Saratov JOURNAL of Medical and Scientific Research

Neurology

Migraine and epilepsy: comorbidity and problems in diagnostics

Year: 2019, volume 15 Issue: №1 Pages: 154-158
Heading: Neurology Article type: Review
Authors: Kalinin V.A., Poverennova I.E., Yakunina A.V., Myakinina A.E.
Organization: Samara State Medical University
Summary:

The purpose of this review is to carry out the analysis of published data on comorbidity of migraine and epilepsy. The review is based on results of epidemiological and genetic studies. Clinical manifestations of two diseases are in many respects similar, which sometimes leads to considerable difficulties in diagnostics. Differential diagnosis is based on careful analysis of clinical manifestations, electroencephalography and neuroimaging data. Genetic forms of epilepsy are often accompanied by migrainous headaches. The unity of some pathophysiological mechanisms of epilepsy and migraine predefines comorbidity and directions of diagnostics and treatment for both diseases. Nevertheless, there is a number of questions which demand more precise answers to improve diagnostics and treatment.

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Distinguishing features of the range of serum antibodies to nervous tissue antigens in Parkinson's disease

Year: 2019, volume 15 Issue: №1 Pages: 151-154
Heading: Neurology Article type: Original article
Authors: Goncharova Z.A., Kolmakova T.S., Oksenjuk O.S., Morgul E.V., Gelpey M.A., Vlasova N.D., Kalmykova Yu.A.
Organization:
Summary:

The goal of this study was to perform a multivariable analysis of immunobiochemical parameters which reflect the state of nervous system microstructure in Parkinson's disease (PD). Materials and Methods. The study included 54 patients of the main group with a diagnosis of PD and 6 patients of the control group. The immunoreactivity profiles of natural regulatory auto-AB in serum were determined by ELISA using the ELI-P-Complex assay. The following parameters were assessed: ABto NF-200, GFAP, S100 proteins, MBP, beta-endorphin, voltage dependent Ca2+channel, H-cholinergic receptors, glutamate, dopamine, serotonin, opiate, GABA receptors. Results. The study revealed significant abnormalities in auto-AB profiles of the examined patients. Conclusion. The findings on the difference in range of auto- AB dependent on the duration of the disease and the revealed associations with the main characteristics of the disease can be used both for early diagnosis and for predicting the course of PD in the future.

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Method of injection reflexotherapy for the treatment of chronic tensiontype headache

Year: 2018, volume 14 Issue: №3 Pages: 380-384
Heading: Neurology Article type: Original article
Authors: Belimova L.N., Balyazin V.A.
Organization:
Summary:

Aim: evaluation of the injection reflexotherapy on the pain syndrome and level of anxiety-depression disorders in patients with chronic tension-type headache (CTTH). Material and Methods. An open controlled trial was conducted on 95 patients with CTTH. The patients were divided into 2 groups by a method of adaptive randomization: patients of comparison group received amitriptyline 35-70 mg/day and tolperisone 450mg/day; patients of basic group were assigned to 2-4 courses of injection reflexotherapy by the developed method. The obtained results were assessed on the basis of scores on the Visual Analogous Scale, McGill Pain Questionnaire, Beck Depression Inventory, State-Trait Anxiety Inventory. Results. Patients of both groups had a positive view on the receiving treatment. According to McGill Pain Questionnaire determined both affective and sensory descriptors of pain, with dominated by sensory descriptors. For psychological status, according to Beck Depression Inventory, moderate depressive symptoms were noted in both groups. Prevalence of trait anxiety was determined by State-Trait Anxiety Inventory. As a result of the treatment, the intensity of pain by VAS reduced from 5,26±0,87 to 1,7±0,78 points (p<0,05) in the comparison group and from 5,17±0,78to 1,65±0,79 (p<0,05) in the basic group. Improvement of parameters of anxiety and depression were found. Conclusion. As the results show, it is very promising to use injection reflexotherapy in treatment of patients with CTTH.

