Pub Date : 2023-10-30DOI: 10.17650/2222-8721-2023-13-3-33-39
K. D. Popov, T. M. Alekseeva, V. D. Nazarov, A. I. Vlasenko, S. M. Malyshev
Currently, there are three drugs in the world for the pathogenetic therapy of spinal muscular atrophy 5q: nusinersen, risdiplam and onasemnogene abeparvovek. At the same time, it is still unknown to what extent this treatment is able to change the natural history of the disease, and the development of methods for evaluating the effectiveness of treatment is the subject of active scientific research. This article is a review of studies of laboratory approaches for assessing the disease severity and the response to nusinersen therapy in patients with spinal muscular atrophy 5q in various age groups.
{"title":"Molecular markers of disease severity and response to nusinersen therapy in 5q spinal muscular atrophy (literature review)","authors":"K. D. Popov, T. M. Alekseeva, V. D. Nazarov, A. I. Vlasenko, S. M. Malyshev","doi":"10.17650/2222-8721-2023-13-3-33-39","DOIUrl":"https://doi.org/10.17650/2222-8721-2023-13-3-33-39","url":null,"abstract":"Currently, there are three drugs in the world for the pathogenetic therapy of spinal muscular atrophy 5q: nusinersen, risdiplam and onasemnogene abeparvovek. At the same time, it is still unknown to what extent this treatment is able to change the natural history of the disease, and the development of methods for evaluating the effectiveness of treatment is the subject of active scientific research. This article is a review of studies of laboratory approaches for assessing the disease severity and the response to nusinersen therapy in patients with spinal muscular atrophy 5q in various age groups.","PeriodicalId":37569,"journal":{"name":"Nervno-Myshechnye Bolezni","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136104913","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 : 2023-10-30DOI: 10.17650/2222-8721-2023-13-3-40-47
M. S. Skorikov, D. V. Vlodavets
Vaccination is recognized as the most effective, safe, and cost-effective way to prevent infectious diseases and their complications. For patients with chronic diseases, and for patients with neuromuscular diseases in particular, vaccination is the highest priority for the prevention of infectious diseases. In the current literature, there is a lack of information describing the principles of vaccination of patients with spinal muscular atrophy and Duchenne muscular dystrophy. In patients with neuromuscular diseases, full immunization has to be done in accordance with the National calendar and recommendations with the introduction of an additional vaccine against such diseases as: rotavirus infection, pneumococcal infection (using an additional dose of 23-valent vaccine), meningococcal infection, virus human papilloma, respiratory viral infection. syncytial virus and influenza. In this regard, of particular importance is the development of recommendations describing the schemes for the use of vaccines in children suffering from spinal muscular atrophy and Duchenne muscular dystrophy.
{"title":"General principles of vaccination of patients with neuromuscular diseases","authors":"M. S. Skorikov, D. V. Vlodavets","doi":"10.17650/2222-8721-2023-13-3-40-47","DOIUrl":"https://doi.org/10.17650/2222-8721-2023-13-3-40-47","url":null,"abstract":"Vaccination is recognized as the most effective, safe, and cost-effective way to prevent infectious diseases and their complications. For patients with chronic diseases, and for patients with neuromuscular diseases in particular, vaccination is the highest priority for the prevention of infectious diseases. In the current literature, there is a lack of information describing the principles of vaccination of patients with spinal muscular atrophy and Duchenne muscular dystrophy. In patients with neuromuscular diseases, full immunization has to be done in accordance with the National calendar and recommendations with the introduction of an additional vaccine against such diseases as: rotavirus infection, pneumococcal infection (using an additional dose of 23-valent vaccine), meningococcal infection, virus human papilloma, respiratory viral infection. syncytial virus and influenza. In this regard, of particular importance is the development of recommendations describing the schemes for the use of vaccines in children suffering from spinal muscular atrophy and Duchenne muscular dystrophy.","PeriodicalId":37569,"journal":{"name":"Nervno-Myshechnye Bolezni","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136106028","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 : 2023-10-30DOI: 10.17650/2222-8721-2023-13-3-48-53
T. V. Markova, V. V. Mavlyukeeva, B. G. Ginzburg, O. A. Shchagina, S. S. Nikitin, E. L. Dadali
