Pub Date : 2023-10-02DOI: 10.30629/2658-7947-2023-28-4-60-67
N. I. Panchenko, N. V. Shuleshova, D. I. Rudenko, D. I. Skulyabin, S. A. Kolchev, S. V. Perfilev, S. V. Lapin
The article presents a clinical case of a 19-year-old patient with reliable autoimmune anti-NMDA encephalitis, developed after a coronavirus infection, which was accompanied by the signs of catatonia, epilepsy and mutism at the onset of the disease. This case enlarges the statistics of observations of this pathology by including the SARS-COV 2 virus to the list of possible etiological factors. The analysis of the catatonia signs, dominating at the onset of the disease, was carried out.
{"title":"Autoimmune аnti-NMDA encephalitis associated with the new coronavirus infection COVID-19","authors":"N. I. Panchenko, N. V. Shuleshova, D. I. Rudenko, D. I. Skulyabin, S. A. Kolchev, S. V. Perfilev, S. V. Lapin","doi":"10.30629/2658-7947-2023-28-4-60-67","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-4-60-67","url":null,"abstract":"The article presents a clinical case of a 19-year-old patient with reliable autoimmune anti-NMDA encephalitis, developed after a coronavirus infection, which was accompanied by the signs of catatonia, epilepsy and mutism at the onset of the disease. This case enlarges the statistics of observations of this pathology by including the SARS-COV 2 virus to the list of possible etiological factors. The analysis of the catatonia signs, dominating at the onset of the disease, was carried out.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":"102 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135899250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-02DOI: 10.30629/2658-7947-2023-28-4-43-53
E. P. Nuzhnyi, M. Yu. Krasnov, A. N. Moskalenko, E. Yu. Fedotova, E. O. Chekanova, S. N. Illarioshkin
Introduction. Paraneoplastic cerebellar degeneration (PCD) is an immune-mediated and rapidly progressive cerebellar syndrome that develops as a result of a cross-immune response to the common antigens for the tumor and cerebellar cells. Timely diagnosis and treatment of PCD improves the functional status and survival of these patients.Objective. To analyze the clinical, laboratory and neuroimaging characteristics of PCD case series in comparison with literature data.Material and methods. 16 patients with PCD (13 women, 3 men) were examined. An assessment of the clinical presentation, brain MRI study, blood and cerebrospinal fl uid laboratory tests were carried out, the data of cancer search and patients follow-up were analyzed.Results. The median age of PCD patients was 55 years, the duration of the disease was 8.5 months (range 4 to 16 months). In 12 patients, PCD was the fi rst manifestation of cancer. The clinical prentation was presented by rapidly progressive cerebellar ataxia, often in combination with oculomotor disturbances, pyramidal and bulbar syndrome, hand tremor and dystonia. An associated cancers were detected in 13 patients (81%). Antineuronal antibodies were found in 14 patients (88%): anti-Yo-1, antibodies to amphiphysin, anti-Hu, anti-CV2 and anti-GAD. Mild atrophic changes of the cerebellum were found in 6 patients, and in 2 cases cerebellar hemiatrophy was observed.Conclusion. PCD is a rare disabling but potentially curable disease. The basis of diagnosis is the analysis of the clinical presentation and neuroimaging data, the detection of antineuronal antibodies and in fl ammatory changes in the cerebrospinal fl uid, as well as a thorough cancer search.
