Saratov JOURNAL of Medical and Scientific Research

№1, 2018, volume 14

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

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.

Keywords: acute cerebrovascular accident, education, health, preventive, risk factors, Saratov, stroke, survey

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

 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.

Keywords: children, fatty acids with a very long chain, genetic disease, heredity, X-linked adrenoleukodystrophy

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

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.

Keywords: pathology of the nervous system, opportunistic diseases, HIV infection, cerebral toxoplasmosis

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

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.

Keywords: acetylcholine receptor antibodies, dynamics, immunoassay method

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

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.

Keywords: ischemic stroke, quality of life, rehabilitational forecast, scales of clinical expression of an apoplectic attack

Multimodal evoked potential in monitoring activity relapsing and remitting multiple sclerosis

Year: 2018, volume 14 Issue: №1 Pages: 157-160
Heading: Neurology Article type: Original article
Authors: Poverennova I.E., Zakharov A.V., Khivintseva E.V.
Organization: Samara State Medical University

The aim of the study was to examine multimodal evoked potential in patients with or without relapse
multiple sclerosis during 12 month. Material and Methods. The study included 32 patients with
established diagnosis of clinically significant multiple sclerosis, a relapsing-remitting course. The EDSS
score was evaluated. All patients underwent a study of multimodal evoked potential. All examined
patients were divided into 2 groups depending on the relapse multiple sclerosis by the end of the year.
Results. Multimodal evoked potentials show ambiguous data on the activity of multiple sclerosis. The
greatest correlation with subsequent activity of multiple sclerosis is shown by stem evoked potentials.
Conclusion. This study is the initial stage in the search for a tool for predicting the course of the disease
in patients with multiple sclerosis. An increase in the group of subjects and inclusion in the analysis of
structural changes in the central nervous system according to magnetic resonance imaging probably will
increase the information content of predictions.

Keywords: Expanded Disability Status Scale, multimodal evoked potential, multiple sclerosis, relapse of multiple sclerosis

"Benign" multiple sclerosis: a variant of favorable disease course and the result of effective treatment

Year: 2018, volume 14 Issue: №1 Pages: 153-156
Heading: Neurology Article type: Review
Authors: Makarov N.S., Kolokolov O.V.
Organization: Saratov State Medical University

The article provides an overview of data on isolated demyelination syndromes that may precede multiple sclerosis, and on the peculiarities of the so-called "benign" form of multiple sclerosis. Clinical and anamnestic criteria for establishing the fact of a "benign" form of multiple sclerosis are presented, as well as trends in the number of these patients in the general population of patients with multiple sclerosis, including in connection with the improvement of treatment methods for this disease.

Keywords: "benign" multiple sclerosis, clinically isolated syndrome, Expanded Disability Status Scale (EDSS), multiple sclerosis, radiologically isolated syndrome

Features of psychoemotional disorders in patients with multiple sclerosis in different clinical and demographic groups

Year: 2018, volume 14 Issue: №1 Pages: 151-153
Heading: Neurology Article type: Short message
Authors: Lukina E.V., Chernysheva О.А., Eliseeva V.A.
Organization: Saratov State Medical University

Purpose: to conduct an analysis of psychoemotional disorders in patients with multiple sclerosis, who are not receiving any treatment for these disorders. Material and Methods. A cohort of patients with a reliable diagnosis of multiple sclerosis, according to the criteria of С Poseur, consisting of 163 people, was selected for the research. A four-dimensional symptomatic questionnaire was used to assess distress, depression, anxiety and somatization (4DSQ) and a self-questionnaire for evaluating the symptoms of fibromyalgia with quantitative measures (WPI, SS, FS). Re-sults. Differences in the average values of the level of distress, depression, anxiety and somatization in patients with multiple sclerosis of different sex, age, with different type of course and duration of the disease are shown. Conclusion. The neuropsychological status of patients depends on the type of course of the disease, the level of distress — from age and sex, the level of somatization —from the age of this category of patients. In the complex treatment of this category of patients it is necessary to use symptomatic treatment in addition to pathogenetic therapy, which has not only neurotrophic and vasoactive effects, but also affects the psychoemotional background of patients.

Keywords: anxiety, depression, distress, multiple sclerosis, somatization

The possibility of using low-intensity helium-neon laser radiation in the treatment of patients with trigeminal neuralgia

Year: 2018, volume 14 Issue: №1 Pages: 149-150
Heading: Neurology Article type: Original article
Authors: Lukina Е.М., Kolesov V.N., Skulovich S.Z., Chernysheva O.A.
Organization: Saratov State Medical University

Purpose: to evaluate the effectiveness of low-intensity helium-neon laser radiation in patients with trigeminal neuralgia. Material and Methods. With the help of low-intensity helium-neon laser radiation, 76 patients with trigeminal neuralgia were treated. For this purpose, helium-neon laser devices AFL-1 and AFDL-1 with a wavelength of laser radiation of 0.63 microns were used, the power flux was 20-25 mW. Results. It is shown that as a result of treatment with this type of radiation in most cases, both nociceptive and neuropathic components of the pain syndrome are stopped. Conclusion. For the management of pain syndrome in trigeminal neuralgia, it is advisable to use low-intensity laser radiation in complex treatment.

Keywords: low-intensity helium- neon laser light, trigeminus neuralgia

Тhe efficiency of complex treatment of different variants of myasthenia gravis

Year: 2018, volume 14 Issue: №1 Pages: 145-148
Heading: Neurology Article type: Original article
Authors: Lapshina O.V., Antipenko Е.А., Gustov A.V.
Organization: Privolzhskiy Research Medical University

The aim: to evaluate the effect of complex restorative treatment on clinical manifestations and the state of oxidative homeostasis in patients with different variants of myasthenia gravis. Material and Methods. The analysis of indicators of biochemiluminescence, muscle strength according to the scales QMGS and MG-ADL, instrumental methods of research (ENMG and respiratory function) before and after treatment in 117 patients with myasthenia gravis is carried out. For comparative analysis of independent samples was used Mann — Whitney U-test, and for paired comparisons was used the Wilcoxon test. Results. The dynamics of oxidative homeostasis, clinical picture, indicators of instrumental methods of research (ENMG, respiratory function) in patients with myasthenia gravis, without thymoma and underwent thymectomy on the background of complex treatment with the use of antioxidant therapy is presented. In all studied groups against the background of complex treatment with application of antioxidant therapy increase in activity of antioxidant protection of organism and decrease in activity of free radical oxidation that correlates with clinical improvement in all groups of patients is noted. Conclusion. The use of antioxidant therapy in complex rehabilitation of patients with myasthenia gravis is pathogenetically justified, especially in patients without thymoma.

Keywords: antioxidant therapy, lipid peroxidation, myasthenia gravis, oxidative homeostasis, thymoma