Craniofacial dysmorphia-deafness-anomalies of the upper limbs is a rare autosomal dominant syndrome caused by variants in the PAX3 gene. In contrast to the two main nosological forms – Waardenburg syndrome types 1 and 3, caused by variants in this gene, the syndrome of craniofacial dysmorphias-deafness-anomalies of the upper limbs is not characterized by the presence of hair hypopigmentation and heterochromia of the iris, while congenital contractures of the wrist and interphalangeal joints of the hands. There is a description in the literature of three patients from the same family with a syndrome caused by the c.141C>G(p.Asn47Lys) variant in the PAX3 gene. Aim of the work is to present the clinical and genetic characteristics of the first Russian patient with the syndrome of craniofacial dysmorphia-deafness-anomalies of the upper extremities. Molecular genetic analysis of a 1-year and 10-month-old proband with phenotypic signs of the syndrome of craniofacial dysmorphia-deafness-anomalies of the upper limbs was carried out by direct automatic Sanger sequencing of the entire coding sequence of the PAX3 gene. Genotyping of parents was carried out by direct automatic sequencing according to Sanger. Sequencing was carried out on an ABIPrism3500хI instrument (Applied Biosystems) in accordance with the manufacturer’s protocol; primer sequences were selected according to the reference sequence of the target regions of the PAX3 gene (NM_181459.4). In Russian proband 1 year 10 months-old, the phenotypic characteristics of the syndrome of craniofacial dysmorphia-deafness-anomalies of the upper limbs did not differ from the description of sick family members presented in the literature. A molecular genetic study revealed a heterozygous variant c.141C>G(p.Asn47Lys) in the PAX3 gene in the presented patient.
{"title":"Clinical and genetic characteristics of the first Russian patient with a syndrome of craniofacial dysmorphia-deafness-anomalies of the upper limbs, caused by a mutation in the <i>PAX3</i> gene","authors":"T. V. Markova, V. V. Mavlyukeeva, B. G. Ginzburg, O. A. Shchagina, S. S. Nikitin, E. L. Dadali","doi":"10.17650/2222-8721-2023-13-3-48-53","DOIUrl":"https://doi.org/10.17650/2222-8721-2023-13-3-48-53","url":null,"abstract":"Craniofacial dysmorphia-deafness-anomalies of the upper limbs is a rare autosomal dominant syndrome caused by variants in the PAX3 gene. In contrast to the two main nosological forms – Waardenburg syndrome types 1 and 3, caused by variants in this gene, the syndrome of craniofacial dysmorphias-deafness-anomalies of the upper limbs is not characterized by the presence of hair hypopigmentation and heterochromia of the iris, while congenital contractures of the wrist and interphalangeal joints of the hands. There is a description in the literature of three patients from the same family with a syndrome caused by the c.141C>G(p.Asn47Lys) variant in the PAX3 gene. Aim of the work is to present the clinical and genetic characteristics of the first Russian patient with the syndrome of craniofacial dysmorphia-deafness-anomalies of the upper extremities. Molecular genetic analysis of a 1-year and 10-month-old proband with phenotypic signs of the syndrome of craniofacial dysmorphia-deafness-anomalies of the upper limbs was carried out by direct automatic Sanger sequencing of the entire coding sequence of the PAX3 gene. Genotyping of parents was carried out by direct automatic sequencing according to Sanger. Sequencing was carried out on an ABIPrism3500хI instrument (Applied Biosystems) in accordance with the manufacturer’s protocol; primer sequences were selected according to the reference sequence of the target regions of the PAX3 gene (NM_181459.4). In Russian proband 1 year 10 months-old, the phenotypic characteristics of the syndrome of craniofacial dysmorphia-deafness-anomalies of the upper limbs did not differ from the description of sick family members presented in the literature. A molecular genetic study revealed a heterozygous variant c.141C>G(p.Asn47Lys) in the PAX3 gene in the presented patient.","PeriodicalId":37569,"journal":{"name":"Nervno-Myshechnye Bolezni","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136104915","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 : 2023-10-30DOI: 10.17650/2222-8721-2023-13-3-64-69
I. V. Sharkova, S. S. Nikitin, T. V. Markova, A. E. Voskanyan, E. A. Melnik, O. A. Shchagina, E. L. Dadali
Distal arthrogryposis is a group of genetically heterogeneous congenital diseases characterized by non-progressive contractures predominantly distal joints of the upper and lower extremities. 11 genes have been identified as pathogenic variants causing the occurrence of autosomal dominant and autosomal recessive types of distal arthrogryposis. Almost all products of these genes are expressed in the structures of the neuromuscular system, which makes it possible to classify distal arthrogryposis as a neuromuscular disease. Type 7 distal arthrogryposis is a rare autosomal dominant disease characterized by two main symptoms: mandibular trismus and pseudocamptodactyly, a specific symptom of limited mobility of the interphalangeal joints during hand dorsiflexion with no restriction during palmar flexion. In all patients described in the literature from different populations with type 7 distal arthrogryposis, the same pathogenic variant c.2021G>A(p.Arg674Gln) was found in the MYH8 gene, the protein product of which is one of the myosin isoforms functioning in the embryonic period and providing the formation of muscle fiber structures. The aim of the work is to describe the clinical and genetic characteristics of the first family case of type 7 distal arthrogryposis in Russian patients. The patients underwent clinical examination and electromyography. Exome sequencing after DNA isolation from the proband’s blood according to the standard method was carried out on the NextSeq 500 platform (Illumina, USA) using the pairedend reading method (2 × 75 bp). Confirmation of the pathogenicity of the identified variants was carried out using automatic Sanger sequencing. As a result of molecular