Vol XXIX, No 3-4 (1997)

The results of computer-tomographic (CT), magnetic-resonance (MR) and electroencephalographic (EEG) studies are given, performed in 104 patients with cerebral ischemia, diagnosis of which caused significant difficulties. Verification of hemispheric ischemic insult with the help of CT and MR during the first three days is possible only in case of squeezing and displacement of the ventricular system and developing of acute hydrocephalus. The most reliable CT and MR data can be revealed on the 7—11-th day of sickness. Insults of the trunk are diagnosed (more reliably by MR) in one third of patients. Method of standard EEG retains its significance when diagnosing small brain infarcts of cortical or subcortical localization. The method of topographic mapping of EEG is more informative and allows to diagnose brain infarct, as well as to observe its dynamics in 4/5 of patients.

Clinical examination of 102 patients including, besides objective neurological examination, determination of functional state of vegetative nervous system, electroencephalography, reoencephalography, stomatologic examination, stomatoscopy, measurement of microcurrent in oral cavity, was carried out. Biochemical investigation involved determination of the total content of testosteron, biologically active free forms of it, concentration of B-endorphine, series E prostaglandines. In 81,3% of patients in vegetative security sympatho-tonic, in 7,8% — vagotonic and in 10,7% — mixed responses were dominant. Change in electroencephalograms and reoencephalograms of the examined patients differed in their dependence on vegetative state. Findings of stomatological examination and stomatoscopy allowed to estimate objectively local changes in oral cavity. The obtained results evidently show the dependence of suprasegmental structures of brain, and of the pituitary body—adrenal gland system as well.

Results of dynamic study of level of antibodies to NMDA- receptors in blood serum of patients at different moments of acute period of disturbance of cerebral circulation of ischemic and hemorrhagic tipe are generalized in the given work. A total of 48 patients of 32—66 years of age with acute disturbance of cerebral circulation, 29 of which — with acute cerebral ischemic and 19 — with acute hemorrhage has been examined. The trends has been identified in changes of the level of antibodies to receptors at different phases of acute period of ischemic insult and acute cerebral hemorrhage. The results can be used for diagnosis and prognosis of the course of different types of acute disturbance of cerebral circulation.

Electromyographical examination of 103 patients with Bell’s palsy in acute and recovering periods of disease has been carried out. A number of functioning motor units, silence period, sinergy coefficients in mimic muscles have been studied. A significant decrease of index of a number of functioning motor units, correlating to severity of facial nerve injury, decrease of the durability of absolute phase of silence period, disturbance of coordinational correlation of mimic muscles are revealed. Significance of revealing prolonged decrease of durability of absolute phase of silence period and increase of sinergy coefficients for prediction of possibility of development of secondary contracture of mimic muscles is presented.

Classification of pathology of nervous system in secondary allergic vasculitis has been developed. Occupational pathology induced by the exposure to antibiotics which, as it is known, are potent allergens, served as a model for studying it. Diffuse, cerebral and peripheric forms of nervous system lesion have been distinguished. Diffuse form is manifested by meningoencephalomyelopolyradiculoneuropathy and its varieties, cerebral one — by cerebral vasculitis mainly with focal multiple microsymptomatics, hypothalamic syndrome, psychopathological symptomatology and initial symptoms of brain blood supply deficiency, peripheric one — by polyneuropathy and mononeuropathy caused by injury of peripheral vessels.

By methods of extra- and transcranial dopplerography, reoencephalography evaluation of correspodence of brain hemoperfusion and reserves of autoregulation during rest and functional tests in patients was carried out with early manifestations of insufficient blood supply of brain. For this purpose 114 patients with such disease and 70 healthy people were examined. The most diagnostic significance for revealing disorders of cerebral hemodynamics in people with early manifestations of ischemic lesion of brain, have alterations of values of linear blood flow speed, range of cerebrovascular reactivity, values of circulation resistance. They indicate adequacy of hemoperfusion, presence of stenosis and intracerebral overdistribution of circulating blood. Pathogenetic variants of insufficient cerebral blood supply are shown in the verterbrobasilar basin.

