Paraneoplastic neurological syndrome: focus on the involvement of the peripheral nervous system

The information about epidemiology, pathogenesis and clinical heterogeneity of paraneoplastic neurological syndrome is summarized and based on Russian and foreign literature. The main attention is devoted to the affection of peripheral nervous systems in patients with oncological diseases. We report the information about anti-neuronal antibodies associated with paraneoplastic syndrome. The diagnostic criteria of paraneoplastic neurological syndromes are presented.</p

The role of neuroimaging in the treatment strategy for epilepsy

&lt;p&gt;&lt;em&gt;Objective&lt;/em&gt;: estimate advantages of using high feld brain MRI in the epilepsy diagnostics. &lt;em&gt;Methods. &lt;/em&gt;Examination of 586 patients with different types of epilepsy was performed to fnd epileptogenic changes in brain substance. &lt;em&gt;Results. &lt;/em&gt;Clinical examples, that illustrate importance of using high feld MRI (1.5 T and more) during examination of the patients with epilepsy in accordance with the International League Against Epilepsy (ILAE) guidelines, are described. &lt;em&gt;Conclusion. &lt;/em&gt;High feld MRI is necessary for timely assessment of the etiology of the disease and the treatment optimization.&lt;/p&gt

"Benign" multiple sclerosis: a variant of favorable disease course and the result of effective treatment

The article provides an overview of data on isolated demyelination syndromes that may precede multiple sclerosis, and on the peculiarities of the so-called "benign" form of multiple sclerosis. Clinical and anamnestic criteria for establishing the fact of a "benign" form of multiple sclerosis are presented, as well as trends in the number of these patients in the general population of patients with multiple sclerosis, including in connection with the improvement of treatment methods for this disease.</p

Konstantin Nikolaevitch Tretiakoff: some of the biography pages (the 125th anniversary of the birth)

Konstantin Tretiakov is one of the founders of Neurological science schools in Sao Paulo (Brazil) and in Saratov. Carrying out the analysis of the materials of the State archive of Saratov, the Russian State Library, the Russian National Library, the library of Saratov Medical University, Internet resources. The information about the K.N. Tretiakov's life, career and scientific work Tretiakov is presented.</p

Public knowledge of risk factors, signs and treatment of stroke: Analysis of the survey results in 2014 and 2017

Aim. This study was conducted to establish levels of knowledge in the general population, and also to determine the impact of educational sessions on stroke knowledge. Material and Methods. Two groups (2014 and 2017 years) completed a stroke knowledge questionnaire (435 respondents). Results. Overall, most of respondents could list 2 or more risk factors, but only 50% in 2014 could list 3 warning signs. More than 80% would call emergency number in response to stroke, but only 25% had heard of thrombolytic therapy. Overall stroke knowledge scores decreased in 2017 despite the public awareness in the media. Conclusion. Currently the knowledge of stroke risk factors, warning signs, and treatment is poor in Saratov. Our study demonstrates that more educational campaigns should be conducted for improve knowledge of stroke symptoms, and therapy.</p

Possibilities of magnetic resonance tomography in identification and diagnostics of neurosyphilis forms

Aim: To evaluate the possibilities of the magnetic resonance tomography (MRT) in diagnostics and identification of neurosyphilis. Materials and methods: A total of 1387 patients with different forms of documented neurosyphilis were examined to study the deficiency of neurological function. The diagnosis of neurosyphilis was confirmed by CSF-study. MRT was performed in 57 cases. Results: Magnetic resonance tomography (MRT) in 6 patients showed no pathology, 16 patients had arachnoid cystic changes and in 16 cases hydrocephaly occurred. Cerebral cortical atrophy was presented in 13 patients, in 12 cases — multifocal changes were visualized, 12 patients had white matter structural changes. Two cases required diagnostics. A 59-year-old man was hospitalized with epileptic seizure, progressive dementia and multifocal neurologic symptoms. A 40-year-old man was examined with recurring episodes of acute cere-brospinal accident and progressing cognitive disorders. Conclusion: MRT could be used in differential diagnostics of neurosyphilis imitating space-occupying lesions of cerebrum and spinal cord, tumors of central nervous system and could help to define the form of neurosyphili

VISUAL DISTURBANCES IN PATIENTS WITH LATENT SYPHILIS

&lt;p&gt;&lt;em&gt;Цель&lt;/em&gt;: определить характер зрительных нарушений у больных латентным сифилисом, оценить возможности исследования зрительных вызванных потенциалов (ЗВП), оптической когерентной томографии (ОКТ) и лазерной конфокальной томографии (ЛКТ) в диагностике и уточнении формы нейросифилиса. &lt;em&gt;Материал&lt;/em&gt; &lt;em&gt;и&lt;/em&gt; &lt;em&gt;методы&lt;/em&gt;&lt;em&gt;. &lt;/em&gt;Обследованы 133 больных скрытым сифилисом на предмет выявления признаков поражения нервной системы и органа зрения. &lt;em&gt;Результаты&lt;/em&gt;&lt;em&gt;. &lt;/em&gt;Рутинное офтальмологическое обследование позволяет обнаружить нарушения зрения у 48 % больных латентным сифилисом. При нейросифилисе наиболее часто встречается ангиопатия сетчатки и первичная атрофия дисков зрительных нервов. Исследование ЗВП, использование ОКТ и ЛКТ позволяют выявлять признаки поражения органа зрения в 66 – 79 % случаев латентного сифилиса, нередко — до появления симптомов и признаков заболевания. &lt;em&gt;Заключение&lt;/em&gt;&lt;em&gt;. &lt;/em&gt;Офтальмологическое обследование должно быть обязательным не только при установленном диагнозе «нейросифилис», но и во всех случаях латентного сифилиса.&lt;/p&gt

Neuroinfection in patient with HIV: case report

Toxoplasmosis is one of the most common opportunistic infections in HIV-positive patients. The onset of HIV-infection with cerebral toxoplasmosis makes this disease a multidisciplinary problem and requires the participation of doctors of various specialties (infectious disease specialists, neurologists, neurosurgeons, general practitioners, etc.). Early diagnosis and treatment of this disease will reduce the risk of deaths and severe consequences. We carry out an analysis of the clinical case of toxoplasma encephalitis in a HIV-infected patient. We have identified errors in the establishing diagnosis. We have given a detailed account a patient management plan. We also comment on some of the problem early disease detection HIV-infection.</p

Expert quality evaluation of out-patient medical care for patients with cerebral infarction in the early recovery period

The purpose of the research is to work out the measures of an improvement of the out-patient rehabilitation of patients with cerebral infarction in the early recovery period. Materials and Methods. Method of the expert evaluation was used for collecting data (29 questionnaires); analysis of variance, Kolmogorov-Smirnovtest, Kendall coefficient of concordance, Kemeni median were applied for processing data. Results. According to the expert opinion it is necessary to increase the role of polyclinics in a process of the rehabilitation of patients with cerebral infarction and to improve the quality of out-patient medical care in cases of this disease. Experts consider that insufficient technical provision and lack of personnel in the system of primary health care foremost lower quality of medical care. Absence of an equipment and staff shortage lead to imperfection of the rehabilitation process and poor results of recovery after cerebral infarction. Conclusion. The improvement of out-patient medical care in the early recovery period of cerebral infarction is possible through the integral impact on all components of the quality: structure (upgrade of equipment and staff provision), process (increase of length and frequency of patients' visits) and result (adoption of efficiency criteria of cerebral infarction treatment)