genetic analysis in a father and son with clinical manifestations of type 7 distal arthrogryposis, a heterozygous c.2021G>A variant in exon 18 of the MYH8 gene, which was previously described in all patients published in the literature, was detected, leading to the replacement of p.Arg674Gln(NM_002472.2) in a protein molecule. The examined patients did not reveal focal neurological symptoms, as well as minor developmental abnomalities, pathology of internal organs, ulnar deviations, equinovarus feet deformities, vertical orientation of the talus, contractures of the hip joints, which were found with varying frequency in previously described patients with variants in the MYH8 gene. Specific clinical signs of type 7 distal arthrogryposis, combined with the presence of a major nucleotide variant, make it possible to optimize the process of molecular genetic diagnosis of this type of hereditary arthrogryposis.
{"title":"Clinical and genetic characteristics of type 7 distal arthrogryposis caused by a pathogenic variant in the <i>MYH8</i> gene","authors":"I. V. Sharkova, S. S. Nikitin, T. V. Markova, A. E. Voskanyan, E. A. Melnik, O. A. Shchagina, E. L. Dadali","doi":"10.17650/2222-8721-2023-13-3-64-69","DOIUrl":"https://doi.org/10.17650/2222-8721-2023-13-3-64-69","url":null,"abstract":"Distal arthrogryposis is a group of genetically heterogeneous congenital diseases characterized by non-progressive contractures predominantly distal joints of the upper and lower extremities. 11 genes have been identified as pathogenic variants causing the occurrence of autosomal dominant and autosomal recessive types of distal arthrogryposis. Almost all products of these genes are expressed in the structures of the neuromuscular system, which makes it possible to classify distal arthrogryposis as a neuromuscular disease. Type 7 distal arthrogryposis is a rare autosomal dominant disease characterized by two main symptoms: mandibular trismus and pseudocamptodactyly, a specific symptom of limited mobility of the interphalangeal joints during hand dorsiflexion with no restriction during palmar flexion. In all patients described in the literature from different populations with type 7 distal arthrogryposis, the same pathogenic variant c.2021G>A(p.Arg674Gln) was found in the MYH8 gene, the protein product of which is one of the myosin isoforms functioning in the embryonic period and providing the formation of muscle fiber structures. The aim of the work is to describe the clinical and genetic characteristics of the first family case of type 7 distal arthrogryposis in Russian patients. The patients underwent clinical examination and electromyography. Exome sequencing after DNA isolation from the proband’s blood according to the standard method was carried out on the NextSeq 500 platform (Illumina, USA) using the pairedend reading method (2 × 75 bp). Confirmation of the pathogenicity of the identified variants was carried out using automatic Sanger sequencing. As a result of molecular genetic analysis in a father and son with clinical manifestations of type 7 distal arthrogryposis, a heterozygous c.2021G>A variant in exon 18 of the MYH8 gene, which was previously described in all patients published in the literature, was detected, leading to the replacement of p.Arg674Gln(NM_002472.2) in a protein molecule. The examined patients did not reveal focal neurological symptoms, as well as minor developmental abnomalities, pathology of internal organs, ulnar deviations, equinovarus feet deformities, vertical orientation of the talus, contractures of the hip joints, which were found with varying frequency in previously described patients with variants in the MYH8 gene. Specific clinical signs of type 7 distal arthrogryposis, combined with the presence of a major nucleotide variant, make it possible to optimize the process of molecular genetic diagnosis of this type of hereditary arthrogryposis.","PeriodicalId":37569,"journal":{"name":"Nervno-Myshechnye Bolezni","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136106029","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 : 2023-10-30DOI: 10.17650/2222-8721-2023-13-3-54-62
V. K. Misikov, A. P. Kovalenko, A. A. Kondur
Dystonic scoliosis as one of the forms of generalized dystonia is a highly disabling form of dystonia, which can lead to damage to internal organs (lungs, heart) and the peripheral nervous system, including the spinal cord. Almost always, those muscles that are involved in the formation of a dystonic posture in generalized dystonia have not been studied in terms of the effectiveness of treatment with botulinum toxin type A and are not reflected in the instructions. As a result, there is no understanding of the general motor interaction with differentiation into targeted and non-targeted muscles, administration doses and control methods. The aim of the work was to evaluate the efficacy and tolerability of high doses of botulinum toxin type A in dystonic scoliosis, as well as to present the introduction of botulinum toxin type A using ultrasound and electromyographic control. We have described a clinical case of a 19-year-old patient suffering from generalized dystonia with S-shaped dystonic scoliosis of the III degree. Deep brain stimulation was recommended as a treatment for the patient. During the waiting period for the timing of the operation, we attempted symptomatic therapy using the drug incobotulotoxin A. Over the next year and a half, 700 units of botulinum toxin type A were administered under ultrasound and electromyographic control every 3–4 months. As a result, treatment of trunk dystonia in the patient during the observation period led to a clinically significant decrease in the degree of curvature (from 37° to 27°, from III to II degree of scoliosis) in the absence of undesirable effects of the drug, including generalized muscle weakness. According to the repeated conclusion of the council of neurosurgeons, surgical intervention is not indicated for the patient due to the positive effect of the introduction of botulinum toxin type A.
