Saratov JOURNAL of Medical and Scientific Research

Neurology

The issue of neuropsychiatric disorders in patients with hypothyroidism

Year: 2016, volume 12 Issue: №3 Pages: 375-378
Heading: Neurology Article type: Original article
Authors: Kutashov V.A., Budnevsky A.V., Ulyanova O.V., Priputnevich D.N.
Organization: Voronezh State Medical Academy
Summary:

The aim of the study was assessment of thyroid function in patients with psychiatric and psychological assistance; to study the structure of AR in patients with hypothyroidism, to reveal alexithymical identifying of personality characteristics of patients with hypothyroidism and AP Materials and Methods. 406 patients with AR at the age of 51.3±4.7 years. To verify the useofTSH hypothyroidism rate and to assess depressive disorder — Hamilton Scale and the Montgomery— Asberg; with clinical and psychopathological study: 1) the scale of self-BH alarm Spielberger (Y. L. Hanin), 2) questionnaire G. Shmisheka 3) Toronto alexithymia scale. Results. Hypothyroidism is set at 116 (28.6%) of 406 patients suffering from RA. Among the 374 patients with depressive disorders hypothyroidism was observed in 116: subclinical — in 76 patients (65.5%), symptomatic — in 40 (34.5%). The first group consisted of 258 patients with the presence of depressive disorders and without hypothyroidism; second — 116 patients with the presence of depression and hypothyroidism. TSH in patients suffering AR, without thyroid dysfunction was 5.2 times lower than in patients with the presence of hypothyroidism. Among AP comorbid with hypothyroidism, are predominant depressive with a predominance of mild and moderate forms. Dominating are anxious-depressive, dysphoric, adynamic, sad, depressive disorders. Conclusion. In patients with AR and hypothyroidism predominant types of personality accentuation are dysthymic, anxious, demonstrative and meticulous.

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Hereditary neuropathies: systematization and diagnostics (clinical case of hereditary motor and sensor neuropathy of the IA type)

Year: 2016, volume 12 Issue: №3 Pages: 370-375
Heading: Neurology Article type: Case report
Authors: Kolokolova A.M., Sitkali I.V., Kolokolov O.V.
Organization: Saratov State Medical University
Summary:

Aim: to study the value of routine methods (clinical symptoms, electrophysiological findings and results of DNA analysis) in diagnostics of hereditary motor sensory neuropathy type IA in outpatient clinics. Material and Methods. The review of foreign literature is represented. The phenotypic polymorphism, genetic heterogeneity and the difficulties of diagnostics are identified. A family with hereditary motor sensory neuropathy of lAtype is presented, which was diagnosed on the base of available methods in outpatient practice (clinical symptoms, genealogical method, electro-physiological findings and DNA analysis results). Results. Routine algorithm (consistent valuation of clinical symptoms, neurophysiologic findings and the results of DNA analysis) helped to verify the diagnosis of hereditary motor sensory neuropathy of lAtype in outpatient practice after more than 20 years of the onset of the disease. Conclusion. The neurologists of outpatient clinics and other specialists must be informed about the availability of diagnostics of hereditary diseases of nervous system.

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Clinical and instrumental risk factors for epileptic seizures in patients after traumatic brain injury

Year: 2016, volume 12 Issue: №3 Pages: 366-370
Heading: Neurology Article type: Original article
Authors: Zakharov A.V., Poverennova I.E., Kurov M.V., Khivintseva E.M.
Organization: Samara State Medical University
Summary:

The aim: analysis of factors influencing the risks of posttraumatic epilepsy (РТЕ). Materials and Methods. The study involved 71 patients with traumatic brain injury of moderate and severe with emerging after her epileptic seizures. Among the subjects was 56 (78.9%) males and 15 (21.1%) females. The average age of the subjects was 65.6±10,3 years. The control group was 25 (71.4%) male patients and 10 (28.6%) females. The average age of the patients was 54.4.±9.3 years. Analysis of factors influencing the risks of РТЕ use nonparametric Spearman correlation and multivari-ate analysis of variance. Results. Among the many factors to be statistically significant risk factors for РТЕ was alcohol intoxication at the time of trauma 27 (38,0%), relative to the control group 2 (5.7%) p

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Influence of non-motor symptoms on the Parkinson's disease features and on quality of patients' life

Year: 2016, volume 12 Issue: №3 Pages: 362-366
Heading: Neurology Article type: Original article
Authors: Goncharova Z.A., Gelpey M.A., Rabadanova E.A.
Organization:
Summary:

The main clinical symptoms of PD are well understood, but it is necessary to continue studying the changes of symptoms as it progresses. The aims of the research were: to study the structure of non-motor symptoms (NMS) at the early and last stages of PD, to determine the frequency and clinical significance of the NMS at different stages of PD, comparing the severity of NMS in PD with the severity of the same symptoms in the natural aging, to study the quality of life (QOL) of patients with the impact assessment of the NMS and the assessment of motor symptoms on this criterion. The material and methods. The study included 79 patients with PDand 25 patients without neurodegenerative disorders (control group). The degree of movement disorders severity was assessed using UPDRS scale. Cognitive function was assessed using the Montreal Cognitive Rating Scale (MoCA). To identify and assess the severity of NMS questionnaire used NMSS. Assessment of quality of life of patients was carried out by PDQ-39 questionnaire. Results. There was a significant difference between the intensity of the NMS in PD patients and the control group. Intensity of NMSs significantly correlated with disease stage, disease duration, with the points on the UPDRS scale. Conclusion. NMS significantly affect the quality of life, their severity and structure varies considerably from early to late stage PD, and they are the result of a neurodegenerative process, inherent in PD, and not the natural aging process.

