Pub Date : 2023-05-18DOI: 10.30629/2658-7947-2023-28-2-25-30
N. E. Seksyaev, Yuliya V. Karakulova, D. Sosnin
Background. Cerebral toxoplasmosis (CT) is one of the most common cause of focal neurological defi cit in HIV/ AIDS group of patients. Timely diagnosis of CT and antiparasitic therapy contribute to decrease of lethal outcomes and disability.Aim. To study neurological manifestations, cognitive functions and neuron-specifi c enolase (NSE) concentration in cerebrospinal fluid (CSF), in HIV/AIDS patients with CT.Material and methods. The 35 patients (10 females and 25 males) from 28 to 50 years old with confirmed diagnosis of HIV/AIDS-associated CT were included in the investigation group. Neurological status, cognitive function and laboratory CSF changings had been studied in prospective investigation before and during the treatment with control points in the 1st and 10th days of the observation.Results. The method of neurological manifestation of CT evaluation had been developed and implemented in practice. The association between neurological defi cit severity (movement and sensory disorders), cognitive decline and increasing CSF concentration of NSE in HIV/AIDS-associated CT was determined that demonstrates the activity of encephalitic process.Conclusion. Dynamic evaluation of NSE concentration in CSF with clinical assessment of neurological manifestation in patients with HIV/AIDS-associated CT may be used for confirmation of specific antiparasitic treatment effectiveness and for increasing clinical criteria significance.
{"title":"Clinical manifestations and neuron-specific enolase cerebrospinal fluid concentration in HIV/AIDS patients with cerebral toxoplasmosis","authors":"N. E. Seksyaev, Yuliya V. Karakulova, D. Sosnin","doi":"10.30629/2658-7947-2023-28-2-25-30","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-2-25-30","url":null,"abstract":"Background. Cerebral toxoplasmosis (CT) is one of the most common cause of focal neurological defi cit in HIV/ AIDS group of patients. Timely diagnosis of CT and antiparasitic therapy contribute to decrease of lethal outcomes and disability.Aim. To study neurological manifestations, cognitive functions and neuron-specifi c enolase (NSE) concentration in cerebrospinal fluid (CSF), in HIV/AIDS patients with CT.Material and methods. The 35 patients (10 females and 25 males) from 28 to 50 years old with confirmed diagnosis of HIV/AIDS-associated CT were included in the investigation group. Neurological status, cognitive function and laboratory CSF changings had been studied in prospective investigation before and during the treatment with control points in the 1st and 10th days of the observation.Results. The method of neurological manifestation of CT evaluation had been developed and implemented in practice. The association between neurological defi cit severity (movement and sensory disorders), cognitive decline and increasing CSF concentration of NSE in HIV/AIDS-associated CT was determined that demonstrates the activity of encephalitic process.Conclusion. Dynamic evaluation of NSE concentration in CSF with clinical assessment of neurological manifestation in patients with HIV/AIDS-associated CT may be used for confirmation of specific antiparasitic treatment effectiveness and for increasing clinical criteria significance.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49171537","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 : 2023-05-18DOI: 10.30629/2658-7947-2023-28-2-38-45
A. R. Karshieva, A. Chechetkin, A. Belopasova, L. Dobrynina
Objective. To determine specific diagnostic criteria for detecting the type of the right-to-left shunt by contrast-enhanced transcranial Doppler ultrasound (cTCD) in young patients with paradoxical embolism and ischemic stroke/TIA.Material and methods. The study included 64 ischemic stroke or transient ischemic attack patients (age 28–44 years) with patent foramen ovale (PFO), atrial septal defect (ASD) or pulmonary arteriovenous malformation (PAVM). cTCD was used to assess the degree of shunting, its change during the Valsalva maneuver (VM), time to the fi rst microembolic signal (MES) detection, and the duration of MES registration.Results. According to cTCD data, 20% of patients with PFO had no shunt at rest, and 80% had a mild to moderate right-to-left shunt. After VM, a severe shunt was detected in 75% of patients in this group and a moderate shunt in 25%. All patients with ASD and PAVM had a marked shunt at rest. The difference in time to first MES detection from the start of contrast administration was not statistically significant for all groups. The duration of MES registration that indicated shunting was shorter in patients with PFO compared to those with ASD (p < 0.001) or with PAVM (p < 0.001) and it was significantly longer in patients with PAVM compared to those with ASD (p < 0.001).Conclusion. The key diagnostic criteria to defi ne the right-to-left shunt type are the functional shunt degree at rest and the duration of MES registration. Severe shunting at rest can suggest the presence of ASD or PAVM, while the duration of MES registration > 2 min suggests a PAVM.