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Clinical significance of hyperglycemia in acute ischemic stroke

Year: 2018, volume 14 Issue: №2 Pages: 220-225
Heading: Neurology Article type: Original article
Authors: Izhbuldina G.l., Novikova L.B.
Organization: Bashkir State Medical University of the Russian Health Care, Ufa Clinical Hospital №18
Summary:

Aim: to study the effect of hyperglycemia on the course and clinical outcome of ischemic stroke (IS) in the acute period. Material and Methods. A total of 862 patients with IS (370 men, 492 women), mean age was 66.1±10.8 years. The degree of neurological deficit (NIHSS scale) and functional disorders (Rankin scale), clinical outcome were assessed. When admitted to hospital, a study of the level of glycemia on an empty stomach was conducted. Results. In 186 (21.6%) patients type 2 diabetes Mellitus (DM) was diagnosed. In 27.8% of patients without DM and 76.3% of patients with DM hyperglycemia was detected. In patients without DM with hyperglycemia, higher than in patients with normoglycemia, the representation of women (by 9.9%), cardioembolic stroke (by 10.5%), severe neurological deficit (by 14.7%), gross impairment of vital activity (by 14.0%), a decrease in the frequency of noticeable positive dynamics (by 14.8%), an increase in mortality (by 11.5%). In patients with DM, hyperglycemia was associated with a higher assessment rate on the Rankin scale of 4-5 points (by 25.6%) and a decrease in the incidence of noticeable positive dynamics (by 27.7%). Conclusion. Development of IS is characterized by high representation of disorders of carbohydrate metabolism (21,6%). The severity of glucose metabolism disorders is interrelated with the severity and clinical outcome of the disease.

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Clinical significance of hyperglycemia in acute ischemic stroke

Year: 2018, volume 14 Issue: №2 Pages: 220-225
Heading: Neurology Article type: Original article
Authors: Izhbuldina G.l., Novikova L.B.
Organization: Bashkir State Medical University of the Russian Health Care, Ufa Clinical Hospital №18
Summary:

Aim: to study the effect of hyperglycemia on the course and clinical outcome of ischemic stroke (IS) in the acute period. Material and Methods. A total of 862 patients with IS (370 men, 492 women), mean age was 66.1±10.8 years. The degree of neurological deficit (NIHSS scale) and functional disorders (Rankin scale), clinical outcome were assessed. When admitted to hospital, a study of the level of glycemia on an empty stomach was conducted. Results. In 186 (21.6%) patients type 2 diabetes Mellitus (DM) was diagnosed. In 27.8% of patients without DM and 76.3% of patients with DM hyperglycemia was detected. In patients without DM with hyperglycemia, higher than in patients with normoglycemia, the representation of women (by 9.9%), cardioembolic stroke (by 10.5%), severe neurological deficit (by 14.7%), gross impairment of vital activity (by 14.0%), a decrease in the frequency of noticeable positive dynamics (by 14.8%), an increase in mortality (by 11.5%). In patients with DM, hyperglycemia was associated with a higher assessment rate on the Rankin scale of 4-5 points (by 25.6%) and a decrease in the incidence of noticeable positive dynamics (by 27.7%). Conclusion. Development of IS is characterized by high representation of disorders of carbohydrate metabolism (21,6%). The severity of glucose metabolism disorders is interrelated with the severity and clinical outcome of the disease.

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Public knowledge of risk factors, signs and treatment of stroke: Analysis of the survey results in 2014 and 2017

Year: 2018, volume 14 Issue: №1 Pages: 177-185
Heading: Neurology Article type: Original article
Authors: Shchanitsyn I.N., Razdorskaya V.V., Kolokolov O.V., Lukina E.V., Loi'ko V.S,
Organization: Center of Medical Inspection, Moscow, Saratov State Medical University
Summary:

Aim. This study was conducted to establish levels of knowledge in the general population, and also to determine the impact of educational sessions on stroke knowledge. Material and Methods. Two groups (2014 and 2017 years) completed a stroke knowledge questionnaire (435 respondents). Results. Overall, most of respondents could list 2 or more risk factors, but only 50% in 2014 could list 3 warning signs. More than 80% would call emergency number in response to stroke, but only 25% had heard of thrombolytic therapy. Overall stroke knowledge scores decreased in 2017 despite the public awareness in the media. Conclusion. Currently the knowledge of stroke risk factors, warning signs, and treatment is poor in Saratov. Our study demonstrates that more educational campaigns should be conducted for improve knowledge of stroke symptoms, and therapy.

