Ukrainian Neurological Journal最新文献

{"title":"Experience of patients with herpetic ganglioneuritis observation in the neurological hospital","authors":"H. Symonenko","doi":"10.30978/unj2021-3-42","DOIUrl":"https://doi.org/10.30978/unj2021-3-42","url":null,"abstract":"Objective — to evaluate the clinical, laboratory and functional parameters of patients with herpetic trigeminal ganglioneuritis in the neurological department. \u0000Methods and subjects. The case anamnesis of 43 patients (26 (60.5 %) female and 17 (39.5 %) male) with a diagnosis of herpetic trigeminal ganglioneuritis were retrospectively analyzed: clinical presentation, data on general blood and urine tests, biochemical blood tests, electrocardiography, ultrasound examination of the main arteries of the brain, organs of the abdominal cavity and small pelvis, rheoencephalography. \u0000Results. Out of 43 hospitalized patients, 31 (72.1 %) had lesion of the first branch (64.5 % of women and 35.5 % of men), 9 (20.9 %) had lesion of the second branch, and 3 (7.0 %) ) — III branch of the trigeminal nerve. Patients older than 46 years predominated (86.0 %). In general, right‑sided lesion was observed in 22 cases (51.2 %), left‑sided — in 21 (48.8 %) cases. In women, right‑sided lesions prevailed (16 patients — 61.5 %), while in men — left‑sided lesions (11 patients — 64.7 %). The main complaint, in addition to rashes, was local pain, which was mainly of a burning character (24 patients — 55.8 %) with simultaneous itching (15 patients — 34.9 %). Severe pain was observed in 23 (53.5 %), moderate in 14 (32.6 %) and mild in 6 cases (13.9 %). Hyperesthesia accompanied pain in 28 (65.1 %) cases, while only 6 (14.0 %) patients demonstrated hypoesthesia. In the case of involvement of the I branch, herpetic kerato‑uveitis was registered in 9 (29.0 %) cases. Edema of the periocular region was observed in 17 patients (54.8 %). In the case of elderly patients, intellectual and mind functions decrease (45 %), positive subcortical reflexes (46.5 %), and moderate coordination disorders (34.9 %) were observed. Among the general and functional analyses carried out, attention was drawn to an increase ESR (39.5 %), as well as metabolic changes in the myocardium on the ECG (65.1 %). In the case of older age group, comorbidities were dominated by bychronic cerebrovascular accident (45 %), arterial hypertension (40.0 %), type 2 diabetes mellitus (25.0 %), and osteochondrosis (20.0 %). \u0000Conclusions. In the case of herpetic lesions, clinical observations confirm the predominant lesion of the I branch of the trigeminal nerve, more marked predominance of elderly women with right‑sided symptoms in the pathological process was observed. Beside the background of typical rashes, severe baking local pain, accompanied by itching and hyperesthesia, dominates in the clinical picture. Despite sometimes delayed hospitalization due to attempts at outpatient or self‑treatment, a general blood analysis often reveals markers of inflammation. The complexity and variability of complaints, as well as examination results, can be mainly explained by the elderly age of patients. \u0000 ","PeriodicalId":296251,"journal":{"name":"Ukrainian Neurological Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130803151","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}

{"title":"Neuroradiological signs of encephalopathy in children with autism spectrum disorders associated with genetic folate deficiency","authors":"D. Maltsev","doi":"10.30978/unj2021-3-16","DOIUrl":"https://doi.org/10.30978/unj2021-3-16","url":null,"abstract":"The results of five meta‑analyzes indicate the association of autism spectrum disorders (ASD) with genetic deficiency of the folate cycle (GDFC) in children. In such cases, specific encephalopathy is formed with predominant immune‑dependent pathways of pathogenesis, the radiological signs of which are insufficiently studied. \u0000Objective —— to describe the typical neuroimaging signs of encephalopathy in children with GDFC suffering from ASD, and to find correlations between clinical signs, mechanisms of nervous system damage and neuroimaging data to optimize the algorithm of diagnosis, monitoring and treatment. \u0000Methods and subjects. The retrospective analysis of medical data of 225 children aged 2 to 9 years with GDFC, in which there were clinical manifestations