{"title":"Diagnostic criteria for determining the type of the right-to-left shunt using contrast-enhanced transcranial Doppler ultrasound in young patients with ischemic stroke/transient ischemic attack","authors":"A. R. Karshieva, A. Chechetkin, A. Belopasova, L. Dobrynina","doi":"10.30629/2658-7947-2023-28-2-38-45","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-2-38-45","url":null,"abstract":"Objective. To determine specific diagnostic criteria for detecting the type of the right-to-left shunt by contrast-enhanced transcranial Doppler ultrasound (cTCD) in young patients with paradoxical embolism and ischemic stroke/TIA.Material and methods. The study included 64 ischemic stroke or transient ischemic attack patients (age 28–44 years) with patent foramen ovale (PFO), atrial septal defect (ASD) or pulmonary arteriovenous malformation (PAVM). cTCD was used to assess the degree of shunting, its change during the Valsalva maneuver (VM), time to the fi rst microembolic signal (MES) detection, and the duration of MES registration.Results. According to cTCD data, 20% of patients with PFO had no shunt at rest, and 80% had a mild to moderate right-to-left shunt. After VM, a severe shunt was detected in 75% of patients in this group and a moderate shunt in 25%. All patients with ASD and PAVM had a marked shunt at rest. The difference in time to first MES detection from the start of contrast administration was not statistically significant for all groups. The duration of MES registration that indicated shunting was shorter in patients with PFO compared to those with ASD (p < 0.001) or with PAVM (p < 0.001) and it was significantly longer in patients with PAVM compared to those with ASD (p < 0.001).Conclusion. The key diagnostic criteria to defi ne the right-to-left shunt type are the functional shunt degree at rest and the duration of MES registration. Severe shunting at rest can suggest the presence of ASD or PAVM, while the duration of MES registration > 2 min suggests a PAVM.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43324286","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 : 2023-05-18DOI: 10.30629/2658-7947-2023-28-2-15-24
L. B. Zavaliy, G. R. Ramazanov, M. Kalantarova, A. Rakhmanina, M. Sinkin, N. Shamalov, S. Petrikov
Introduction. Diagnosis of patients with facial neuropathy (FN) is challenging because different sources of medical information off er a wide variety of approaches.Aim. Analysis of the features of diagnosing patients with FN by practicing neurologists.Material and methods. Anonymous online survey of neurologists adhering to the principles of evidence-based medicine (n = 172, work experience — 6 [3; 11] years), including 10 questions.Results. In 56.4% of cases, doctors diagnose patients with FN in accordance with “foreign” guidelines, however, older specialists still prefer Russian sources, and doctors with little work experience prefer the experience of colleagues (p = 0.018). Scales of assessment of facial muscles function are used by 28.5% of specialists, the description method is used by 95.9%. The content of the clinical protocol varies considerably. A highly significant correlation was observed: the lower the muscle is located on the face, the less often its function is assessed (r = –0.938, p < 0.000). Less than 1/3 of doctors use tests to assess the function of the facial muscles of the lower third of the face. Doctors significantly more often focus on the manifestations of the disease (decrease in the strength and tone of facial muscles, lagophthalmos, hyperacusis) than on the complications of FN (increased muscle tone on the healthy or affected side, synkinesis, post-paralytic hemispasm), p < 0.000. Magnetic resonance imaging is prescribed by more than 70% of specialists, computed tomography — by 25%, stimulation electroneuromyography — by 38,4% (in 1/4 of cases only on the affected side of the face). More than 95% of neurologists refer patients for consultations to doctors of other specialties, mainly to an otorhinolaryngologist (58.7%) and an ophthalmologist (56.9%), and only 23.2% to surgical specialists. About 2/3 of doctors refer patients for rehabilitation, however, there is no clinical protocol for the rehabilitation of this pathology.Conclusion. The study showed a greater adherence of the interviewed Russian specialists to evidence-based medicine, as well as a high degree of inter-expert variability of opinions, which dictates the necessity of the development of Russian guidelines.