765 patients with different forms of arterial hypertension, having cerebrovascular insufficiency, were examined. Correlations of parameters of cerebral and system hemodynamics, microcirculation and functional state of the central nervous system under conditions of controlled physical exercise were studied. The prognostic significance of the early objectivization of initial manifestations of cerebral circulation insufficiency before development of arterial hypertension in preclinical and early clinical stages of brain vascular diseases and the possibil ity of de term in ing functional reserves of cerebral neurodynamics and hemodynamics were shown.

On the basis of immunological study of 65 patients with multiple sclerosis and 37 patients with myastenia the laboratory ways were offered for diagnosis of these diseases. For immunodiagnosis of multiple sclerosis a peroral rezerpine test was performed, based on the patients’ blood deficiency of serotonin and absence of immune system reaction on introducing agents, altering the balance of this mediator. For diagnosis of myasthenia acetylcholine test and immune variant of neostigmine methylsulfate test are offered, which are based on registration of altering of balance of endogenous acetylcholine in the patients’ blood under the enfluence of introducing neostigmine methylsulfate.

Working classification of birth traumas of spine and spinal cord has been worked up, which corresponds to conventional international classification of spinal and spinal cord traumas. It allows to make the diagnosis easier and to carryout purposeful pathogenic therapy in reasonable time.

In 107 patients with chronic insufficiency of brain circulation of atherosclerotic genesis (of different expressiveness) lipid level of blood serum is determined, cholesterine coefficient of atherogenecity and supposed by the authors coefficient of lipid disorders are calculated. The obtained results have been compared with data of analogous examination of 78 patients, having atherosclerotic stenocardia of tension. Integral evaluation of blood lipid spectrum with regard to its peculiarities allowed to determine that expressiveness of lipid disorders in patients with cerebral atherosclerosis is not reduced, and is even increased in coronary atherosclerosis.

The article considers a possibility of developing disorders in psychic adaptation of video-display terminals users. Such disorders among the VDT users were more frequent than among people from the control group. It was shown that possibility of such reactions depends on duration of VDT usage. More distinct changes were observed in the group, having been worked with VDT for more than 144 months. People with the less experience of VDT operating (up to 48 hours) are also included in the risk group. Among different professional groupes the largest changes were noticed among programmers, the least — among PC operators.

Peculiarities of infringement of the vegetative status in children, suffered concussion of brain are revealed. Disintegration of activity of vegetative systems was displayed by suppression of ergotropic link, causing insufficient vegetative reaction and inadequate vegetative provision of activity. Interrelation of character of vegetative reaction with terms of remote period was observed. Influence of age of the children, character of medical history, degree of clinical compensation was shown.

A doubtless significance of neurodynamic process in ensuring morphogenesis and, in particular, reparative processes, was a groundwork for creating a neurodynamic model of tissue reparation. According to a new model the obligatory condition of reparative morphogenesis effectiveness is the body generation and subsequent change of neurodynamic patterns. Experimentally, on the example of the skin wound the role of neurodynamic factor in reparative morphogenesis was proved. We managed to reveal reasons, leading to pathologic deviations in development of regenerative process. It was shown that the main role in reparative morphogenesis play generation and change of regulating neurotrophic patterns.

Difficulties in treating discirculatory encephalopathy (DE) in the elderly are caused by a combination of degenerative and vascular processes, which mutually burden each other. The development of the disease against the background of natural aging of the body makes it necessary to take into account age-related changes in the reactivity of the body, a decrease in its adaptive capabilities, and a violation of the mechanisms of autoregulation [6]. This whole complex of pathological changes requires a special therapeutic approach that considers the body as a single functional system. It can be assumed that drugs of a non-specific plan will be effective, mobilizing the internal reserves of an aging organism.

Migraine is one of the most common diseases among the various forms of headache. Their frequency reaches 38%. Several main blocks are involved in the pathophysiology of migraine cephalgias: cerebral, the interaction of certain neurotransmitter systems, the state of the trigeminal and vascular systems.