{"title":"Paraneoplastic cerebellar degeneration","authors":"E. P. Nuzhnyi, M. Yu. Krasnov, A. N. Moskalenko, E. Yu. Fedotova, E. O. Chekanova, S. N. Illarioshkin","doi":"10.30629/2658-7947-2023-28-4-43-53","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-4-43-53","url":null,"abstract":"Introduction. Paraneoplastic cerebellar degeneration (PCD) is an immune-mediated and rapidly progressive cerebellar syndrome that develops as a result of a cross-immune response to the common antigens for the tumor and cerebellar cells. Timely diagnosis and treatment of PCD improves the functional status and survival of these patients.Objective. To analyze the clinical, laboratory and neuroimaging characteristics of PCD case series in comparison with literature data.Material and methods. 16 patients with PCD (13 women, 3 men) were examined. An assessment of the clinical presentation, brain MRI study, blood and cerebrospinal fl uid laboratory tests were carried out, the data of cancer search and patients follow-up were analyzed.Results. The median age of PCD patients was 55 years, the duration of the disease was 8.5 months (range 4 to 16 months). In 12 patients, PCD was the fi rst manifestation of cancer. The clinical prentation was presented by rapidly progressive cerebellar ataxia, often in combination with oculomotor disturbances, pyramidal and bulbar syndrome, hand tremor and dystonia. An associated cancers were detected in 13 patients (81%). Antineuronal antibodies were found in 14 patients (88%): anti-Yo-1, antibodies to amphiphysin, anti-Hu, anti-CV2 and anti-GAD. Mild atrophic changes of the cerebellum were found in 6 patients, and in 2 cases cerebellar hemiatrophy was observed.Conclusion. PCD is a rare disabling but potentially curable disease. The basis of diagnosis is the analysis of the clinical presentation and neuroimaging data, the detection of antineuronal antibodies and in fl ammatory changes in the cerebrospinal fl uid, as well as a thorough cancer search.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135900156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-02DOI: 10.30629/2658-7947-2023-28-4-35-42
A. D. Dorokhov, E. V. Ivashkova, A. G. Ilves, K. K. Mineev, I. G. Negoreeva, A. M. Petrov, L. N. Prakhova, I. D. Stolyarov, G. G. Shkilnyuk, V. N. Tartakovskiy, T. L. Tcvetkova, V. A. Zubarev
Rationale. Walking and balance disorders, modi fi ed foot muscles kinematics and walking stereotypes are typical for the patients with Multiple Sclerosis (MS).Objective. To assess the biomechanical parameters of the feet in MS patients with diff erent neurological status during walking.Material and methods. Data analysis of 102 patients with relapsing-remitting MS was carried out for two groups depending on the value of the Expanded Disability Status Scale (EDSS). Plantar pressure distribution was measured on with the pedographic platform emed, novel gmbh, Munich, Germany, using a “fi rst step” protocol.Results and conclusion. Loading of the heel, the area of central metatarsal heads is decreased and loading of the toes is increased during walking in MS patients. Diff erences were found for the spreading coeffi cient (the ratio of the width to the length of the foot), the dynamic width of the foot in patients with an EDSS ≥ 4 is signi fi cantly less in the instep, in the middle and in the narrowest parts of the foot, which leads to the decrease of the contact area. It has been shown that patients with MS who are mobile or walk without assistance are more likely to have pes cavus foot compared to MS patients with minor impairments. The load of the medial side of the foot is greater than the lateral side, which indicates the predominance of the valgus foot. The pronation-supination index is signi fi cantly higher in the patients with moderate impairments in toe-off phase. Evaluation of foot deformity based on the measurement of biomechanical parameters of plantar pressure distribution makes it possible to plan the treatment and rehabilitation tactics in MS patients.