{"title":"Diagnosis of patients with facial neuropathy by practicing neurologists: online survey","authors":"L. B. Zavaliy, G. R. Ramazanov, M. Kalantarova, A. Rakhmanina, M. Sinkin, N. Shamalov, S. Petrikov","doi":"10.30629/2658-7947-2023-28-2-15-24","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-2-15-24","url":null,"abstract":"Introduction. Diagnosis of patients with facial neuropathy (FN) is challenging because different sources of medical information off er a wide variety of approaches.Aim. Analysis of the features of diagnosing patients with FN by practicing neurologists.Material and methods. Anonymous online survey of neurologists adhering to the principles of evidence-based medicine (n = 172, work experience — 6 [3; 11] years), including 10 questions.Results. In 56.4% of cases, doctors diagnose patients with FN in accordance with “foreign” guidelines, however, older specialists still prefer Russian sources, and doctors with little work experience prefer the experience of colleagues (p = 0.018). Scales of assessment of facial muscles function are used by 28.5% of specialists, the description method is used by 95.9%. The content of the clinical protocol varies considerably. A highly significant correlation was observed: the lower the muscle is located on the face, the less often its function is assessed (r = –0.938, p < 0.000). Less than 1/3 of doctors use tests to assess the function of the facial muscles of the lower third of the face. Doctors significantly more often focus on the manifestations of the disease (decrease in the strength and tone of facial muscles, lagophthalmos, hyperacusis) than on the complications of FN (increased muscle tone on the healthy or affected side, synkinesis, post-paralytic hemispasm), p < 0.000. Magnetic resonance imaging is prescribed by more than 70% of specialists, computed tomography — by 25%, stimulation electroneuromyography — by 38,4% (in 1/4 of cases only on the affected side of the face). More than 95% of neurologists refer patients for consultations to doctors of other specialties, mainly to an otorhinolaryngologist (58.7%) and an ophthalmologist (56.9%), and only 23.2% to surgical specialists. About 2/3 of doctors refer patients for rehabilitation, however, there is no clinical protocol for the rehabilitation of this pathology.Conclusion. The study showed a greater adherence of the interviewed Russian specialists to evidence-based medicine, as well as a high degree of inter-expert variability of opinions, which dictates the necessity of the development of Russian guidelines.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47818201","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 : 2023-05-18DOI: 10.30629/2658-7947-2023-28-2-73-82
E. Seliverstova, V. Voitenkov, V. Komantsev, M. Sinkin, A. Grin
Neurological examination plays the main role in diagnostic and management of radiculopathies. In addition, the instrumental methods could be used for diagnosis of the morphological and functional state of paraspinal muscles. Paraspinal muscles are symmetrical back muscles surrounding the spinal column and supporting it. Magnetic resonance imaging (MRI) as well as needle electromyography (EMG) and ultrasound are used for instrumental diagnosis of paraspinal muscles conditions. We provide the review on the current scope of studies on radiculopathies and non-specific back pain. MRI is the principle standard for radiculopathy diagnosis, but other methods such as muscle ultrasound and needle electromyography are also used here. MRI is characterized by a high cost, and it is impossible to carry it out if there are magnetic objects present in the patient’s body. EMG and ultrasound both are not sufficient enough to study the level of the fatty replacement of the paraspinal muscle, while this parameter is quite significant for measuring a radiculopathy outcome. Thus, we consider it rational to recommend using these methods in combination. Indications for the combined examination may be such complex cases as anatomical anomalies of spinal roots, atypical disease pattern.