{"title":"Methodology of botulinum therapy in the treatment of dystonic scoliosis in generalized dystonia (clinical case)","authors":"V. K. Misikov, A. P. Kovalenko, A. A. Kondur","doi":"10.17650/2222-8721-2023-13-3-54-62","DOIUrl":"https://doi.org/10.17650/2222-8721-2023-13-3-54-62","url":null,"abstract":"Dystonic scoliosis as one of the forms of generalized dystonia is a highly disabling form of dystonia, which can lead to damage to internal organs (lungs, heart) and the peripheral nervous system, including the spinal cord. Almost always, those muscles that are involved in the formation of a dystonic posture in generalized dystonia have not been studied in terms of the effectiveness of treatment with botulinum toxin type A and are not reflected in the instructions. As a result, there is no understanding of the general motor interaction with differentiation into targeted and non-targeted muscles, administration doses and control methods. The aim of the work was to evaluate the efficacy and tolerability of high doses of botulinum toxin type A in dystonic scoliosis, as well as to present the introduction of botulinum toxin type A using ultrasound and electromyographic control. We have described a clinical case of a 19-year-old patient suffering from generalized dystonia with S-shaped dystonic scoliosis of the III degree. Deep brain stimulation was recommended as a treatment for the patient. During the waiting period for the timing of the operation, we attempted symptomatic therapy using the drug incobotulotoxin A. Over the next year and a half, 700 units of botulinum toxin type A were administered under ultrasound and electromyographic control every 3–4 months. As a result, treatment of trunk dystonia in the patient during the observation period led to a clinically significant decrease in the degree of curvature (from 37° to 27°, from III to II degree of scoliosis) in the absence of undesirable effects of the drug, including generalized muscle weakness. According to the repeated conclusion of the council of neurosurgeons, surgical intervention is not indicated for the patient due to the positive effect of the introduction of botulinum toxin type A.","PeriodicalId":37569,"journal":{"name":"Nervno-Myshechnye Bolezni","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136106027","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 : 2023-10-29DOI: 10.17650/2222-8721-2023-13-3-25-32
I. A. Komarov, A. R. Malakhova, T. P. Vasilyeva, E. Yu. Shukan, O. Yu. Aleksandrova, R. A. Zinchenko, A. V. Polyakov, S. S. Nikitin, E. Yu. Sapego, S. I. Kutsev
Background . Spinal muscular atrophy (SMA) is a severe rare disease that has been widely discussed in recent years. Achievements in etiopathogenetic therapy and the social significance of the disease (child population, high mortality), the cost of treatment attracted the attention of the public and the goverment, which, among other things, led to the formation of a separate area with the creation of a fund to finance the treatment of patients with orphan diseases. Aim . To conduct an analysis of the socio-economic efficiency of mass neonatal screening for SMA in the Russian Federation. Materials and methods . A survey of patients (their parents) and doctors was conducted. The current clinical guidelines and the standard of medical care for children with SMA were studied. The cost of medicines is taken from the State Register of Maximum Selling Prices. If the drug is not included in the List of Vital Essential and Necessary Drugs, cost information from the procurement data is used. Results . The socioeconomic burden of SMA on identified patients was about 3,994,289,548 rubles per year prior to screening. The very introduction of mass neonatal screening will amount to about 679,224,000 rubles in year. At the same time, a disease detected in a timely manner due to neonatal screening and timely prescribed effective treatment can lead to a reduction in the cost of specialized and palliative care by 54,073,271 rubles, direct non-medical costs by 88,137,423 rubles, and indirect costs by 154,197,900 rubles per year, which together is more than 7 % of the calculated burden of SMA. Conclusion . The introduction of mass screening will lead to the fact that the number of annually detected patients will increase from current values to the actual value of the prevalence when registering patients with milder forms of SMA. The need for drug supply with drugs and medical care in general will increase. At the same time, children diagnosed with SMA will not die in the early years of life, their survival rate, life expectancy will increase, the quality of life will improve, infant mortality will decrease, which is the main task of neonatal screening and one of the goals of the National Healthcare Project.