of ASD (183 boys and 42 girls). The diagnosis of ASD was made by child psychiatrists according to the criteria of DSM‑IV‑TR (Diagnostic and Statistical Manual of mental disorders) and ICD‑10 (The International Statistical Classification of Diseases and Related Health Problems). Pathogenic polymorphic variants of folate cycle genes were determined by PCR with restriction. Neuroimaging was performed by MRI of the brain in conventional modes (T1‑ and T2‑weighted, FLAIR) on tomographs with a magnetic induction of 1.5 T. To study the associations between the indicators, the odds ratio (OR) and the 95 % confidence interval (95 % SI) were used. \u0000Results. There are 5 main groups of neuroimaging signs characteristic of leukoencephalopathy, temporal mesial sclerosis, PANS/PITANDS/PANDAS, congenital CMV neuroinfection and postnatal encephalitis, mild congenital CNS abnormalities. Neuroimaging signs are closely associated with the results of special laboratory tests that characterize the known immune‑dependent mechanisms of CNS damage, and with the emergence of relevant clinical syndromes, consistent with modern concepts of major infectious or autoimmune lesions of the nervous system in immunosuppressed patients. Laboratory‑radiological‑clinical complexes (virus‑induced temporal mesial sclerosis, autoimmune limbic encephalitis, autoimmune subcortical encephalitis, autoimmune or virus‑induced demyelinating lesions of the cerebral hemispheres and mild congenital malformations) have been identified. \u0000Conclusions. Encephalopathy in children with ASD associated with GDFC has a complex pathogenesis and is the result of combining a number of immune‑dependent forms of CNS damage in different ways in different patients, leading to a heterogeneous clinic‑radiological phenotype. \u0000 ","PeriodicalId":296251,"journal":{"name":"Ukrainian Neurological Journal","volume":"283 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121141011","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}

{"title":"Post-stroke cognitive impairment: screening with MMSE and MoCA and predictors of their persistence after treatment at the Stroke Center","authors":"Y. Flomin, V. Gurianov, L. Sokolova","doi":"10.30978/unj2021-3-31","DOIUrl":"https://doi.org/10.30978/unj2021-3-31","url":null,"abstract":"Objective — to analyze the results of screening for post‑stroke cognitive impairment (PCI) in patients with cerebral stroke (CS) admitted to the Stroke Center (SC) in different disease phases, and to determine independent predictors of the PCI persistence at discharge. \u0000Methods and subjects. 399 patients were enrolled, including 242 (60.7 %) men and 157 (39.3 %) women with the median age was 66.2 years (IQR 58.5 — 76.3). IS was diagnosed in 331 (82.9 %), and ICH in 68 (17.1 %) patients. Among patients with IS, 137 (41.4 %) had an atherothrombotic subtype, 152 (46.0 %) had a cardioembolic subtype, 21 (6.3 %) had a lacunar subtype, another 21 (6.3 %) had another or unknown cause of stroke. Patients were screened for PCI using the Mini‑Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) on admission and at discharge. Participants with MMSE score of 0 — 24 or a MoCA score of 0 — 25 were considered having PCI. Upon admission, all patients were assessed using the National Institutes of Health Stroke Scale (NIHSS), Bartel Index, and Modified Rankine Scale (mRS). The method of constructing and analyzing logistic regression models was used to determine independent predictors of the preservation of PCI at discharge. The analysis was carried out using the MedCalc v. 19.1. \u0000Results. The baseline NIHSS score ranged from 0 to 39 (median 11, IQR 6 — 18). The majority (64.2 %) of the subjects were hospitalized within the first 30 days from the CS onset. The MMSE score on admission ranged from 0 to 30 (median 20, IQR 2 — 27), and in 179 (44.9 %) of the patients the initial score was 0 to 17 (severe PCI), whereas in 61 (15 3 %) of the participants it was 18 to 24 (moderately severe PCI) and only 159 (39.8 %) persons scored 25 to 30 (no PCI). The baseline MoCA score ranged from 0 to 30 (median 15, IQR 1 — 24), and 356 (89.2 %) patients were shown to have PCI (score 0 to 25). According to screening with MMSE at discharge, 125 (31.4 %) patients had severe PCI, and 67 (16.8 %) had moderately severe PCI. The MoCA assessment before discharge