{"title":"Instrumental methods for assessing the state of the paravertebral lumbar muscles in patients with lumbosacral radiculopathy and nonspecific muscle-skeletal pain","authors":"E. Seliverstova, V. Voitenkov, V. Komantsev, M. Sinkin, A. Grin","doi":"10.30629/2658-7947-2023-28-2-73-82","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-2-73-82","url":null,"abstract":"Neurological examination plays the main role in diagnostic and management of radiculopathies. In addition, the instrumental methods could be used for diagnosis of the morphological and functional state of paraspinal muscles. Paraspinal muscles are symmetrical back muscles surrounding the spinal column and supporting it. Magnetic resonance imaging (MRI) as well as needle electromyography (EMG) and ultrasound are used for instrumental diagnosis of paraspinal muscles conditions. We provide the review on the current scope of studies on radiculopathies and non-specific back pain. MRI is the principle standard for radiculopathy diagnosis, but other methods such as muscle ultrasound and needle electromyography are also used here. MRI is characterized by a high cost, and it is impossible to carry it out if there are magnetic objects present in the patient’s body. EMG and ultrasound both are not sufficient enough to study the level of the fatty replacement of the paraspinal muscle, while this parameter is quite significant for measuring a radiculopathy outcome. Thus, we consider it rational to recommend using these methods in combination. Indications for the combined examination may be such complex cases as anatomical anomalies of spinal roots, atypical disease pattern.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48715776","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 : 2023-05-18DOI: 10.30629/2658-7947-2023-28-2-31-37
I. Shetova, E. Grigorieva, V. D. Shtadler, V. Krylov
Assessment of patients with intracranial aneurysms in the late postoperative period consists of both determining structural changes in computed tomography (CT) and the neurological and cognitive status of the patient. Meantime, the topic of the relationship between structural pathology in CT and cognitive impairment has not been suffi ciently disclosed.Objective: to determine CT, functional and cognitive outcomes in the long-term period of surgical treatment of cerebral aneurysms.Material and methods. The data of CT angiography of 49 patients operated on for intracranial aneurysms were analyzed. 39 patients were examined neurologically for 2.3 years using a range of rating scales.Results. The residual part of the aneurysm after surgery was found in 50% of patients with complex aneurysms, more often in patients with PMA-PSA aneurysms. The connection between the method of surgery and the preserved cervical part with structural changes in the brain and the development of cognitive impairment in the late postoperative period has not been proven.Conclusion. CT angiography preoperatively makes it possible to identify a group of complex aneurysms with a high risk of preservation of the cervical part and the development of brain structural changes. The predictors of the development of ischemic changes in the brain, hydrocephalus, and cognitive dysfunctions was the advanced age of patients, the duration of the operation, and a history of hypertension.