{"title":"Socioeconomic efficiency of neonatal screening for spinal muscular atrophy in the Russian Federation","authors":"I. A. Komarov, A. R. Malakhova, T. P. Vasilyeva, E. Yu. Shukan, O. Yu. Aleksandrova, R. A. Zinchenko, A. V. Polyakov, S. S. Nikitin, E. Yu. Sapego, S. I. Kutsev","doi":"10.17650/2222-8721-2023-13-3-25-32","DOIUrl":"https://doi.org/10.17650/2222-8721-2023-13-3-25-32","url":null,"abstract":"Background . Spinal muscular atrophy (SMA) is a severe rare disease that has been widely discussed in recent years. Achievements in etiopathogenetic therapy and the social significance of the disease (child population, high mortality), the cost of treatment attracted the attention of the public and the goverment, which, among other things, led to the formation of a separate area with the creation of a fund to finance the treatment of patients with orphan diseases. Aim . To conduct an analysis of the socio-economic efficiency of mass neonatal screening for SMA in the Russian Federation. Materials and methods . A survey of patients (their parents) and doctors was conducted. The current clinical guidelines and the standard of medical care for children with SMA were studied. The cost of medicines is taken from the State Register of Maximum Selling Prices. If the drug is not included in the List of Vital Essential and Necessary Drugs, cost information from the procurement data is used. Results . The socioeconomic burden of SMA on identified patients was about 3,994,289,548 rubles per year prior to screening. The very introduction of mass neonatal screening will amount to about 679,224,000 rubles in year. At the same time, a disease detected in a timely manner due to neonatal screening and timely prescribed effective treatment can lead to a reduction in the cost of specialized and palliative care by 54,073,271 rubles, direct non-medical costs by 88,137,423 rubles, and indirect costs by 154,197,900 rubles per year, which together is more than 7 % of the calculated burden of SMA. Conclusion . The introduction of mass screening will lead to the fact that the number of annually detected patients will increase from current values to the actual value of the prevalence when registering patients with milder forms of SMA. The need for drug supply with drugs and medical care in general will increase. At the same time, children diagnosed with SMA will not die in the early years of life, their survival rate, life expectancy will increase, the quality of life will improve, infant mortality will decrease, which is the main task of neonatal screening and one of the goals of the National Healthcare Project.","PeriodicalId":37569,"journal":{"name":"Nervno-Myshechnye Bolezni","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136135718","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 : 2023-10-29DOI: 10.17650/2222-8721-2023-13-3-10-17
A. K. Shakaryan, I. Kh. Belyaletdinova, S. V. Shakhgildyan, O. E. Ivanova, T. P. Eremeeva, A. P. Gmyl, O. Yu. Baykova, A. N.-I. Mustafina, L. I. Kozlovskaya
Acute flaccid myelitis is a syndrome characterized as the development of acute flaccid paralysis of one or more limbs due to lesions of the anterior horns of the spinal cord, which occurs against the background of a viral infection. More than 300 acute flaccid paralysis cases are registered in the Russian Federation annually, most of them are of a non-infectious etiology. In some cases, patients develop a complex of symptoms similar to poliomyelitis, but without isolation of polioviruses from stool samples. Clinical characteristics of such cases include acute onset, fever, persistent peripheral asymmetric paresis/paralysis of predominantly proximal parts of the limbs, and absence of pathological reflexes, pelvic disturbances, or pyramidal symptoms. In literature, such complex of symptoms is referred as acute flaccid myelitis. We provide an analysis of 18 cases of acute flaccid myelitis detected in the Russian Federation in the period from 2015 to 2019. A clear seasonality of the disease from July to November was noted. Studies of faecal samples, cerebrospinal fluid and blood samples did not reveal the pathogen. In all patients, regardless of therapy, there was a positive trend, but complete recovery was not achieved: paresis of varying severity persisted, mainly in the proximal extremities Therefore, acute flaccid myelitis cases as acute flaccid paralysis cases of unknown etiology require an additional observation and an expanded algorithm of laboratory investigation aimed to finding a possible pathogen.