{"title":"Assessment of biomechanical parameters of feet in patients with multiple sclerosis during walking","authors":"A. D. Dorokhov, E. V. Ivashkova, A. G. Ilves, K. K. Mineev, I. G. Negoreeva, A. M. Petrov, L. N. Prakhova, I. D. Stolyarov, G. G. Shkilnyuk, V. N. Tartakovskiy, T. L. Tcvetkova, V. A. Zubarev","doi":"10.30629/2658-7947-2023-28-4-35-42","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-4-35-42","url":null,"abstract":"Rationale. Walking and balance disorders, modi fi ed foot muscles kinematics and walking stereotypes are typical for the patients with Multiple Sclerosis (MS).Objective. To assess the biomechanical parameters of the feet in MS patients with diff erent neurological status during walking.Material and methods. Data analysis of 102 patients with relapsing-remitting MS was carried out for two groups depending on the value of the Expanded Disability Status Scale (EDSS). Plantar pressure distribution was measured on with the pedographic platform emed, novel gmbh, Munich, Germany, using a “fi rst step” protocol.Results and conclusion. Loading of the heel, the area of central metatarsal heads is decreased and loading of the toes is increased during walking in MS patients. Diff erences were found for the spreading coeffi cient (the ratio of the width to the length of the foot), the dynamic width of the foot in patients with an EDSS ≥ 4 is signi fi cantly less in the instep, in the middle and in the narrowest parts of the foot, which leads to the decrease of the contact area. It has been shown that patients with MS who are mobile or walk without assistance are more likely to have pes cavus foot compared to MS patients with minor impairments. The load of the medial side of the foot is greater than the lateral side, which indicates the predominance of the valgus foot. The pronation-supination index is signi fi cantly higher in the patients with moderate impairments in toe-off phase. Evaluation of foot deformity based on the measurement of biomechanical parameters of plantar pressure distribution makes it possible to plan the treatment and rehabilitation tactics in MS patients.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":"151 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135900152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-30DOI: 10.30629/2658-7947-2023-28-4-24-34
S. S. Petrikov, N. A. Shamalov, L. B. Zavaliy, O. L. Evdokimova, M. V. Neznanova, I. A. Tyrov, A. N. Koriagin, A. G. Fomkin, D. V. Kuular, T. A. Nikulina
The timing and volume of neuroimaging for patients with facial nerve neuropathy (FNN) are a cause for discussion. Aim. To study the current volume of neuroimaging in patients with FNN and to determine the essential diagnostic protocol. Material and methods. Magnetic resonance imaging (MRI) data analysis of adult patients with FNN (n = 833). Protocols were taken from the Uni fi ed Medical Information and Analytical System of Moscow (EMIAS). The essential diagnostic protocol was created. A prospective study was conducted with new protocol. Results. According to EMIAS, the timing of MRI was 3 months from the fi rst symptoms to do diagnostics, the longest period from diagnosis to appointment to MRI was 83 days. The list of pulse sequences was given in the protocol in ¾ of cases. The most indicated regimes were T1 WI (80.7%), T2 WI (90.6%), T2 FLAIR (73.2%), less often DWI (54.9%). Studies with contrast amounted to 22.8%. In total, the pathology was detected in 429 (51.5%) patients, including 88 (20.5%) intracranial tumors. In 216 (25.9%) patients, the changes were most likely associated with FNN, of which in 44.5% of cases were in fl ammatory, 21.3% — tumor, 16.2% — demyelinating process, 11.2% — postoperative changes. According to the new protocol, the cause of FNN was directly identi fi ed in 56.6% of patients, of which in idiopathic — 31,6% of cases, in symptomatic — 70.6% (p = 0.005). Changes that cannot be associated with FNN, but require the participation of a specialist, were detected in a 1/4 of patients. Only in 20.8% of cases, the MRI results were normal. Conclusion. Recommended volume of neuroimaging for patients with FNN is MRI of the brain and parotid salivary glands with contrast within 1 month from the fi st symptoms. Regimes: T1 WI, T2 WI, FLAIR (with a slice thickness of 1 mm), DWI, 3D TOF, free recession in equilibrium (SSFP, FIESTA-C, CISS, FFE, etc.), sensitive to magnetic fi eld inhomogeneity (T2*, SWI, SWAN, etc.), and also T1 WI after intravenous contrast.