{"title":"Computed tomography, functional and cognitive changes in the long-time period of surgery of cerebral aneurysms","authors":"I. Shetova, E. Grigorieva, V. D. Shtadler, V. Krylov","doi":"10.30629/2658-7947-2023-28-2-31-37","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-2-31-37","url":null,"abstract":"Assessment of patients with intracranial aneurysms in the late postoperative period consists of both determining structural changes in computed tomography (CT) and the neurological and cognitive status of the patient. Meantime, the topic of the relationship between structural pathology in CT and cognitive impairment has not been suffi ciently disclosed.Objective: to determine CT, functional and cognitive outcomes in the long-term period of surgical treatment of cerebral aneurysms.Material and methods. The data of CT angiography of 49 patients operated on for intracranial aneurysms were analyzed. 39 patients were examined neurologically for 2.3 years using a range of rating scales.Results. The residual part of the aneurysm after surgery was found in 50% of patients with complex aneurysms, more often in patients with PMA-PSA aneurysms. The connection between the method of surgery and the preserved cervical part with structural changes in the brain and the development of cognitive impairment in the late postoperative period has not been proven.Conclusion. CT angiography preoperatively makes it possible to identify a group of complex aneurysms with a high risk of preservation of the cervical part and the development of brain structural changes. The predictors of the development of ischemic changes in the brain, hydrocephalus, and cognitive dysfunctions was the advanced age of patients, the duration of the operation, and a history of hypertension.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45766065","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 : 2023-05-18DOI: 10.30629/2658-7947-2023-28-2-5-14
A. I. Garifullin, E. I. Sultanova, I. V. Asfandiyarova, A. B. Khusainova, M. E. Gordeeva, A. Shakirova, A. A. Korneeva, A. F. Tukaev, D. N. Efremova, A. S. Sinitsina, E. O. Sobyanina, A. Usmanova, E. I. Ikhsanova
Мyasthenia gravis is a common disease, for adequate treatment of which early detection, knowledge of its clinical manifestations and possible methods of therapy is required. This review provides up-to-date information regarding the issues of myasthenia gravis. The aim of the paper: to systematize the latest scientific data on the pathogenesis, genetic characteristics, methods of treatment of myasthenia gravis, as well as to identify the relationship between myasthenia gravis and other diseases. The following databases were used to search for published studies: Pubmed, Web of Science, EBSCOhost and Scopus. The search was carried out in the time period from the date of establishment of the corresponding database until October 2022. Following search terms were used: “myasthenia gravis”, “myasthenia treatment”, “myasthenia epidemiological features”, “myasthenia and thymoma “myasthenia pathogenesis””. Тhe main studies on the epidemiology of myasthenia gravis are indicated, the key clinical forms and their pathogenetic characteristics, the relationship between myasthenia gravis and thymoma, and the main methods of treatment are also given.
Мyasthenia危重症是一种常见病，为了进行适当的治疗，需要及早发现，了解其临床表现和可能的治疗方法。这篇综述提供了关于重症肌无力问题的最新信息。本文旨在对重症肌无力的发病机制、遗传特征、治疗方法等方面的最新科学资料进行系统整理，并探讨重症肌无力与其他疾病的关系。使用以下数据库搜索已发表的研究:Pubmed, Web of Science, EBSCOhost和Scopus。检索时间从相应数据库建立之日起至2022年10月。使用的检索词如下:“重症肌无力”、“重症肌无力治疗”、“重症肌无力流行病学特征”、“重症肌无力与胸腺瘤”、“重症肌无力病机”。Тhe介绍了重症肌无力流行病学的主要研究，重症肌无力的主要临床表现及其发病特点，重症肌无力与胸腺瘤的关系，以及重症肌无力的主要治疗方法。
{"title":"Myastenia gravis: features of epidemiology, pathogenesis, treatment and relation to thymomas","authors":"A. I. Garifullin, E. I. Sultanova, I. V. Asfandiyarova, A. B. Khusainova, M. E. Gordeeva, A. Shakirova, A. A. Korneeva, A. F. Tukaev, D. N. Efremova, A. S. Sinitsina, E. O. Sobyanina, A. Usmanova, E. I. Ikhsanova","doi":"10.30629/2658-7947-2023-28-2-5-14","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-2-5-14","url":null,"abstract":"Мyasthenia gravis is a common disease, for adequate treatment of which early detection, knowledge of its clinical manifestations and possible methods of therapy is required. This review provides up-to-date information regarding the issues of myasthenia gravis. The aim of the paper: to systematize the latest scientific data on the pathogenesis, genetic characteristics, methods of treatment of myasthenia gravis, as well as to identify the relationship between myasthenia gravis and other diseases. The following databases were used to search for published studies: Pubmed, Web of Science, EBSCOhost and Scopus. The search was carried out in the time period from the date of establishment of the corresponding database until October 2022. Following search terms were used: “myasthenia gravis”, “myasthenia treatment”, “myasthenia epidemiological features”, “myasthenia and thymoma “myasthenia pathogenesis””. Тhe main studies on the epidemiology of myasthenia gravis are indicated, the key clinical forms and their pathogenetic characteristics, the relationship between myasthenia gravis and thymoma, and the main methods of treatment are also given.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47310229","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 : 2023-03-16DOI: 10.30629/2658-7947-2023-28-1-62-66
N. Muzhikina, N. Koroleva, G. V. Kataeva, A. Korotkov, I. Stolyarov
Clinical case of structural epilepsy in a patient with multiple sclerosis is presented, which shows the achievement of seizure’s stable remission, which is extremely rare in forms of epilepsy with a multi-focal lesion another etiology and a long history of the disease without combination with multiple sclerosis. Video-EEG monitoring, positron emission tomography of the brain with 18F-deoxyglucose, expand the possibilities of diagnosing form of epilepsy in patients with combined pathology, which allows prescribing adequate therapy.