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Transradial approach for carotid artery stenting

Year: 2016, volume 12 Issue: №2 Pages: 304-311
Heading: Neurology Article type: Review
Authors: Shchanitsyn I.N., Sharafutdinov M.R., Larin I.V.
Organization: Saratov State Medical University, State Autonomous Institution of Health of the Republic of Tatarstan "Emergency Hospital"
Summary:

Carotid artery stenting (CAS) has proved to be a valuable alternative to carotid endarterectomy in patients with carotid artery stenosis. Therefore, avoiding complications becomes crucial in CAS. The results are constantly improving because of the introduction of new embolic protection devices and small calibre stenting systems. For many years, transfemoral approach has been the most common access during CAS, mainly due to its short learning curve and possibility to accept large bore catheters. However, this approach is not always feasible because of vessel pathology or aberrant anatomy of the iliofemoral arteries and the aortic arch. Carotid artery stenting using transradial approach was safe and technically feasible, but limited data exist on radial access in carotid artery stenting. The rationale for the transradial approach was to attempt to reduce the incidence of bleeding complications at the vascular access site and to avoid the necessity for prolonged bed rest. Several pilot studies and one randomised prospective trial have confirmed the safety and efficacy of transradial approach for CAS. This article reports review of literature and our initial experience using the radial artery as access for carotid stenting.

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Nervous system diseases comorbid to psoriasis

Year: 2016, volume 12 Issue: №2 Pages: 300-303
Heading: Neurology Article type: Review
Authors: Fisun A.V., Kolokolov O.V., Bakulev A.L., Makarov N.S., Kravchenya S.S., Schabogina A.A., Popova O.V.
Organization: Saratov State Medical University
Summary:

The information about the cormorbid pathology in patients with skin and nervous systems diseases is summarized on the base of Russian and foreign scientific literature. The main attention is devoted to the combination of nervous system pathology with psoriasis and psoriatic arthritis. The high risk of cerebrovascular diseases development is pointed in psoriasis. Material concerning neuropathy caused by the cytostatics usage is represented in patients with psoriasis.

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Rare forms neurological disorders in an HIV-infected patient

Year: 2016, volume 12 Issue: №2 Pages: 296-299
Heading: Neurology Article type: Case report
Authors: Sotskova V.A., Kolokolov O.V., Shuldyakov А.А., Makarov N.S.
Organization: Saratov State Medical University
Summary:

The study aims paying the attention of specialists in rare cases of pathology of the nervous system in HIV-infected patients. The clinical case of brain abscess in a 32 year-old HIV-positive patient. Against the background of the surgical and antiretroviral treatment of brain abscess in HIV-positive patients it managed to achieve a virologic response and regression of neurological symptoms. Presented clinical case can be useful for specialists in determining the tactics of treatment of brain abscess in HIV-infected patients.

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Polyneuropathy: clinical polymorphism and the algorithms of diagnostics

Year: 2016, volume 12 Issue: №2 Pages: 292-296
Heading: Neurology Article type: Review
Authors: Sitkali I.V., Kolokolov O.V., Lukina E.V., Grigorieva E.A., Popova O.V.
Organization: Saratov State Medical University
Summary:

The information about epidemiology and clinical polymorphism of neuropathies is summarized on the base of Russian and foreign literature. The algorithm of clinical observation in patients with polyneuropathy is presented.

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Early and late myasthenia gravis

Year: 2016, volume 12 Issue: №2 Pages: 287-292
Heading: Neurology Article type: Original article
Authors: Romanova T.V., Poverennova I.E.
Organization: Samara State Medical University
Summary:

The aim: the hypothesis testing of the existence of two different groups of patients with different age at disease onset in a large population of patients with methods multidimensional constellation. Materials and Methods. Analysis of 444 patients enrolled in the register of patients with myasthenia in the Samara region. The duration of disease was more than 1 year. Statistical results of the study was carried out using a multi-dimensional grouping by cluster analysis Checking the quality of the classification was carried out using discriminant analysis. Results. Transient age between the two groups was defined as 40 years. The most important criteria of distinction patients group was sex of the patient and the presence of thymic hyperplasia. Conclusion. These clinical and immunologic patterns of early-onset and late-onset myasthenia gravis can serve as a basis of formation flow forecast model of myasthenia gravis and to create an algorithm of patient management.

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Parkinsonism accompanying the left frontal lobe tumor

Year: 2016, volume 12 Issue: №2 Pages: 285-287
Heading: Neurology Article type: Case report
Authors: Razdorskaya V.V., Kolokolov O.V., Lomakin A.l., Yudina G.K.
Organization: Saratov Regional Clinical Hospital, Saratov State Medical University
Summary:

Objective: to draw the attention of experts on rare cause of secondary parkinsonism — a brain tumor. Material and methods. The clinical observation of the patient 52 years with Parkinson's syndrome. Brain MRI. Results. In parallel the patient had classical progressing clinic bilateral parkinsonism in combination with progressive cognitive decline. MRI research revealed the left frontal lobe tumor. Conclusions. Secondary parkinsonism as a result of intracerebral neoplasms are caused mostly by compression of basal ganglia or mesencephalon increasing tumors. Hemiparkinsonism in these cases usually precedes the other focal neurological symptoms.

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