indicated PCI in 324 (81.2 %) patients. According to both MMSE and MoCA, the rate of PCI on admission was significantly higher than at discharge (p < 0.001). Among the 240 patients who had PCI according to MMSE score, 239 (99.6 %) had PCI according to the MoCA score. However, among 159 patients who screened negative for PCI with MMSE at admission, 117 (73.6 %) screened positive with MoCA. Screening results using both MMSE and MoCA were not significantly associated with affected hemisphere. ICH was associated with lower (p < 0.0001) MMSE and MoCA scores compared with IS. Predictors of PCI according to MMSE score at discharge were a longer time interval from CS onset to SC admission, and a lower baseline MMSE score. However, with MoCA, the predictors were AT subtype IS, lesions in the distribution of the right or both middle cerebral arteries, older patient age, and a lower baseline MoCA score. \u0000Conclusions. In pa","PeriodicalId":296251,"journal":{"name":"Ukrainian Neurological Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129722552","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}

{"title":"Corelation of gait parameters, cognitive impairment and brain atrophy in patients with Parkinson’s disease and the «normally aging population»","authors":"P. Diachenko, I. Leta, G. Moskovko","doi":"10.30978/unj2021-3-54","DOIUrl":"https://doi.org/10.30978/unj2021-3-54","url":null,"abstract":"Objective — to identify the most significant markers of gait that indicate a decrease in cognitive function based on investigation of the corelation of cognitive impairment, gait parameters and atrophy of brain structures in groups of patients with Parkinson’s disease and the «normally aging population». \u0000Methods and subjects. 66 subjects were examined: 30 patients with Parkinson’s disease (mean age 54.9 ± 5.9, 50 % men) and 33 without neurological pathology (mean age 52.7 ± 7.6, 66 % men). All of them underwent neurological examination, assessment of temporal and spatial gait parameters using the GaitRite system, grading of brain atrophy using a comprehensive visual rating scale of MRI scans and assessment of cognitive status using the Montreal Cognitive Assessment Scale. \u0000Results. Cognitive performance was significantly lower in the subgroup of patients with Parkinson’s disease compared to the subgroup of «normally aging population». The gait profile of patients with Parkinson’s disease significantly differed from the gait profile of individuals from the «normal aging» subgroup by slower gait velocity, shorter step length and stride length for both limbs. The gait parameters, which showed a strong correlation with cognitive tests, differed in the subgroups, but gait velocity, stride length and step length for both extremities were common among them. These common gait parameters showed a strong direct correlation with brain atrophy in the subgroup of patients with Parkinson’s disease, but only velocity correlated with atrophy in the subgroup of «normal aging» among all of them. It was determined by the method of multiple regression analysis that it was precisely the atrophy of the brain that turned out to be the most influential factor in the decrease in cognitive function in the general group and subgroups. \u0000Conclusions. The gait profile in Parkinson’s disease subgroup is characterized by lower velocity, shorter step length, stride length for both limbs and significantly differs from the subgroup of «normal aging». These changes are a consequence of the influence of the disease on the motor sphere. Velocity showed a strong correlation in both subgroups not only with cognitive abilities, but also with cerebral atrophy. This confirms the hypothesis about the possibility of using gait velocity as a universal sensitive marker for current and longitudinal assessment of cognitive function, especially in clinical practice. \u0000 ","PeriodicalId":296251,"journal":{"name":"Ukrainian Neurological Journal","volume":"47 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113975837","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}

{"title":"Professor M. M. Lapinskyi and students","authors":"Т. А. Dovbonos","doi":"10.30978/unj2021-3-5","DOIUrl":"https://doi.org/10.30978/unj2021-3-5","url":null,"abstract":"","PeriodicalId":296251,"journal":{"name":"Ukrainian Neurological Journal","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133695404","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}

