Zh Nevrol Psikhiatr
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Zh Nevrol Psikhiatr · Jan 2020
[Actual issues of serum aquaporin-4 autoantibodies evaluation in the diagnostics of neuromyelitis optica spectrum disorders].
To analyze the usage and timeliness of aquaporin-4 antibodies (AQP4-IgG) serology test in the diagnostics of neuromyelitis optica spectrum disorders (NMOSD) in routine clinical practice. ⋯ A comparison of the time from HS attack to the AQP4-IgG test administration (T1, years), from HS attack to NMOSD diagnosis (T2, years) was undertaken as well as the number of attacks during these periods (N1, N2) were counted in three groups of patients. Group 1 - with the first HS attack before or in 2008 (n=6), group 2 - from 2009 to 2013 (n=12), group 3 - from 2014 to 2018 (n=9) accordingly. A statistically significant decrease in T1, T2, N1, N2 was found in successive time intervals of 5 years (p<0.05). In 8 of 27 (28.6%) patients the first attack of NMOSD was presented with non-specific symptoms (NS attack). In 7 patients (77.8%) of 9 misdiagnosed as multiple sclerosis (MS) an increase in attack frequency was found while on disease modifying therapies (DMTs) and increase in attack severity was found in 8 (88.9%). In all 9 cases the diagnosis was revised to NMOSD after AQP4-IgG test was performed with positive result. The time interval from disease course worsening while on DMTs until the test was 7 [4; 37] months, and the number of relapses - 2 [0; 3]. In 4 of 27 patients with suspected NMOSD, the repeated AQP4-IgG test only was positive for increased antibodies titer. The time interval between first test negative and retest administered was 20 [6.1; 47.8] months. In 3 of 4 patients (75%) one or more attacks occurred during this time period. In 4 patients the presence of AQP4-IgG in the first analysis was not followed by the diagnosis of NMOSD. In recent years, apropos AQP4-IgG test administration improved, but the problem remains with the timeliness for retest with first result negative. It is advisable to expand the indications for its use. The timeliness for serum AQP4-IgG retest in cases of unexplained deterioration in the course of proposed MS on DMTs and the lack of awareness of the test diagnostic value are still relevant.
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Zh Nevrol Psikhiatr · Jan 2020
[Mechanisms of changes in the spinal segmental level in patients with post-traumatic cervical myelopathy].
To study the neurophysiological mechanisms of motor deficit in patients with post-traumatic cervical myelopathy. ⋯ The main neurophysiological mechanisms of motor deficit in patients with post-traumatic cervical myelopathy are the combination of the primary neuronal damage at the level of spinal cord injury and the development of secondary axonal neuropathy more caudally at the first three years after spinal cord injury.
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Zh Nevrol Psikhiatr · Jan 2020
[General and primary incidence of mental disorders and their structure in people referred for support to the medical facilities of internal affairs organizations].
To analyze the structure of the incidence of mental disorders of persons attached to medical support to the medical units of the Ministry of Internal Affairs of Russia (MCH MIA) for the period 2013-2018. ⋯ The majority of mental disorders are neurotic, stress-related and somatoform disorders, which, with timely diagnosis and comprehensive treatment, can be fully treated.
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Zh Nevrol Psikhiatr · Jan 2020
Biography Historical Article[P.E. Flechsig's contribution to a Russian-German scientific exchange in the fields of neuropathology and psychiatry].
The University of Leipzig has played an important role in the Russian-German scientific exchange in the fields of psychiatry and neurology in the 19th century. An outstanding but almost forgotten protagonist of that exchange was the psychiatrist and neurologist Paul Flechsig, who enjoyed worldwide recognition for his neuroanatomical works. Famous Russian neurologists and psychiatrists as Vladimir Bekhterev, Liverij Osipovich Darkshevich, Vladimir Chizh not only learned from Flechsig's experience, but also undertook independent research, which gave them impulses for furthering their carriers in Russia.