NEUROPHYSIOLOGICAL PARAMETERS IN PATIENTS WITH MYELOPATHY AT A REMOTE STAGE OF REHABILITATION

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Abstract

Aim. Comparison of neurophysiological parameters in patients with myelopathy at the remote stages of rehabilitation depending on the dynamics in their condition. Methods. 87 patients with cervical and thoracic myelopathies with a lesion duration from 2 to 26 years were examined. Of these, 51 patients did not have dynamics in the neurological and functional status after a month-long rehabilitation course (group 1), 32 patients had a positive trend (group 2). The electroneuromyography method was used to research n. tibialis conduction, and transcranial magnetic stimulation was used to research corticospinal conduction for m. abductor hallucis. Results. In patients of the 1st group, signs of peripheral axonopathy (decreased amplitude and increased thresholds of CMAP of n. tibialis) and disturbances in the dynamics of spinal motoneuron pool (repeated F-waves) were found to be statistically significantly (р<0.05); more often there were no MEP on cortical magnetic stimulation (р<0.05). Patients of the 2nd group statistically significantly (р<0.05) more often showed signs of myelinopathy in terms of F-wave parameters (decrease of the conduction velocity, increase in the duration of F-waves). Conclusion. Preservation of suprasegmental (presence of MEP from the muscles of the feet) and segmental (absence of peripheral axonopathy) in patients with myelopathy is an important condition for a positive rehabilitation prognosis at the remote stages of recovery. By this, patients with a long duration of the disease differ from those who have recently become ill, where peripheral axonopathy plays a smaller role, and more important is the change in conduction according to the type of myelinopathy. However, in the later stages of rehabilitation, myelinopathy has a certain significance, which can be seen from the F-wave parameters in the group of patients with positive dynamics.

About the authors

Elena A. Kovrazhkina

Federal Center for Cerebrovascular Pathology and Stroke

Email: elekov2@yandex.ru
ст. науч. сотр. ФГБУ ФЦППИ Москва, Россия

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