{"title":"Mechanisms of glycolysis and bioenergy state of cells at the stages of cardiosurgical interventions in patients with hypoxic — ischemic impairments of the brain","authors":"Dmytro Mankovsky","doi":"10.30978/unj2021-3-11","DOIUrl":"https://doi.org/10.30978/unj2021-3-11","url":null,"abstract":"Objective — to study the features of bioenergetic provision of oxidative homeostasis (OH) in patients with hypoxic‑ischemic brain lesions (HIBL) before and after cardiac surgery (CS) using artificial circulation (AC). \u0000Methods and subjects. Clinical and biochemical studies were performed in 38 patients, including 14 with ischemic stroke, 15 with encephalopathy, and 9 with severe cognitive dysfunction. \u0000Results. Analysis of metabolic indicators of glycolysis activity and energy homeostasis of cells before and after CS revealed the patterns of changes in the disorganization of glycolysis mechanisms, intensification of anaerobic mechanisms while limiting the energy supply of cells. The obtained data confirm the formation of specific postoperative metabolic provision of bioenergy in patients with CS, which should be considered as one of the triggers of HIBL and individualization of antioxidant cerebroprotection in the preoperative period, taking into account the state of bioenergetic metabolism of cells and the dominant mechanisms of glycolysis. \u0000Conclusions. Preoperative antioxidant cerebroprotection as a means of prevention of hypoxic‑ischemic brain lesions during cardiac surgery using artificial circulation should be based on the determination of bioenergetic and metabolic reserves, the depletion of which by antioxidant drugs suppression should not be considered, as activation of anaerobic glycolysis at simultaneous metabolic suppression of mitochondrial bioenergetics is a factor of formation or aggravation of ischemic lesions of brain. \u0000 ","PeriodicalId":296251,"journal":{"name":"Ukrainian Neurological Journal","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124434298","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}

{"title":"The role of «hunger hormone» in the regulation of eating behavior in patients with Parkinson’s disease","authors":"K. Tarianyk","doi":"10.30978/UNJ2021-1-2-25","DOIUrl":"https://doi.org/10.30978/UNJ2021-1-2-25","url":null,"abstract":"Objective — to evaluate the correlation between ghrelin levels, body mass index and the course of the disease in patients with Parkinson’s disease\u0000Methods and subjects. We examined 40 patients with Parkinson’s disease and 20 patients without signs of neurodegenerative disease (control group), who were examined and admitted to the neurological department. Patients were distributed into groups: 1 group — 20 patients with a disease duration of 12.1 ± 2.3 years, group 2 — 20 patients with a disease duration of 7.3 ± 1.6 years, group 3 — control, 20 patients without signs of morbidity. The diagnosis was made according to the criteria of the World Brain Bank of Great Britain. The severity of the disease was determined by the Hen and Yar scale. All patients, after signing the consent agreement, underwent a general clinical, neurological examination with assessment of anthropometric parameters: height, weight, body mass index. Also, patients underwent laboratory determination of serum ghrelin levels using the method of enzyme‑linked immunosorbent assay (ELISA) on the basis of the Research Institute of Genetic, Immunological Basis of Pathology and Pharmacogenetics of the Ukrainian Medical Dental Academy.\u0000Results. Studies indicate that in the group of patients with a longer course of the disease (group 1) there was an increase in BMI, which can be interpreted as obesity or overweight, compared with group 2 and control, where the rate was normal. In group 2, where the duration of the disease was shorter, there was a decrease in BMI, accompanied by weight loss of patients. In each group of examined patients there were patients with different forms of the disease, but in the second group patients with akinetic‑rigid form of the disease prevailed, so these patients in neurological status suffered more from stiffness, immobility. Normally, ghrelin level rises in the morning during hunger and decreases after eating. A similar picture was observed in the control group of patients, where the rate of morning ghrelin was elevated. When assessing fasting plasma ghrelin levels in groups of patients, there is a slight decrease in the indicator compared with the control group.