{"title":"Structural epilepsy in a patient with multiple sclerosis","authors":"N. Muzhikina, N. Koroleva, G. V. Kataeva, A. Korotkov, I. Stolyarov","doi":"10.30629/2658-7947-2023-28-1-62-66","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-1-62-66","url":null,"abstract":"Clinical case of structural epilepsy in a patient with multiple sclerosis is presented, which shows the achievement of seizure’s stable remission, which is extremely rare in forms of epilepsy with a multi-focal lesion another etiology and a long history of the disease without combination with multiple sclerosis. Video-EEG monitoring, positron emission tomography of the brain with 18F-deoxyglucose, expand the possibilities of diagnosing form of epilepsy in patients with combined pathology, which allows prescribing adequate therapy.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45860408","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 : 2023-03-16DOI: 10.30629/2658-79472023-28-1-47-53
A. V. Gavrilenko, V. Kochetkov, A. Kuklin, A. V. Abramyan, N. N. Al-Yousef, S. O. Popov, R. M. Yakhin
No multicenter randomized clinical trial has been conducted worldwide to date on indications, types of surgery and their comparison with conservative treatment in patients with PI BSA.Aims: of the study is to improve the results of surgical treatment in patients with pathological tortuosity of the internal carotid arteryMaterial and methods. Тhe study included 115 patients (38 (33%) men and 77 (67%) women) with PI ICA aged 35 to 72 years (average age 54.2 ± 7.5 years) divided into 2 groups. 61 patients (53%) of group I underwent BSA resection with lower mouth and 54 patients (47%) of group II underwent BSA prosthetics. Depending on the degree of neurological disorders, patients were distributed according to the classifi cation of A.V. Pokrovsky.Results. In patients with СМН1, the clinical eff ect was due to the absence of cerebrospinal and focal neurological symptoms. As a result of surgical treatment of PI BSA in group I, a clinical eff ect was achieved in 54 (89%) patients. In group II, regression of clinical-neurological symptoms was observed in 40 (74%) patients.Conclusions. Resection and prosthetics of BSA PI in order to stop neurological symptoms and prevent ischemic stroke in patients with this pathology is a safe and eff ective method of surgical treatment.
