurogenesis anticipation mechanisms
Abstract
Clinico-psychopathogical and experiementally-psychological studies of 65 patients with neurotic disorders showed in them presence of three stages of neurosis formation during psycho-injuring situation. To prolonging behavoral disorders of the third stage an absence or insufficient expressiveness of anticipation properties of a person lead. It was more frequently observed in women, than in men. Apart from sex differentiation an age specificity in forming neurosis has been revealed too. Age specific characteristic envolved encreasing and persistence of boardering mental disorders in middle-agel years in comparison with the younger years. This has been confirmed in experimental and psychological studies (indices of situational and psychological alarm, deviations from autogenic and vegetative coefficient).
Integration ideas in modern medicine
Abstract
In modern conditions, the integration of scientific knowledge is becoming an integral part of the progress and effectiveness of scientific research. In medicine, the progress of integration is of particular importance. It develops according to the dialectical laws of evolution, reflecting its logical essence. The interdependence of the structural and functional components of the integral system of the organism lies in the fact that each component of the phenomenon acts as a condition for the other and is conditioned by it.
Myelopolyradiculoneuritis with lesions predominantly across the spinal cord
Abstract
Acute primary myelitis is an inflammatory disease of the spinal cord. Transverse and multifocal myelitis is distinguished, differing in the size and number of foci of inflammation in individual segments of the spinal cord. Acute transverse myelitis is considered as a separate nosological form in the 10th revision of the International Classification of Diseases. The introduction of such modern paraclinical examination methods as electroneuromyography (ENMG), magnetic resonance imaging (MRI), make it possible to visualize the morphological substrate of the disease, to better understand the nature and mechanisms of its development.
Difficulties in the differential diagnosis of endogenous, organic and psychogenic disorders
Abstract
Over the past decades, the number of acute reactive psychoses with a classic picture of clouding of consciousness, traditionally considered hysterical for pathogenesis, has been steadily decreasing. L.V. Romasenko (1988) provides data on the intranosomorphosis of hysterical manifestations in forensic psychiatric practice, a decrease in the number of hysterical reactions outside the framework of hysterical psychopathies during 60 years of observation. If in the 1946 manual on forensic psychiatry, hysterical twilight states are shown as a frequent occurrence, and Ganser's syndrome is considered at the same time as a kind of pseudodement state, then already in Forensic Psychiatry (1988) a typical clinic of Ganser's syndrome is defined as an acutely occurring twilight disorder of consciousness and the conclusion is made that "at present in the forensic psychiatric clinic there is rarely a clinically expressed Ganser syndrome." Finally, the latest manual from Forensic Psychiatry (1998) describes the same clinic and concludes that "this syndrome does not currently occur in the forensic psychiatric clinic." A classic description of the Ganser syndrome is given in the "Guide to Psychiatry" by E. Bleuler (1920). The most vividly pathogenetic mechanisms of reactive states are presented in "General psychopathology" by K. Jaspers (1997).
Cerebral vasculitis: clinical features and diagnostic principles
Abstract
Cerebral vasculitis (CV) is a severe, potentially disabling disease that usually develops in the presence of rheumatic, infectious, medicinal, or malignant diseases. In rare cases, isolated (primary) vasculitis of the central nervous system (CNS) is observed [17, 33]. The complex pathogenesis, polymorphism of clinical manifestations, and the absence in most cases of reliable non-invasive diagnostic criteria for CV complicate early diagnosis and treatment. In this regard, it seems relevant to analyze the features of clinical manifestations and diagnostic capabilities in cerebrovascular pathology caused by vasculitis.
Magnetic resonance imaging in the diagnosis of multiple sclerosis cerebral foci
Abstract
The close attention to the problem of multiple sclerosis (MS) is by no means accidental. The widespread prevalence of the disease, the young age of the patients, the low effectiveness of therapy and the high percentage of disability among people of the most working age cause extreme concern [3, 7, 19]. MS is the most common demyelinating disease of the nervous system, which is characterized by a polysymptomatic and recurrent course [1, 4, 5, 59]. According to R. Detd. et al. (1977) and S.M. Poser et al. (1983), MS occurs in 4-10% of cases in different countries, more often in the south of Russia, Israel, the United States, Europe and Latin America. The pathogenesis of the disease is not fully understood, in particular, the role of genetic factors and autoimmune processes in the mechanisms of MS development has not been fully determined [2, 55, 70]. The basis of the disease is the process of demyelination with the formation of disseminated dense sclerotic foci in the white matter of the brain [31, 33]. These foci, resembling gliosis scars, are the result of a local inflammatory process, accompanied by the destruction of the myelin sheaths and axons of nerve cells [28]. The pathological feature of MS is considered to be a violation of the blood-brain barrier. In the acute phase of the disease, the disintegration of oligodendrocytes, which make up the myelin sheath of axons, and the migration of activated immune cells to the focus of antigenic conflict (into microglia and astrocytes) occur. In this case, there is “muff-like adhesion” of endothelial cells and leukocytes around venules and along the pathways with the subsequent formation of dense sclerotic plaques [8, 16]. In some cases, remyelination occurs, and then re-disintegration with the formation of plaques. In postmortem examination, MS foci are most often detected near the anterior and posterior parts of the lateral ventricles, in the region of the semi-oval center, subcortical nuclei, trunk, cerebellum, in the spinal cord, and also in the optic nerves.