\u0000Conclusions. There is a clear correlation between the duration of the disease, body mass index and hunger hormone levels in patients with Parkinson’s disease. In patients with the initial stages of the disease there is a decrease in body mass index, which is a prognostically unfavorable sign. Fluctuations in ghrelin levels may be associated with decreased energy intake due to gastrointestinal dysfunction, increased energy expenditure caused by motor manifestations of the disease, or increased glucose metabolism with the use of drugs and changes in the eating behavior of patients.\u0000 ","PeriodicalId":296251,"journal":{"name":"Ukrainian Neurological Journal","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124396142","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}

{"title":"Structure of cognitive disorders and predictors of their occurrence in patients after cardiac surgery","authors":"A. Belinsky, L. Rasputina, Y. Mostovoy, O. Mostova, T. D. Danilevich","doi":"10.30978/UNJ2021-1-2-30","DOIUrl":"https://doi.org/10.30978/UNJ2021-1-2-30","url":null,"abstract":"Objective — to determine the presence and severity of moderate cognitive disorders (CD) in patients before and after cardiac surgery in the early postoperative period \u0000Methods and subjects.  56 patients were examined, including 19 (33.9 %) men and 37 (66,1 %)  women  , mean age  60.86 ± 8.86. Cardiac surgery was performed for ischemic heart disease in 37 (66.1 %) patients, for valvular heart disease — in 19 (33.9 %, p = 0.02). Assessment of cognitive functions was performed before surgery, on the 3rd and 7th day of the postoperative period using the Montreal Cognitive Test. \u0000Results. Before surgery, most patients (75.0 %) had mild CRs, 5.4 % had moderate CRs (p <0.01), and 19.6 % had no CRs (p = 0.02). In general, the distribution by the severity of CR in the early postoperative period did not differ from that before surgery, but there were patients with severe CR (3.6 and 1.8 %, respectively, on the 3rd and 7th days, p = 0.05) ...In the structure of CD, on the 3rd day of the postoperative period, there was a significant decrease in visually constructive skills (4.07 versus 3.7; p < 0.001), a deterioration in the ability to consistently calculate (2.66 versus 2.45; p = 0.02), repetition phrases (1.16 versus 1.0; p = 0.02). On the 7th day of the postoperative period, there was a significant decrease in verbal speed (0.48 versus 0.32; p = 0.006) and an improvement in memory (1.79 versus 2.29; p = 0.01). Probable predictors of the onset of cognitive disorders in the early postoperative period are: a history of stroke — r = –0.282; p = 0.04. There was a correlation with the presence of atherosclerotic lesions of the coronary arteries according to coronary angiography (r = –0.259; p = 0.05), surgery performed under cardiopulmonary bypass (r = 0.29; p = 0.03), and a tendency towards statistical  significance of correlation with the presence of signs of dyslipidemia according to lipid profile data (r = –0.227; p = 0.09). \u0000 Conclusions. It was found that 75 % of patients had mild CR before surgery. The distribution according to the severity of CR in the early postoperative period differed from that before surgery by the appearance of patients with severe CR. In the CR structure, on the 3rd day of the postoperative period, a statistically significant decrease in visual‑constructive skills, a deterioration in the ability to consistently calculate and repeat a phrase were observed. On the 7th day, a statistically significant decrease in verbal speed and an improvement in memory were noted. Probable predictors of CR in the early postoperative period are a history of acute cerebrovascular accident, atherosclerotic lesion of the coronary arteries according to coronary angiography, surgery performed under cardiopulmonary bypass, the presence of signs of dyslipidemia according to lipid profile data. \u0000 ","PeriodicalId":296251,"journal":{"name":"Ukrainian Neurological Journal","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121594644","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}