{"title":"Prevention of ischemic stroke in patients with pathological tortuosity of the internal carotid artery","authors":"A. V. Gavrilenko, V. Kochetkov, A. Kuklin, A. V. Abramyan, N. N. Al-Yousef, S. O. Popov, R. M. Yakhin","doi":"10.30629/2658-79472023-28-1-47-53","DOIUrl":"https://doi.org/10.30629/2658-79472023-28-1-47-53","url":null,"abstract":"No multicenter randomized clinical trial has been conducted worldwide to date on indications, types of surgery and their comparison with conservative treatment in patients with PI BSA.Aims: of the study is to improve the results of surgical treatment in patients with pathological tortuosity of the internal carotid arteryMaterial and methods. Тhe study included 115 patients (38 (33%) men and 77 (67%) women) with PI ICA aged 35 to 72 years (average age 54.2 ± 7.5 years) divided into 2 groups. 61 patients (53%) of group I underwent BSA resection with lower mouth and 54 patients (47%) of group II underwent BSA prosthetics. Depending on the degree of neurological disorders, patients were distributed according to the classifi cation of A.V. Pokrovsky.Results. In patients with СМН1, the clinical eff ect was due to the absence of cerebrospinal and focal neurological symptoms. As a result of surgical treatment of PI BSA in group I, a clinical eff ect was achieved in 54 (89%) patients. In group II, regression of clinical-neurological symptoms was observed in 40 (74%) patients.Conclusions. Resection and prosthetics of BSA PI in order to stop neurological symptoms and prevent ischemic stroke in patients with this pathology is a safe and eff ective method of surgical treatment.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49168589","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 : 2023-03-16DOI: 10.30629/26587947-2023-28-1-54-61
G. R. Ramazanov, E. A. Kovaleva, L. Akhmatkhanova, A. I. Vyshlova, E. A. Klychnikova, S. Petrikov
Dabigatran etexilate (DE) is a direct thrombin inhibitor that has been shown to be eff ective and safe in preventing thrombotic events in a number of studies. Currently idarucizumab, which is a monoclonal antibody and a DE antagonist, is used to immediately inactivate the DE-induced eff ect.Objective. Еvaluation of the effi ciency and safety of idarucizumab in patients receiving DE.Material and methods. 6 patients (2 men, 4 women) aged 61 to 86 years (mean age 72.8 ± 10.6 years) receiving DE, who are expected to use idarucizumab in achieving the goal of sTLT or surgery.Results. In none of the patients the use of idarucizumab was accompanied by a decrease in thrombin time of less than 11 seconds which could indicate a hypercoagulable phenomenon. Before inactivation of dabigatran etexilate thrombin time was signifi cantly higher (p < 0.05) than after the administration of the drug. There were no statistically signifi cant diff erences in the concentration of D-dimer before and after the administration of idarucizumab which indicates the absence of procoagulant properties of this drug. None of the patients developed clinically signifi cant arterial and/ or venous thrombotic events such as recurrent IS, myocardial infarction, deep vein thrombosis of the lower extremities and pulmonary embolism, during the entire period of hospitalization.Conclusion. The use of idarucizumab is allowed for systemic thrombolytic therapy and emergency surgical treatment in patients taking DE. Idarucizumab quickly and safely neutralizes the anticoagulant eff ect of DE and doesn’t have a prothrombotic activity.
{"title":"Clinical experience with idarucizumab in patients with atrial fi brillation taking dabigatran etexilate","authors":"G. R. Ramazanov, E. A. Kovaleva, L. Akhmatkhanova, A. I. Vyshlova, E. A. Klychnikova, S. Petrikov","doi":"10.30629/26587947-2023-28-1-54-61","DOIUrl":"https://doi.org/10.30629/26587947-2023-28-1-54-61","url":null,"abstract":"Dabigatran etexilate (DE) is a direct thrombin inhibitor that has been shown to be eff ective and safe in preventing thrombotic events in a number of studies. Currently idarucizumab, which is a monoclonal antibody and a DE antagonist, is used to immediately inactivate the DE-induced eff ect.Objective. Еvaluation of the effi ciency and safety of idarucizumab in patients receiving DE.Material and methods. 6 patients (2 men, 4 women) aged 61 to 86 years (mean age 72.8 ± 10.6 years) receiving DE, who are expected to use idarucizumab in achieving the goal of sTLT or surgery.Results. In none of the patients the use of idarucizumab was accompanied by a decrease in thrombin time of less than 11 seconds which could indicate a hypercoagulable phenomenon. Before inactivation of dabigatran etexilate thrombin time was signifi cantly higher (p < 0.05) than after the administration of the drug. There were no statistically signifi cant diff erences in the concentration of D-dimer before and after the administration of idarucizumab which indicates the absence of procoagulant properties of this drug. None of the patients developed clinically signifi cant arterial and/ or venous thrombotic events such as recurrent IS, myocardial infarction, deep vein thrombosis of the lower extremities and pulmonary embolism, during the entire period of hospitalization.Conclusion. The use of idarucizumab is allowed for systemic thrombolytic therapy and emergency surgical treatment in patients taking DE. Idarucizumab quickly and safely neutralizes the anticoagulant eff ect of DE and doesn’t have a prothrombotic activity.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44423885","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 : 2023-03-16DOI: 10.30629/26587947-2023-28-1-5-12
