Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova最新文献

{"title":"[Repeated ischemic strokes due to infectious arteritis of both internal carotid and basilar arteries as a complication of sphenoiditis and otitis].","authors":"L A Kalashnikova, A S Filatov, Yu I Akhmetshina","doi":"10.17116/jnevro202412408231","DOIUrl":"10.17116/jnevro202412408231","url":null,"abstract":"<p><p>The article presents a case of a 54-year-old female patient who, over the course of 2 years, suffered 5 cerebrovascular accidents (CVA) due to infectious arteritis of both internal carotid arteries (ICA) and basilar artery as a complication of sphenoiditis and otitis. According to neuroimaging data, the steno-occlusive process in the ICA developed gradually, starting with the intracranial ICA narrowing with the contrast enhancement by vessel wall, the development of its occlusion six months later, and the detection of the extracranial ICA occlusion with the formation of «flame sign» at its mouth a year later. Repeated examination of the cerebrospinal liquid at an early stage of the disease revealed cytosis up to 367/3 and protein 0.66 g/l. The correct diagnosis was established only after 3 years with a retrospective analysis of clinical, neuroimaging, and laboratory data. Therefore, targeted antibiotic therapy was not carried out, which led to the progression of ICA occlusion and repeated strokes. Infectious arteritis should be taken into account in the differential diagnosis of the causes of the ICA occlusive process.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"124 8. Vyp. 2","pages":"31-37"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019765","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":"[Chronic epidural spinal cord stimulation for gait impairments in Parkinson's disease and atypical parkinsonism].","authors":"V V Kovalev, E V Bril, M S Semenov, L T Lepsveridze, Yu A Seliverstov, N A Suponeva, E A Povalyaeva","doi":"10.17116/jnevro2024124111100","DOIUrl":"https://doi.org/10.17116/jnevro2024124111100","url":null,"abstract":"<p><p>Spinal cord stimulation is a well-established, minimally invasive surgical technique that has been effectively utilized for the treatment of chronic pain syndromes. In the past 15 years, there has been a significant increase in reports on the use of spinal stimulation for patients with advanced Parkinson's disease (PD), as well as in isolated cases of atypical parkinsonism. These reports frequently highlight a positive impact of spinal stimulation on gait impairments. A hallmark symptom of advanced PD, as well as several phenotypes of progressive supranuclear palsy, is the freezing of gait phenomenon. This condition, akin to postural instability, is likely linked to disruptions in multimodal integration across various levels of locomotor control. Given its poor responsiveness to dopaminergic therapy, freezing of gait remains one of the most debilitating symptoms in parkinsonism. This review consolidates current knowledge on the use of chronic epidural spinal cord stimulation in patients with PD and atypical parkinsonism, with a focus on its potential to alleviate locomotor disorders, particularly freezing of gait.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"124 11","pages":"100-112"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848076","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":"[Clinical presentation and diagnosis of Parkinson's disease in patients with schizophrenia spectrum disorders].","authors":"M R Khommyatov, I G Smolentseva, S A Golubev, A V Goryunov, M A Samushiya","doi":"10.17116/jnevro202412411173","DOIUrl":"https://doi.org/10.17116/jnevro202412411173","url":null,"abstract":"<p><strong>Objective: </strong>To study the features of the clinical picture and diagnosis of Parkinson's disease (PD) in patients with schizophrenia spectrum disorders (SSD).</p><p><strong>Material and methods: </strong>The analysis of databases of four psychoneurological dispensaries in Moscow with the allocation of groups of patients with diagnoses of SSD (F20-F25 according to ICD-10) was carried out. Among these groups, a targeted search for patients with an established diagnosis of PD (G20) was conducted. Among this category of patients, the incidence of PD, the therapy taken, the premotor symptoms of PD and the parameters characterizing the features of the clinical picture and diagnosis of PD were analyzed.</p><p><strong>Results: </strong>A total of 9124 patients with SSD were identified, among them 11 people diagnosed with PD, while the final incidence of PD was 0.1% (95% CI 0-0.2%). The average age at onset of SSD and PD was 33.18±8.72 years and 58.9±8.1 years, respectively. The average time between the appearance of the first signs of PD and the final diagnosis was 5.09±1.92 years. The most commonly used antipsychotic in the group of patients with PD was quetiapine (54.5%); clozapine and some typical antipsychotics were used less frequently. The most common premotor symptoms were apathy, depression, anxiety, constipation and orthostatic hypotension. Hyposmia and behavioral disorders in the REM sleep phase were less common.