面神经病变(FNN)患者的神经显像时机和体积是一个值得讨论的问题。的目标。研究FNN患者目前的神经影像量，并确定必要的诊断方案。材料和方法。成年FNN患者的磁共振成像(MRI)资料分析(n = 833)。协议取自莫斯科统一医疗信息和分析系统(EMIAS)。基本的诊断方案被创建。采用新方案进行前瞻性研究。结果。根据EMIAS，从首次出现症状到进行诊断，MRI的时间为3个月，从诊断到预约再到MRI的最长时间为83天。四分之三的病例的治疗方案中给出了脉冲序列列表。最常见的是T1 WI (80.7%)， T2 WI (90.6%)， T2 FLAIR(73.2%)，较少的是DWI(54.9%)。造影剂研究占22.8%。其中颅内肿瘤88例(20.5%)，病理检出429例(51.5%)。216例(25.9%)患者的改变最可能与FNN相关，其中44.5%的病例为炎性，21.3%为肿瘤，16.2%为脱髓鞘过程，11.2%为术后改变。根据新方案，56.6%的患者可直接诊断出FNN的病因，其中特发性为31.6%，症状性为70.6% (p = 0.005)。在1/4的患者中发现了与FNN无关但需要专家参与的变化。仅20.8%的病例MRI结果正常。结论。对于FNN患者，推荐的神经影像学检查是在首次出现症状后1个月内对大脑和腮腺涎腺进行MRI对比检查。检查机制:T1 WI、T2 WI、FLAIR(片厚1mm)、DWI、3D TOF、平衡自由衰退(SSFP、fista - c、CISS、FFE等)、对磁场不均匀性敏感(T2*、SWI、SWAN等)，以及静脉造影术后的T1 WI。
{"title":"Neuroimaging in facial nerve neuropathy","authors":"S. S. Petrikov, N. A. Shamalov, L. B. Zavaliy, O. L. Evdokimova, M. V. Neznanova, I. A. Tyrov, A. N. Koriagin, A. G. Fomkin, D. V. Kuular, T. A. Nikulina","doi":"10.30629/2658-7947-2023-28-4-24-34","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-4-24-34","url":null,"abstract":"The timing and volume of neuroimaging for patients with facial nerve neuropathy (FNN) are a cause for discussion. Aim. To study the current volume of neuroimaging in patients with FNN and to determine the essential diagnostic protocol. Material and methods. Magnetic resonance imaging (MRI) data analysis of adult patients with FNN (n = 833). Protocols were taken from the Uni fi ed Medical Information and Analytical System of Moscow (EMIAS). The essential diagnostic protocol was created. A prospective study was conducted with new protocol. Results. According to EMIAS, the timing of MRI was 3 months from the fi rst symptoms to do diagnostics, the longest period from diagnosis to appointment to MRI was 83 days. The list of pulse sequences was given in the protocol in ¾ of cases. The most indicated regimes were T1 WI (80.7%), T2 WI (90.6%), T2 FLAIR (73.2%), less often DWI (54.9%). Studies with contrast amounted to 22.8%. In total, the pathology was detected in 429 (51.5%) patients, including 88 (20.5%) intracranial tumors. In 216 (25.9%) patients, the changes were most likely associated with FNN, of which in 44.5% of cases were in fl ammatory, 21.3% — tumor, 16.2% — demyelinating process, 11.2% — postoperative changes. According to the new protocol, the cause of FNN was directly identi fi ed in 56.6% of patients, of which in idiopathic — 31,6% of cases, in symptomatic — 70.6% (p = 0.005). Changes that cannot be associated with FNN, but require the participation of a specialist, were detected in a 1/4 of patients. Only in 20.8% of cases, the MRI results were normal. Conclusion. Recommended volume of neuroimaging for patients with FNN is MRI of the brain and parotid salivary glands with contrast within 1 month from the fi st symptoms. Regimes: T1 WI, T2 WI, FLAIR (with a slice thickness of 1 mm), DWI, 3D TOF, free recession in equilibrium (SSFP, FIESTA-C, CISS, FFE, etc.), sensitive to magnetic fi eld inhomogeneity (T2*, SWI, SWAN, etc.), and also T1 WI after intravenous contrast.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136344748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-30DOI: 10.30629/2658-7947-2023-28-4-16-23
N. I. Salouhina, M. R. Nodel, V. A. Tolmacheva
The main treatment for cervical dystonia (CD) is botulinum toxin type A (BTA) injections, but several long-term studies have found that between 19-46% of patients discontinue treatment. Anxiety and depression play a signi fi cant role in reducing the quality of life in patients with CD, according to previous surveys.Aim: to assess the dynamics of CD symptom severity, emotional disturbance, and quality of life in patients under different treatment methods.Material and methods. 61 patients with CD, 16 (26%) men and 45 (74%) women, age 50 [40; 59] years, duration of illness 4 [2; 7] years, age at onset 44 [34; 54] years, were studied. Changes in motor and aff ective disturbances, quality of life in patients with CD were assessed after 2 and 4 months in the context of diff erent treatment methods — BTA monotherapy, antidepressant (AD), combined therapy (AD + AD).Results. Combination therapy (BT + AD) was shown to be superior to BTA monotherapy in long-term follow-up of patients in terms of correction of depression, anxiety, integrative assessment of quality of life and severity of dystonia. After 4 months of treatment, the (BT + AD) subgroup maintained the positive trend achieved in dystonia severity (p < 0.001). At the end of the follow-up period in the BT group, the positive eff ect of therapy had regressed to baseline levels of dystonia severity.Conclusion. To achieve a sustained therapeutic response in patients with CD, diagnosis and appropriate correction of emotional disturbances is necessary. The potential effi cacy of antidepressants in the treatment of motor and sensory symptoms of CD requires further investigation.