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On the clinical picture and diagnosis of rare neurological diseases

Year: 2018, volume 14 Issue: №1 Pages: 174-177
Heading: Neurology Article type: Case report
Authors: Ulyanova O.V., Kutashov V.A., Brezhneva N.V.
Organization: Regional Children's Clinical Hospital No. 1 (Voronezh), Voronezh State Medical University n.a. N.N. Burdenko
Summary:

 The article presents clinical observation of patient H, 2007 year of birth., with X-linked adrenoleukodystrophy (X-ALD). This is a rare hereditary metabolic disease, not only in Russia but also worldwide. It belongs to the group of peroxisomal diseases, is associated with the accumulation of fatty acids with a very long chain and is characterized by a combined lesion of the nervous system and adrenal glands. X-ALD in neurology and Pediatrics require a targeted individual approach to each patient, genetic tests in relatives and prenatal diagnosis among patients at risk.

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Neuroinfection in patient with HIV: case report

Year: 2018, volume 14 Issue: №1 Pages: 168-173
Heading: Neurology Article type: Case report
Authors: Sotskova V.A., Bachilo Е.М., Shuldyakov А.А., Kolokolov O.V., Barylnik Yu.B., Potemina L.P., Krajnova O.N.
Organization: Saratov Regional Centre for Disease Prevention and Control of AIDS
Summary:

Toxoplasmosis is one of the most common opportunistic infections in HIV-positive patients. The onset of HIV-infection with cerebral toxoplasmosis makes this disease a multidisciplinary problem and requires the participation of doctors of various specialties (infectious disease specialists, neurologists, neurosurgeons, general practitioners, etc.). Early diagnosis and treatment of this disease will reduce the risk of deaths and severe consequences. We carry out an analysis of the clinical case of toxoplasma encephalitis in a HIV-infected patient. We have identified errors in the establishing diagnosis. We have given a detailed account a patient management plan. We also comment on some of the problem early disease detection HIV-infection.

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Dynamics of acetylcholine receptors antibody titer in myasthenia gravis

Year: 2018, volume 14 Issue: №1 Pages: 164-168
Heading: Neurology Article type: Original article
Authors: Romanova T.V., Poverennova I.E., Zakharov A.V.
Organization: Samara State Medical University
Summary:

The aim was to examine the longitudinal association between myasthenia gravis clinical severity and concentration of acetylcholine receptor (AChR) antibodies to evaluate if AChR-antibody variations correlate to disease severity. Material and Methods. Antibodies were determined by enzyme immunoassay. The International Clinical Classification (MGFA) was used to grade the severity of the disease. The level of antibodies was compared with the severity of the condition and the form of the disease at the stage of diagnosis in 65 patients, as well as in repeated studies in 26 patients. Results. The titer of AChR-antibodies did not correlate with the severity of the condition, however, a direct relationship between the change in the level of acetylcholine receptor antibodies and the change in the clinical state during the course of the disease was obtained. Conclusion. Repeated AChR-antibody measurements will help to predict the clinical state of the patient and can be used to correct immunosuppressive therapy.

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Use of the scale of clinical expression of the stroke for determining the rehabilitation prediction

Year: 2018, volume 14 Issue: №1 Pages: 161-164
Heading: Neurology Article type: Original article
Authors: Repina L.A., Romanova T.V., Poverennova I.E.
Organization: Samara State Medical University
Summary:

The aim is to study the relationship between the parameters of neurological status and quality of life of patients who first underwent ischemic strokes in the carotid basin to predict the outcome of an acute cerebrovascular accident. Material and Methods. 73 patients with ischemic stroke in the carotid artery basin were examined. Analyzed indices of the scales, reflecting the severity of motor deficit (NIHSS, Rankin, Rivermead, Fugl-Meyer), the initial evaluation and parameters of quality of life using the questionnaire SF-3624-36 months after inpatient treatment. Patients were divided into groups of favorable and unfavorable outcome according to the questionnaire SF-36. Results. A direct correlation between the level of physical and psychological health and indicators Of the Fugl-Meyer scale and a negative correlation between the level of psychological health and the severity of stroke on the NIHSS scale in a group with an adverse outcome was revealed. Conclusion. Indicators scales Fugl-Meyer, and NIHSS obtained in the acute period of ischemic stroke can be used to build a predictive model of outcome of stroke.

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