</p><p><strong>Conclusion: </strong>The results confirm the difficulty of managing patients with comorbidity of PD and SSD. Psychiatrists should pay close attention to the features of motor symptoms in patients with SSD and carefully identify clinical signs that may indicate the presence of PD or other neurodegenerative diseases with parkinsonism.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"124 11","pages":"73-80"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848225","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":"[Thrombosed aneurysm of the internal carotid artery, complicated by the development of ischemic stroke followed by subarachnoid hemorrhage].","authors":"P G Shnyakin, A V Botov, P G Rudenko, A O Gavrilova","doi":"10.17116/jnevro2024124091135","DOIUrl":"10.17116/jnevro2024124091135","url":null,"abstract":"<p><p>Thrombosed cerebral aneurysms can cause embolism of the distal cerebral arteries and manifest as the development of ischemic stroke or transient ischemic attack. As a rule, thromboembolic complications develop with giant and large aneurysms, but they are also possible with sizes less than 1 cm. In case of such complications, according to the standards of treatment of ischemic stroke, antithrombotic therapy is necessary, which is associated with the risk of rupture of the aneurysm. The article presents our own clinical observation of the development of ischemic stroke against the background of an embolism from the sac of a thrombosed aneurysm of the internal carotid artery in a young patient, which was later complicated by aneurysm rupture and subarachnoid hemorrhage, which required urgent surgical intervention.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"124 9","pages":"135-140"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482058","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":"[Breathing disorders during sleep in patients with dystrophic myotonia].","authors":"Yu N Rushkevich, E V Malgina, S A Likhachev","doi":"10.17116/jnevro2024124121137","DOIUrl":"https://doi.org/10.17116/jnevro2024124121137","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the results of nocturnal breathing parameters during sleep based on nocturnal pulse oximetry and to study of characteristics of external respiration in genetically confirmed patients with dystrophic myotonia (DM).</p><p><strong>Material and methods: </strong>The subjects of the study were patients with genetically confirmed DM types 1 and 2 who were hospitalized in the neurological departments of the Republican Scientific and Practical Center for Neurology and Neurosurgery. The clinical picture of the disease, comorbidities, sleep questionnaires, laboratory tests, overnight pulse oximetry and spirometry were performed and analyzed.</p><p><strong>Results: </strong>There was a significant decrease in the main parameters of the spirogram, which reflect disturbances in the function of external respiration of a restrictive type, due to a decrease in the efforts of the respiratory muscles. A study of the respiratory parameters of the polysomnogram revealed a decrease in the average total level of blood oxygen saturation (SpO₂) and SpO₂ during the period of night sleep, minimum SpO₂, apnea/hypopnea index and desaturation index, which indicates a decrease in blood oxygen saturation during sleep and a predisposition to obstructive sleep apnea (OSA).</p><p><strong>Conclusion: </strong>The results reflect the presence of frequent breathing disorders during sleep and external respiration parameters in DM patients. The identified changes are due to weakness of the respiratory muscles, as well as the muscles of the oropharyngeal zone, which is confirmed by the high probability of OSA according to the Berlin Questionnaire and a decrease in respiratory function parameters. Breathing disorders during night sleep in DM require timely diagnosis, monitoring of symptoms and, if necessary, their treatment due to the significance of their impact on the quality of life in DM patients.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"124 12","pages":"137-141"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900591","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 effectiveness of drug therapy in the rehabilitation of patients with post-stroke aphasia].","authors":"S V Kotov, E V Isakova, M M Shcherbakova, V A Zenina","doi":"10.17116/jnevro2024124111132","DOIUrl":"10.17116/jnevro2024124111132","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of the restoration of aphasic disorders in patients in the early recovery period of ischemic stroke (IS) who received complex therapy, which included speech therapy and injections of the drug Cellex.