{"title":"Cervical dystonia: ways to achieve long-term treatment eff ects and improve patients’ quality of life","authors":"N. I. Salouhina, M. R. Nodel, V. A. Tolmacheva","doi":"10.30629/2658-7947-2023-28-4-16-23","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-4-16-23","url":null,"abstract":"The main treatment for cervical dystonia (CD) is botulinum toxin type A (BTA) injections, but several long-term studies have found that between 19-46% of patients discontinue treatment. Anxiety and depression play a signi fi cant role in reducing the quality of life in patients with CD, according to previous surveys.Aim: to assess the dynamics of CD symptom severity, emotional disturbance, and quality of life in patients under different treatment methods.Material and methods. 61 patients with CD, 16 (26%) men and 45 (74%) women, age 50 [40; 59] years, duration of illness 4 [2; 7] years, age at onset 44 [34; 54] years, were studied. Changes in motor and aff ective disturbances, quality of life in patients with CD were assessed after 2 and 4 months in the context of diff erent treatment methods — BTA monotherapy, antidepressant (AD), combined therapy (AD + AD).Results. Combination therapy (BT + AD) was shown to be superior to BTA monotherapy in long-term follow-up of patients in terms of correction of depression, anxiety, integrative assessment of quality of life and severity of dystonia. After 4 months of treatment, the (BT + AD) subgroup maintained the positive trend achieved in dystonia severity (p < 0.001). At the end of the follow-up period in the BT group, the positive eff ect of therapy had regressed to baseline levels of dystonia severity.Conclusion. To achieve a sustained therapeutic response in patients with CD, diagnosis and appropriate correction of emotional disturbances is necessary. The potential effi cacy of antidepressants in the treatment of motor and sensory symptoms of CD requires further investigation.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":"162 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136343943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-30DOI: 10.30629/2658-7947-2023-28-4-5-15
E. V. Isakova
The symptom of vertigo and dizziness is often detected in patients with COVID-19. The article discusses issues related to damage to the peripheral and vestibular parts of the vestibular analyzer in patients infected with the SARS-CoV-2 virus. The possible mechanisms of the pathogenesis of the development of cerebral stroke in this viral infection, its features are described. A description of the forms of damage to the peripheral part of the vestibular analyzer, including vestibular neuronitis, benign paroxysmal positional vertigo, Meniere’s disease, is presented. Other possible causes of the development of the symptom of vertigo and dizziness in patients with COVID-19 that are not associated with damage to the vestibular analyzer are also considered
{"title":"Symptom of vertigo and dizziness in patients with COVID-19","authors":"E. V. Isakova","doi":"10.30629/2658-7947-2023-28-4-5-15","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-4-5-15","url":null,"abstract":"The symptom of vertigo and dizziness is often detected in patients with COVID-19. The article discusses issues related to damage to the peripheral and vestibular parts of the vestibular analyzer in patients infected with the SARS-CoV-2 virus. The possible mechanisms of the pathogenesis of the development of cerebral stroke in this viral infection, its features are described. A description of the forms of damage to the peripheral part of the vestibular analyzer, including vestibular neuronitis, benign paroxysmal positional vertigo, Meniere’s disease, is presented. Other possible causes of the development of the symptom of vertigo and dizziness in patients with COVID-19 that are not associated with damage to the vestibular analyzer are also considered","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136343942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-19DOI: 10.30629/2658-7947-2023-28-3-55-60
V. V. Ponomarev, T. A. Rakot
A clinical analysis of a patient with undifferentiated granulomatous systemic vasculitis with a predominant lung lesion and its complication in the form of chronic hypertrophic convexital pachymeningitis of fungal (candidal) etiology is presented. A differential diagnosis with granulomatosis with polyangiitis was carried out. Modern literature data on diagnostic criteria and methods of treatment of this rare pathology are given.
