MOTOR CHRONIC INFLAMMATORY DEMYELINATING POLYNEUROPATHY IN A CHILD.

Motor chronic inflammatory demyelinating polyneuropathy (M-CIDP) is a form of atypical CIDP. This article presents a clinical observation of M-CIDP in a 15-year-old boy, as well as a description of laboratory and instrumental diagnostic data. The boy had a chronic development (> 2 months) of flaccid tetraparesis, predominantly of the proximal muscles of the limbs, without sensory disorders. According to electroneuromyography, there were signs of demyelinating lesions of the proximal parts of the peripheral nerves. There was an increase in the thickness of the nerves of the upper limbs according to ultrasound. In the liquor protein-cell dissociation, as well as in the blood, IgG antibodies to the surface glycoprotein S of the SARS-CoV-2 coronavirus were found. The clinical and neurophysiological picture corresponded to the reliable criteria for CIDP. The therapy with intravenous immunoglobulins had a significant positive effect in the form of an increase in the strength of the limb muscles.Copyright © Russian Neurological Journal. All rights reserved.

MOTOR CHRONIC INFLAMMATORY DEMYELINATING POLYNEUROPATHY IN A CHILD.

Motor chronic inflammatory demyelinating polyneuropathy (M-CIDP) is a form of atypical CIDP. This article presents a clinical observation of M-CIDP in a 15-year-old boy, as well as a description of laboratory and instrumental diagnostic data. The boy had a chronic development (> 2 months) of flaccid tetraparesis, predominantly of the proximal muscles of the limbs, without sensory disorders. According to electroneuromyography, there were signs of demyelinating lesions of the proximal parts of the peripheral nerves. There was an increase in the thickness of the nerves of the upper limbs according to ultrasound. In the liquor protein-cell dissociation, as well as in the blood, IgG antibodies to the surface glycoprotein S of the SARS-CoV-2 coronavirus were found. The clinical and neurophysiological picture corresponded to the reliable criteria for CIDP. The therapy with intravenous immunoglobulins had a significant positive effect in the form of an increase in the strength of the limb muscles.Copyright © Russian Neurological Journal. All rights reserved.

MOTOR CHRONIC INFLAMMATORY DEMYELINATING POLYNEUROPATHY IN A CHILD.

Motor chronic inflammatory demyelinating polyneuropathy (M-CIDP) is a form of atypical CIDP. This article presents a clinical observation of M-CIDP in a 15-year-old boy, as well as a description of laboratory and instrumental diagnostic data. The boy had a chronic development (> 2 months) of flaccid tetraparesis, predominantly of the proximal muscles of the limbs, without sensory disorders. According to electroneuromyography, there were signs of demyelinating lesions of the proximal parts of the peripheral nerves. There was an increase in the thickness of the nerves of the upper limbs according to ultrasound. In the liquor protein-cell dissociation, as well as in the blood, IgG antibodies to the surface glycoprotein S of the SARS-CoV-2 coronavirus were found. The clinical and neurophysiological picture corresponded to the reliable criteria for CIDP. The therapy with intravenous immunoglobulins had a significant positive effect in the form of an increase in the strength of the limb muscles.Copyright © Russian Neurological Journal. All rights reserved.

[The effectiveness of cytoflavin in complex therapy of patients with the coronavirus infection COVID-19]. / Effektivnost' primeneniya Tsitoflavina v kompleksnoi terapii patsientov s COVID-19.

OBJECTIVE: To study therapy, including a sequential course of the drug Cytoflavin, on the dynamics of neurological and general status in patients with new coronavirus infection COVID-19. MATERIAL AND METHODS: 47 patients with a new coronavirus infection COVID-19, admitted to the hospital and having a state of moderate severity, according to the criteria of the Interim Guidelines of the Ministry of Health of the Russia for the prevention, diagnosis and treatment of a new coronavirus infection (COVID-19, version 9 of 10.26.2020). Clinical and neurological research, laboratory and instrumental examination methods were used before and after the course of therapy. RESULTS: When a sequential Cytoflavin regimen is used in patients with COVID-19 infection, along with standard therapy, a significant improvement in neurological and general status is observed, as well as a significant positive dynamics in the results of laboratory and instrumental research methods (markers of a systemic inflammatory response, hemostasis and oxygenation disorders), which indicates on the influence of the significant effect of Cytoflavin on the processes of inflammation and hypercoagulability in COVID-19 infection. CONCLUSION: The use of the drug Cytoflavin in the complex therapy of patients with COVID-19 infection is pathogenetically justified and expedient. The data obtained make it possible to recommend the inclusion of Cytoflavin in the treatment protocols for patients with COVID-19 coronavirus infection to optimize therapy and improve the course and outcome of the disease, as well as a longer use of Cytoflavin and repeated courses of its use in patients with COVID-19 infection.