{"title":"Clinical and epidemiological characteristics of acute flaccid myelitis cases in children registered in the Russian Federation in 2015–2019","authors":"A. K. Shakaryan, I. Kh. Belyaletdinova, S. V. Shakhgildyan, O. E. Ivanova, T. P. Eremeeva, A. P. Gmyl, O. Yu. Baykova, A. N.-I. Mustafina, L. I. Kozlovskaya","doi":"10.17650/2222-8721-2023-13-3-10-17","DOIUrl":"https://doi.org/10.17650/2222-8721-2023-13-3-10-17","url":null,"abstract":"Acute flaccid myelitis is a syndrome characterized as the development of acute flaccid paralysis of one or more limbs due to lesions of the anterior horns of the spinal cord, which occurs against the background of a viral infection. More than 300 acute flaccid paralysis cases are registered in the Russian Federation annually, most of them are of a non-infectious etiology. In some cases, patients develop a complex of symptoms similar to poliomyelitis, but without isolation of polioviruses from stool samples. Clinical characteristics of such cases include acute onset, fever, persistent peripheral asymmetric paresis/paralysis of predominantly proximal parts of the limbs, and absence of pathological reflexes, pelvic disturbances, or pyramidal symptoms. In literature, such complex of symptoms is referred as acute flaccid myelitis. We provide an analysis of 18 cases of acute flaccid myelitis detected in the Russian Federation in the period from 2015 to 2019. A clear seasonality of the disease from July to November was noted. Studies of faecal samples, cerebrospinal fluid and blood samples did not reveal the pathogen. In all patients, regardless of therapy, there was a positive trend, but complete recovery was not achieved: paresis of varying severity persisted, mainly in the proximal extremities Therefore, acute flaccid myelitis cases as acute flaccid paralysis cases of unknown etiology require an additional observation and an expanded algorithm of laboratory investigation aimed to finding a possible pathogen.","PeriodicalId":37569,"journal":{"name":"Nervno-Myshechnye Bolezni","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136135717","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 : 2023-10-29DOI: 10.17650/2222-8721-2023-13-3-18-24
A. Yu. Yurkov, T. I. Shustova, N. S. Alekseeva, V. I. Popadyuk
Background . Hypotonic dysphonia occupies a special place in the structure of functional dysphonia in terms of prevalence. At the same time, the autonomic nervous system has a significant impact on the course and outcome of the disease. However, data on the neurovegetative status of patients with hypotonic dysphonia in the scientific literature are extremely rare and do not fully reflect its features. Aim . To determine the neurovegetative status of laryngological patients with hypotonic dysphonia. Materials and methods . 26 patients (6 men and 20 women) with hypotonic dysphonia and hypersensitivity of the larynx (main group) and 45 patients (13 men and 32 women) with hypersensitivity of the larynx without signs of dysphonia (comparison group) were examined as a control, data on the functional state of the autonomic nervous system in 20 practically healthy people (5 men and 15 women) aged 18 to 25 years were used. The state of vegetative parameters – vegetative tone, vegetative reactivity and vegetative activity support – were evaluated using the medical diagnostic complex “Valenta”. The examination of patients included anamnestic analysis, objective examination of lororgans according to generally accepted methods and video stroboscopy of the larynx. Results . The differences between healthy and sick people regarding neurovegetative indicators are obvious, unidirectional and indicate the existence of autonomic disorders in both groups of patients. The ratios of vegetative parameters recorded during the study indicate the involvement of autonomic nervous system not only in the development of laryngeal hypersensitivity, but also in the pathogenesis of functional dysphonia of the hypotonic type. Conclusion . Thus, neurovegetative disorders – vegetative dystonia and autonomic dysfunction – are one of the factors of the pathogenesis of hypotonic dysphonia.
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