{"title":"Clinical case of hypertrophic convexital pachymeningitis","authors":"V. V. Ponomarev, T. A. Rakot","doi":"10.30629/2658-7947-2023-28-3-55-60","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-3-55-60","url":null,"abstract":"A clinical analysis of a patient with undifferentiated granulomatous systemic vasculitis with a predominant lung lesion and its complication in the form of chronic hypertrophic convexital pachymeningitis of fungal (candidal) etiology is presented. A differential diagnosis with granulomatosis with polyangiitis was carried out. Modern literature data on diagnostic criteria and methods of treatment of this rare pathology are given.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42694016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-19DOI: 10.30629/2658-7947-2023-28-3-22-27
N. Koberskaya, V. Perepelov, D. Smirnov, V. Gridin, N. Yakhno
Currently, instrumental brain imaging plays a significant role in the examination of patients with cognitive impairment. It is important for diagnostic process, prognosis of the course of neurodegenerative, cerebrovascular and other diseases, clarification of the role of individual brain structures and systems in the development of cognitive and other neuropsychiatric disorders.The purpose of the study was to analyze the volumes of the medial temporal lobes (MTL), hippocampus and brain volume in middle-aged patients with pre-mild cognitive decline.Material and methods. 38 patients (33 women, 5 men) of middle age (60.77 ± 9.4 years) were examined. Patients were divided into two groups: with subjective cognitive decline (SCD) – 15 patients, aged 53.5 ± 6.94 years and subtle cognitive decline (StCD) – 23 people aged 63.35 ± 8.64 years (groups statistically did not differ in age). All patients underwent a neuropsychological examination with an assessment of the cognitive sphere, magnetic resonance imaging of the brain, including the assessment of the presence and degree of microangiopathy (MAP), morphometry of the medial temporal lobes, hippocampus, brain volume and a study for the presence of the allele of the apolyprotein E gene (ApoE4).Results. A decrease in the average and total hippocampal volume was found in patients with StCD compared to patients with SCD. Also, MAP was significantly more common in patients with StCD. There were no differences in the degree of MTL atrophy. A decrease in the volume of the left hippocampus was revealed in patients with aggravated heredity for dementia. The average and total volume of the hippocampus is reduced in carriers of the ApoE4 allele of the apolyprotein gene. Correlation analysis showed the relationship between the average volume of the hippocampus and the volume of the brain.