Acute CoVID-19-associated bilateral neuropathy of the abducens nerve in a child

We have presented the first description of acute bilateral neuropathy of the abducens nerve associated with COVID-19 in a child. A boy aged 2 years 2 months acutely developed bilateral convergent strabismus, the next day fatigue, drowsiness, and a single vomiting not associated with food intake, were joined. A differential diagnosis was performed between brainstem encephalitis, other organic (non-inflammatory) lesions of the brain stem, and idiopathic bilateral neuropathy of the abducens nerves. According to laboratory data, mild lymphocytosis, mild eosinophilia were detected, according to polymerase chain reaction DNA of the herpes virus type 1/2, cytomegalovirus, herpes virus type 6, Epstein-Barr, tick-borne encephalitis, borrelia, anaplasma, RNA ehrlichia were not detected. IgM and IgG to tick-borne encephalitis were not detected. Neurophysiological and neuroimaging examinations did not reveal any pathology. On the 6th day of the disease, SARS-CoV-2 RNA was detected by polymerase chain reaction of the nasopharynx and oropharynx discharge. The final diagnosis was formulated - bilateral neuropathy of the abducens nerves. Bilateral convergent paralytic strabismus. Concomitant diagnosis: new coronavirus infection, subclinical form (positive by polymerase chain reaction in the discharge from the throat and nose of the 2019-nCoV coronavirus (SARS-CoV-2) RNA). Decrease in the severity of strabismus was noted over time against the background of the therapy. Clinicians dealing with the COVID-19 should also pay attention to its ophthalmological manifestations and take into account that it can debut with them, as was in our case.

Management and rehabilitation of patients with persistent olfactory disorders (hypo- And anosmia) (literature review)

We present a review of the literature and our own data on the management and rehabilitation of impairment or persistent loss of the olfactory function - hypo- and anosmia. Approaches for restoring impaired olfactory function can be divided into olfactory training, pharmacological and physiotherapy. Smell training is carried out according to a number of protocols that differ mainly in the used arsenal of smells, as well as in the frequency of their presentation. Pharmacologically, it is proposed to use steroids used both topically (intranasally) and systemically;there is no common view on the effectiveness of this approach. Physiotherapy involve electrical stimulation of the olfactory filaments in the area of their exit into the nasal cavity (lateral masses of the ethmoid bone). In our opinion the most rational approach is the use of training methods using different smells.

Anosmia and ageusia as the early signs in patients with laboratory confirmed COVID- 19 infection

Aim of our study was to examine the presentation and characteristics of olfactory and taste impairment in patients with laboratory-confirmed COVID-19. Methods: 41 patients with laboratory confirmed COVID- 19. Average age was 39.7±9.3 years (range 27-46 years). We used a questionnaire with questions about the smell and taste disturbances. Results: We found that violation of smell and taste was observed in 27 (65,9%) and 24 (58.5%) patients, respectively. Both symptoms were seen in 23 patients (56,1%) cases. It's important to note that in 5 (12,2%) patients, hyposmia manifested itself at the onset of the disease earlier than other symptoms of COVID-19 4 (9,8%) patients reported anosmia along with headache and fever at the onset of the disease. All patients with impaired smell and taste had a mild or moderate course of the COVID-19. Conclusion: Anosmia, hyposmia, and ageusia appear to be early signs of a possible COVID-19. Screening for these symptoms in patients with minimal or no infectious disease symptoms and patients with negative COVID-19 will help to prevent further spread of infection.