Neuropsychic development of premature babies in remote periods of life
Abstract
Premature babies are one of the most important health problems worldwide. People began to be interested in the prospects for further neuropsychic development (NDP) of prematurely born children even when their nursing and treatment were associated with great difficulties. It is known that the bulk (up to 80%) of neurological diseases develop in the ante- and perinatal periods of life. Among the main causes of brain damage that may already exist in a child by the time of his birth, the following are distinguished: congenital and hereditary diseases, hypoxic-ischemic damage, intrauterine infections [2].
Nikolai Kirillovich Bogolepov (09/25/1900 - 10/15/1980) - doctor, scientist, teacher, public figure
Abstract
With my teacher in the field of neurological science - Hero of Socialist Labor, laureate of the State Prize of the USSR, Honored Scientist of the RSFSR, Honored Doctor of the RSFSR, Academician of the USSR Academy of Medical Sciences, Doctor of Medical Sciences, Professor Nikolai Kirillovich Bogolepov, I first met and met in 1957, when I entered in postgraduate studies in neurology at the Central Institute for the Expertise of Working Ability and Organization of Labor of Disabled People (TSIETIN).
Modern trends in research and treatment of Meniere's disease. (based on the materials of the 4th International Symposium on Meniere's disease. - 1999, Paris, France)
Abstract
Last spring, the IV International Symposium on Meniere's Disease was held in Paris, timed to coincide with the 200th anniversary of the birth of Prosper Meniere. Scientists from all over the world took part in the symposium. During it, all aspects of Meniere's disease were discussed. At the presentation on epidemiology and pathogenesis, participants were able to familiarize themselves with new concepts in the field of the etiology of the disease, and during the sessions of the sections on clinical and audio-vestibular studies and diagnostics, those present exchanged valuable information from their own experience. Finally, participants discussed the benefits of various treatments for Meniere's disease, including drug therapy (with betahistine dihydrochloride), surgery, and in situ treatment.
Resolution of the VIII All-Russian Congress of Neurologists
Abstract
Over the years after the VII All-Russian Congress of Neurologists, the activities of the All-Russian Society continued to improve as a professional association of neurologists. In October 1996, a new Charter of the company was adopted, which significantly expanded the rights of the regional branches of the company and allowed the branches to conduct independent financial and economic activities and other forms of work due to the characteristics of the region.
Professor Vladimir Dmitrievich Troshin
Abstract
February 2002 marks the 70th anniversary of the birth and 52 years of medical, scientific and social activity of the head of the Department of Neurology, Neurosurgery and Medical Genetics of the Nizhny Novgorod State Medical Academy, Honored Scientist of the Russian Federation, Academician of the EA AMS, Doctor of Medical Sciences, Professor Vladimir Dmitrievich Troshin.
Acute disseminated encephalomyelitis associated with hepatitis C virus infection (Arch. Neurol. — 2001. — Oct. — 58(10). — P. 1679—1681: англ.)
Abstract
Acute disseminated encephalomyelitis (ADE) is a manifestation of an autoimmune demyelinating process in the central nervous system, while it is known that this disease is often preceded by various acute viral infections. The combination of ADE with viral hepatitis C (HCV) was first detailed in a peer-reviewed article and illustrated by the following clinical observation.
Dizziness and headache: a common association in children and adolescents (J. Child. Neurol. — 2001. — OCT. —16(10). — P 727—730: англ.)
Abstract
Dizziness is known to be a common concomitant symptom of migraine attacks in adults. In the pediatric population, the association of clinical symptoms is less obvious. The authors examined the medical histories of children and adolescents (31 cases in total) who underwent special testing of vestibular functions from July 1994 to July 2000.
Hemicrania continua is not that rare (Neurology. —2001. —Sep. 25. — 57(6). —P. 948—951: англ.)
Abstract
Chronic paroxysmal hemicrania is a sensitive headache characterized by a prolonged course, moderate or severe pain syndrome and unilateral localization. The literature describes about 90 cases of such a headache, however, the clinical forms of chronic paroxysmal headache have not yet been determined.
Evaluation of placebo use in migraine without aura, migraine with aura and episodic tension-type headache acute attacks (Arq. Neuropsiquiatr. —2001. —Sep. —59(3-A). —P. 552—558: португал.)
Abstract
This study investigated the effectiveness of placebo in the relief of migraine attacks without aura, migraine with aura, and episodic tension headaches. Patients with headache attacks who applied for emergency care (from March 1997 to November 1999) were divided into 3 groups (each group included 30 participants): migraine without aura (MBA), migraine with aura (MCA ) and with episodic tension headache (EGBN).
Blepharoclonus and Arnold—Chiari malformation (Acta Neurol. Scand. — 2001. — Aug. —104(2).— P. 113—117: англ.)
Abstract
Clonic blepharospasm - high-amplitude contractions of the circular muscle of the eye. This syndrome occurs in some diseases, such as traumatic brain injury. In this work, clinical observations with Arnold-Chiari malformation, in which clonic blepharospasm is shown for the first time.
Stroke patterns in cardio-embolic infarction in a population-based study (Neurol. Res. — 2001. — Jun. — 23(4). — P. 309—314: англ.)
Abstract
The population study used determines the features of the course of strokes or the so-called stroke pattern in patients with cardio-embolic infarction. In a prospective population study for 14 years (1985-1997), cardio-embolic infarction was diagnosed in 882 (37.9%) of 2330 patients who had had the first acute cerebrovascular accident.