{"title":"Magnetic resonance morphometry of the brain volume, medial temporal lobes and hippocampus in middle-aged patients with premild cognitive decline","authors":"N. Koberskaya, V. Perepelov, D. Smirnov, V. Gridin, N. Yakhno","doi":"10.30629/2658-7947-2023-28-3-22-27","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-3-22-27","url":null,"abstract":"Currently, instrumental brain imaging plays a significant role in the examination of patients with cognitive impairment. It is important for diagnostic process, prognosis of the course of neurodegenerative, cerebrovascular and other diseases, clarification of the role of individual brain structures and systems in the development of cognitive and other neuropsychiatric disorders.The purpose of the study was to analyze the volumes of the medial temporal lobes (MTL), hippocampus and brain volume in middle-aged patients with pre-mild cognitive decline.Material and methods. 38 patients (33 women, 5 men) of middle age (60.77 ± 9.4 years) were examined. Patients were divided into two groups: with subjective cognitive decline (SCD) – 15 patients, aged 53.5 ± 6.94 years and subtle cognitive decline (StCD) – 23 people aged 63.35 ± 8.64 years (groups statistically did not differ in age). All patients underwent a neuropsychological examination with an assessment of the cognitive sphere, magnetic resonance imaging of the brain, including the assessment of the presence and degree of microangiopathy (MAP), morphometry of the medial temporal lobes, hippocampus, brain volume and a study for the presence of the allele of the apolyprotein E gene (ApoE4).Results. A decrease in the average and total hippocampal volume was found in patients with StCD compared to patients with SCD. Also, MAP was significantly more common in patients with StCD. There were no differences in the degree of MTL atrophy. A decrease in the volume of the left hippocampus was revealed in patients with aggravated heredity for dementia. The average and total volume of the hippocampus is reduced in carriers of the ApoE4 allele of the apolyprotein gene. Correlation analysis showed the relationship between the average volume of the hippocampus and the volume of the brain.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42735169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-19DOI: 10.30629/2658-7947-2023-28-3-61-68
A. A. Golovacheva, V. Golovacheva
Kinesiotherapy is eff ective in the treatment of chronic nonspecific back pain (CNBP), but its eff ectiveness in tensiontype headache (TTH) is unclear. The effectiveness of kinesiotherapy in patients with CNBP and comorbid TTH has been little studied.The aim of the study was to evaluate the effectiveness of kinesiotherapy in patients with CNBS and comorbid TTH. Patients and methods. 52 patients (22 men and 30 women, mean age 32.4 ± 7.5 years) with CNBP and combined TTH were included in the study. All patients received standard treatment, of which 28 patients received kinesiotherapy (Group 1) and 24 patients were included in the comparison group (Group 2). All patients used pain diaries. All patients were tested by using the Beck Anxiety Inventory, the Beck’s Depression Inventory, the Pain Catastrophization Scale, the Kinesiophobia Scale, the Oswestry Disability Index, the Roland–Morris Disability Questionnaire, the Headache Impact Test 6, numerical pain rating scale before treatment and 3, 6 months after treatment. Clinical effcacy was assessed by reducing the frequency and intensity of headache (by ≥ 50%), back pain (by ≥ 30%), and by increasing functional activity during the day (by ≥ 30%).Results. At 6 months follow-up signifiantly more patients in group 1 than in group 2 achieved a clinical effect on TTH and CNBP: 78.5% (n = 22) compared to 41.7% (n = 10); OR (95% CI) = 1.99. In 9 patients (32%) of group 1, a complete remission of TTH and CNBP was noted, in group 2 there were no such patients. At 6 months follow-up group 1 showed a significant improvement (p < 0.05) in comparison with group 2 in terms of functional activity and emotional state.Conclusion. Kinesiotherapy for CNBP and combined TTH is effective both for back pain and headache. It increases functional activity and improves the emotional state of patients.