</p><p><strong>Material and methods: </strong>The study included 62 right-handed patients with aphasia hospitalized in the acute period of IS in Ramenskoye Hospital, who subsequently underwent the second stage of rehabilitation in the neurological department of the Moscow regional clinical institute <i>n</i>.a. M.F. Vladimirskiy. Patients received rehabilitation treatment at both stages, including speech therapy sessions, and were randomized into two groups. Group 1 - 32 patients, whose treatment complex included two courses of injections of Cellex in the acute and recovery period (main group), patients of group 2 (<i>n</i>=30) received basic and therapy for secondary prevention of IS. To assess the condition of patients, the stroke scale of the National Institutes of Health of the United States (NIHSS), a modified Rankin scale, a screening method for patients with aphasia, and the Goodglass-Kaplan scale (GKS) were used.</p><p><strong>Results: </strong>There was a statistically significant improvement in the neurological status in patients of both groups in both the acute and early recovery periods, and the shifts in patients of group 1 in both periods of IS were higher. After the course of treatment, a statistically significant regression of aphasia was noted: in patients of group 1, the score increased from 1 [0.75, 2] to 4 [3, 4] points, whereas in patients of group 2 - from [0, 1.75] to 3 [2, 3.75] points (<i>p<</i>0.001 between groups). Communication skills in group 1 patients increased from 0.5 [0, 1] to 4 [2, 4] points, while in group 2 patients - from 1 [0, 2] to 3 [1, 3] points (<i>p<</i>0.001 between groups).</p><p><strong>Conclusion: </strong>As a result of the study, data were obtained indicating that drug support for rehabilitation measures with Cellex, carried out in the form of two consecutive courses in the acute and early recovery periods of IS, significantly increased the effectiveness of speech therapy and accelerated the consolidation of the speech network of the brain, obviously because of activation of neuroplasticity processes.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"124 11","pages":"132-139"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848516","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":"[Melatonergic antidepressant agomelatine: augmentation of antipsychotic drugs in treatment of post-schizophrenic depression].","authors":"S V Ivanov","doi":"10.17116/jnevro20241240815","DOIUrl":"https://doi.org/10.17116/jnevro20241240815","url":null,"abstract":"<p><p>The article presents an analytical review of the data on the effectiveness of agomelatine as an augmentation of antipsychotics in the treatment of post-schizophrenic depression (PSD). The results of 5 published studies with a total sample size of 137 patients, the duration of therapy from 28 to 180 days with the appointment of agomelatin in combination with antipsychotics, including cases of additional use of drugs of other classes (normotimics, antidepressants, anxiolytics, anticholinergic correctors) were used. As a result, a pronounced effect was established in the indicators of respondents and patients in remission, combined with a favorable tolerability and safety profile, determining the prospects for the use of agomelatin in the therapy of PSD. Certain limitations in the methodology, including open and uncontrolled research design and small sample sizes, determine the relevance of systematic controlled trials to confirm the results obtained.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"124 8","pages":"5-12"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302073","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":"[Indicators of cognitive impairment of varying severity in the acute period of ischemic stroke].","authors":"A M Tynterova, E R Barantsevich","doi":"10.17116/jnevro202412408214","DOIUrl":"https://doi.org/10.17116/jnevro202412408214","url":null,"abstract":"<p><strong>Objective: </strong>To assess phenotype and identify biomarkers of cognitive impairment (CI) of varying severity in patients in the acute period of ischemic stroke (IS) based on the analysis of clinical and paraclinical indicators.</p><p><strong>Material and methods: </strong>Two hundred and forty patients with diagnosed IS and presence of CI were examined. Depending on the scores on the Montreal Cognitive Assessment Scale, patients were divided into two groups: group 1 (<i>n</i>=182) with mild CI, group 2 (<i>n</i>=58) with dementia. On admission, stroke severity according to the National Institutes of Health Stroke Scale (NIHSS), activities of daily living assessed by the Barthel Scale and patient independence assessed by the modified Rankin Scale (mRS) were determined. Neuropsychological examination was performed on day 14 and included investigation of episodic memory, executive functions, speech, gnosis, praxis, and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) parameters. Immunological diagnostics included a study of the concentration of cytokines of various groups (interleukin (IL)-1b, IL-6, IL-16, granulocyte-macrophage colony-stimulating factor (GM-CSF), chemokines CXCL10, CXCL11, CXCL9, tumor necrosis factor α (TNFα)). Neuroimaging parameters were assessed using brain MRI data with verification of the STRIVE criteria and the medial temporal lobe atrophy scale (MTA). The standard application software package SPSS Statistics, Pandas and SciPy libraries were used for statistical analysis.