A. Tappakhov, T. Popova
Parkinson’s disease (PD) is one of the most common neurodegenerative diseases in the world. While until recently MRI was used exclusively for the diagnosis of symptomatic forms of parkinsonism, recent advances in neuroimaging allow the detection of signs of nigral degeneration (MR biomarkers of PD). The article discusses the possibilities of modern MRI modes sensitive to iron (SWI, T2*) and neuromelanin (neuromelanin-sensitive MRI); emphasis is placed on identifying false-negative and false-positive results of the study. The imaging of nigrosome-1 in the dorsal substantia nigra (SN) in MRI-SWI has been discussed since 2013. In the absence of nigral degeneration, this area is defi ned as a hyperintense ovoid area within the dorsolateral border of the hypointense SN (“swallow’s tail” sign). If the optimistic results of the fi rst studies testifi ed to the high sensitivity and specifi city of this technique in PD (the absence of the “swallow’s tail” sign), then in subsequent studies, similar changes were detected in patients with other neurodegenerations with parkinsonism. In addition, the diagnostic value of this technique occurs when using tomographs with a magnetic fi eld strength of at least 3 Tc. Similar conclusions can be drawn about the use of neuromelanin-sensitive MRI, since it is necessary to use high-fi eld magnetic tomographs of 3 Tc or more to detect nigral degeneration, and results similar to PD can also be found in atypical forms of parkinsonism. However, the search for signs of nigral degeneration may be useful in the diff erential diagnosis of PD and non-neurodegenerative disorders. In addition to MRI in the diagnosis of PD, the article discusses neuroimaging in various types of multisystem atrophy, progressive supranuclear palsy, and dementia with Lewy bodies. The article is illustrated with own MRI scans of the brains of patients with PD and other forms of parkinsonism.
{"title":"The role of magnetic resonance imaging in the diff erential diagnosis of Parkinson’s disease","authors":"A. Tappakhov, T. Popova","doi":"10.30629/26587947-2023-28-1-5-12","DOIUrl":"https://doi.org/10.30629/26587947-2023-28-1-5-12","url":null,"abstract":"Parkinson’s disease (PD) is one of the most common neurodegenerative diseases in the world. While until recently MRI was used exclusively for the diagnosis of symptomatic forms of parkinsonism, recent advances in neuroimaging allow the detection of signs of nigral degeneration (MR biomarkers of PD). The article discusses the possibilities of modern MRI modes sensitive to iron (SWI, T2*) and neuromelanin (neuromelanin-sensitive MRI); emphasis is placed on identifying false-negative and false-positive results of the study. The imaging of nigrosome-1 in the dorsal substantia nigra (SN) in MRI-SWI has been discussed since 2013. In the absence of nigral degeneration, this area is defi ned as a hyperintense ovoid area within the dorsolateral border of the hypointense SN (“swallow’s tail” sign). If the optimistic results of the fi rst studies testifi ed to the high sensitivity and specifi city of this technique in PD (the absence of the “swallow’s tail” sign), then in subsequent studies, similar changes were detected in patients with other neurodegenerations with parkinsonism. In addition, the diagnostic value of this technique occurs when using tomographs with a magnetic fi eld strength of at least 3 Tc. Similar conclusions can be drawn about the use of neuromelanin-sensitive MRI, since it is necessary to use high-fi eld magnetic tomographs of 3 Tc or more to detect nigral degeneration, and results similar to PD can also be found in atypical forms of parkinsonism. However, the search for signs of nigral degeneration may be useful in the diff erential diagnosis of PD and non-neurodegenerative disorders. In addition to MRI in the diagnosis of PD, the article discusses neuroimaging in various types of multisystem atrophy, progressive supranuclear palsy, and dementia with Lewy bodies. The article is illustrated with own MRI scans of the brains of patients with PD and other forms of parkinsonism.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44783255","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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