{"title":"Kinesiotherapy in chronic back pain and combined tension type headache","authors":"A. A. Golovacheva, V. Golovacheva","doi":"10.30629/2658-7947-2023-28-3-61-68","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-3-61-68","url":null,"abstract":"Kinesiotherapy is eff ective in the treatment of chronic nonspecific back pain (CNBP), but its eff ectiveness in tensiontype headache (TTH) is unclear. The effectiveness of kinesiotherapy in patients with CNBP and comorbid TTH has been little studied.The aim of the study was to evaluate the effectiveness of kinesiotherapy in patients with CNBS and comorbid TTH. Patients and methods. 52 patients (22 men and 30 women, mean age 32.4 ± 7.5 years) with CNBP and combined TTH were included in the study. All patients received standard treatment, of which 28 patients received kinesiotherapy (Group 1) and 24 patients were included in the comparison group (Group 2). All patients used pain diaries. All patients were tested by using the Beck Anxiety Inventory, the Beck’s Depression Inventory, the Pain Catastrophization Scale, the Kinesiophobia Scale, the Oswestry Disability Index, the Roland–Morris Disability Questionnaire, the Headache Impact Test 6, numerical pain rating scale before treatment and 3, 6 months after treatment. Clinical effcacy was assessed by reducing the frequency and intensity of headache (by ≥ 50%), back pain (by ≥ 30%), and by increasing functional activity during the day (by ≥ 30%).Results. At 6 months follow-up signifiantly more patients in group 1 than in group 2 achieved a clinical effect on TTH and CNBP: 78.5% (n = 22) compared to 41.7% (n = 10); OR (95% CI) = 1.99. In 9 patients (32%) of group 1, a complete remission of TTH and CNBP was noted, in group 2 there were no such patients. At 6 months follow-up group 1 showed a significant improvement (p < 0.05) in comparison with group 2 in terms of functional activity and emotional state.Conclusion. Kinesiotherapy for CNBP and combined TTH is effective both for back pain and headache. It increases functional activity and improves the emotional state of patients.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48430108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-19DOI: 10.30629/2658-7947-2023-28-3-36-43
K. V. Firsov, A. Kotov, M. G. Amirchanyan
Drug-resistant forms of epilepsy are an important medical and social problem.Goal of the work. Evaluation of the probability of achieving remission after correction of therapy in patients with drug-resistant focal epilepsy.Material and methods. The study included 309 patients divided into three heterogeneous groups: a group of patients with focal pharmacoresistant epilepsy; a group of patients with super refractory focal epilepsy; control group – patients who had not previously received treatment. The examination included history taking, clinical and neurological examination, routine EEG and/or EEG video monitoring, MRI of the brain, and analysis of medical records. Therapy was adjusted.Results. After correction of therapy, remission in patients in Group 1 was achieved in 27.8% of patients, improvement – in 27.1%, no effect – in 45.1%; in Group 2, remission was achieved in 13.2% of patients, improvement – in 28.6%, no effect – in 58.2%; in Group 3, remission was achieved in 41.2% of patients, improvement – in 32.9%, no effect – in 25.9%. Negative prognostic factors did not show a significant correlation with the lack of effect of therapy.Conclusion. After correction of therapy, remission was achieved in several patients with drug-resistant focal epilepsy, while negative prognostic factors do not exclude the possibility of achieving remission.
{"title":"The probability of achieving remission after correction of therapy in patients with pharmacoresistant focal epilepsy","authors":"K. V. Firsov, A. Kotov, M. G. Amirchanyan","doi":"10.30629/2658-7947-2023-28-3-36-43","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-3-36-43","url":null,"abstract":"Drug-resistant forms of epilepsy are an important medical and social problem.Goal of the work. Evaluation of the probability of achieving remission after correction of therapy in patients with drug-resistant focal epilepsy.Material and methods. The study included 309 patients divided into three heterogeneous groups: a group of patients with focal pharmacoresistant epilepsy; a group of patients with super refractory focal epilepsy; control group – patients who had not previously received treatment. The examination included history taking, clinical and neurological examination, routine EEG and/or EEG video monitoring, MRI of the brain, and analysis of medical records. Therapy was adjusted.Results. After correction of therapy, remission in patients in Group 1 was achieved in 27.8% of patients, improvement – in 27.1%, no effect – in 45.1%; in Group 2, remission was achieved in 13.2% of patients, improvement – in 28.6%, no effect – in 58.2%; in Group 3, remission was achieved in 41.2% of patients, improvement – in 32.9%, no effect – in 25.9%. Negative prognostic factors did not show a significant correlation with the lack of effect of therapy.Conclusion. After correction of therapy, remission was achieved in several patients with drug-resistant focal epilepsy, while negative prognostic factors do not exclude the possibility of achieving remission.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44646431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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