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 2019
Review[Evaluation of serum neurofilament light chains levels for diagnosis, treatment monitoring and prognosis in multiple sclerosis].
Pathophysiological processes in multiple sclerosis frequently not diagnosed by clinicians become available for analysis only on the basis of paraclinical data (biomarkers). Nowadays neurofilament light chain can be defined as a promising biomarker for multiple sclerosis (MS). Neurofilaments are a structural part of normal neuronal processes consisting of light, intermediate and heavy chains. ⋯ Cutting-edge highly sensitive methods make it possible to detect neurofilament light chains not only in the cerebrospinal fluid but also in the blood serum thus opening the opportunities to utilize them in routine diagnosis in clinical practice. This review comprises existing data on the possible opportunities for research of serum neurofilament light chains in terms of exacerbations, effectiveness of basic therapy, assessment of individual disability, the atrophy of central nervous system structures. Also, there is some information on comparison of two methods: routine MRI of the brain with the contrast agents and detection of serum neurofilament light chains.
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Zh Nevrol Psikhiatr · Jan 2019
[Neurostimulation of the supraorbital nerve with the Cefaly device - a new method for the treatment of migraine].
Treatment of migraine mainly includes pharmacological approaches aimed at breaking migraine attacks and preventive treatment to reduce their frequency. Despite the wide range of pharmacological agents, frequent side effects and pharmacotherapy resistance in patients with migraine determine the urgency of finding new alternative treatment strategies. ⋯ Stimulation of the supraorbital nerve with the percutaneous Cefaly device ('Cefaly Technology sprl', Seraing, Belgium) in clinical randomized, controlled studies has demonstrated efficacy in significantly reducing both the frequency of migraine attacks and the total number of days with headache. Cefaly is the first FDA approved migraine prevention medical device.