{"title":"Guillain – Barré syndrome associated with SARS-CoV-2 infection","authors":"E. Tsoma","doi":"10.30978/UNJ2021-1-2-38","DOIUrl":"https://doi.org/10.30978/UNJ2021-1-2-38","url":null,"abstract":"Neurological manifestations of COVID‑19 infection are caused by its effects on CNS (headache, dizziness, disturbance of consciousness, convulsions, etc.) and PNS (anosmia, ageusia, visual impairment, radiculo‑ and neuropathy). Guillain – Barré syndrome (GBS) is a rare autoimmune disease associated with damage to the peripheral nervous system. 40 — 70 % of cases are associated with a previous infection: cytomegalovirus, Epstein–Barr virus, Haemophilus influenzae type b, Mycoplasma pneumoniae, Campylobacter jejuni etc. The clinical characteristics of this condition are progressive muscle weakness, reduction or loss of tendon reflexes (hyporeflexia and areflexia), paresthesias, paresis of the cranial nerves. The diagnosis is based on clinical data, cerebrospinal fluid analysis (protein level, cytosis, antigangliosid antibodies), as well as electroneuromyography. Most patients with Guillain – Barré syndrome totally recover. However, the most dangerous and severe complication of acute inflammatory demyelinating polyneuropathy is paralysis of the respiratory muscles. About a quarter of patients require urgent treatment at intensive care unit with mechanical ventilation and/or tracheostomy. Mortality in Guillain – Barré syndrome can reach to 10 %. There have been several reports of COVID‑19‑related GBS in the world scientific medical literature during the last year, but more information about this association and its implications is still missing. The aim of this report was to analyze the available information about cases of Guillain – Barré syndrome associated with COVID‑19 infection, to compare different variants of this condition and to share our own experience in clinical management of such patient.","PeriodicalId":296251,"journal":{"name":"Ukrainian Neurological Journal","volume":"259 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115666891","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}

{"title":"Мyasthenia gravis complicated by comorbid pathology","authors":"M. Marchuk","doi":"10.30978/UNJ2021-1-2-49","DOIUrl":"https://doi.org/10.30978/UNJ2021-1-2-49","url":null,"abstract":"Acquired myasthenia gravis is a rare pathology of the spectrum of neuromuscular disorders and is characterized by the production of autoantibodies to various components of the neuromuscular synapse. The clinical picture is based on typical symptoms: dynamic ptosis, oculomotor dysfunction, diplopia, masticatory muscle weakness, pathological muscle fatigue, in case of dominance of oropharyngeal muscle weakness, patients complain of dysphagia, dysarthria, dyspnea resulting from insolvency.. This variant of the disease is the most dangerous, as it is characterized by a high risk of myasthenic crisis. In addition, the course of myasthenia gravis may be complicated by the development of comorbid pathology, which can be classified into four main groups. These include causal conditions in the development of diseases with a single mechanism of development for myasthenia gravis, such as cross‑autoimmune damage to the heart muscle. The group of complications of myasthenia includes myasthenic, cholinergic and mixed crises. Unrelated diseases are competitive, so in the elderly, myasthenia gravis is accompanied by a wide range of chronic diseases, such as hypertension, diabetes and others. The last group that should be targeted is intercurrent diseases — acute pathologies that develop against the background of myasthenia. Infectious diseases involving the most vulnerable respiratory system are potentially dangerous in the latter group. Knowledge of these potential factors of decompensation of myasthenia gravis will predict the development and timely diagnose the pathology. Timely treatment in a life‑threatening condition can be critical, since myasthenia gravis differs significantly from other diseases of the neuromuscular system in the rate of critical decompensation and the difficulty of normalizing the patient’s severe condition.","PeriodicalId":296251,"journal":{"name":"Ukrainian Neurological Journal","volume":"44 8","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132707987","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}