</p><p><strong>Results: </strong>Patients of group 2 had lower scores in all cognitive domains with the greatest reduction in perception, constructive praxis, semantic information processing and mnestic function. These analyses revealed a higher degree of IQCODE, prevalence of features corresponding to STRIVE/MTA criteria in patients of group 2, while patients of group 1 had higher NIHSS and mRS scores. When serum concentrations of cytokines were assessed, patients of group 1 showed higher concentrations of IL-1b, IL-6, GM-CSF and TNFα, while group 2 patients had higher concentrations of cytokine CXCL10.</p><p><strong>Conclusion: </strong>The presence of pre-stroke CI, baseline indicators of the patient's functional status, neuroimaging parameters of MTA/STRIVE and age are reflected in the structure and severity of cognitive deficit in the acute period of IS. Investigation of the role of interleukins, GM-CSF, TNFα and CXCL10 in the pathogenesis of IS and their association with the progression of post-stroke CI requires further studies with a larger sample size and longer follow-up period.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"124 8. Vyp. 2","pages":"14-20"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019761","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":"[Experience of using eculizumab in refractory myasthenia gravis].","authors":"S B Stepanova, M I Karpova, A F Vasilenko, M A Domashenko","doi":"10.17116/jnevro202412407285","DOIUrl":"10.17116/jnevro202412407285","url":null,"abstract":"<p><p>Myasthenia gravis (MG) is a chronic autoimmune disease mediated by autoreactive T- and B-cells and manifested by progressive pathological muscle weakness and fatigue. Traditional immunomodulatory treatment does not always lead to the clinical picture significant improvement, despite adequate dosage and duration of use. Refractory myasthenia gravis requires new therapeutic approaches development and implementation. The range of target innovative agents in refractory MG includes monoclonal antibodies, which act directly on individual components of the complement system. Based on the results of randomized controlled trials, data on the effectiveness and safety of eculizumab, which inhibits the C5 component of the complement system, is presented. We present our own clinical experience of using eculizumab in a young woman with refractory generalized AChR-positive MG with a rapid decrease in the severity of symptoms to a minimum level and restoration of ability to work, and the absence of adverse events during therapy.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"124 7. Vyp. 2","pages":"85-90"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037864","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":"[Mistakes in the diagnosis of neuromyelitis optic spectrum diseases lead to wrong therapy and deterioration of patients' condition].","authors":"O V Boyko, M A Omarova, V V Gosteva, A A Kuznetsov, A N Boyko","doi":"10.17116/jnevro202412407296","DOIUrl":"10.17116/jnevro202412407296","url":null,"abstract":"<p><p>Neuromyelitis optic spectrum diseases (NMOSD) are a group of rare neuroimmunological diseases involving mainly the optic nerves and spinal cord, to a lesser extent the brain, and causing severe exacerbations that lead to persistent disability of patients. For many years, opticoneuromyelitis was considered a prognostically unfavorable variant of the course of multiple sclerosis (MS), however, in 2004, specific autoantibodies to aquaporin-4 were found in such patients, which made it possible to isolate NMOSD into a separate group of demyelinating diseases other than MS. Due to similar clinical signs and the predominantly remitting course of diseases, it is often difficult to make a correct diagnosis and, accordingly, prescribe effective therapy, which often leads to incorrectly selected therapy with incorrect diagnosis. In some cases, this leads to a worsening of the course of NMOSD. We present a case of late diagnosis of NMOSD that confirms the development of exacerbation in the patient 2 months after the first course of therapy with alemtuzumab prescribed as a highly effective therapy for highly active remitting MS. Timely diagnosis of NMOSD makes it possible to exclude such cases.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"124 7. Vyp. 2","pages":"96-100"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037865","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}