[The electroneuromyographic study of the radial nerve: compressive ischemic neuropathy of the posterior interosseous nerve].

The electroneuromyographic study of the posterior interosseous nerve (PIN) with determination of conduction block (CB) at the level of the upper third of the forearm using the surface electrodes has been carried out. Seven healthy volunteers, 22 patients with compressive-ischemic neuropathy (CIN) at the level of the supinator, 14 patients with the total affection of the radical nerve, aged from 21 to 64 years, have been studied. The M-response has been recorded from the extensor digitorum communis. Stimulation has been performed at: (1) the middle of the forearm; (2) the lateral brachium; (3) the axillary crease; (4) the Erb's point; (5) the sulcus of ulnar nerve; (6) the cubital flexion; (7) the inner part of the shoulder. A method of stepwise stimulation has been used in the segment "a middle third of the forearm--a middle third of the shoulder". The M-responses of similar shape and amplitude have been recorded by stimulation of the first and second points in the controls. The M-responses recorded by stimulation of the brachial plexus were higher by average of 44,2% compared to the radical nerve in the shoulder area. The focal CB was found between two stimulation points in 86,4% of patients with PIN CIN that was confirmed by the method of stepwise nerve stimulation as well. The correlation between CB and the data of the global electromyogram was revealed. In patients with the total affection of the radical nerve, the M-responses during stimulation of distal and proximal PIN points were absent and the similar M-responses were recorded by stimulation of the brachial plexus (the Erb's point and the axillary crease) as well as the inner part of the shoulder.

[Electroneuromyographic study of the median nerve: peculiarities of M-response from the anterior forearm muscles during stimulation of the brachial plexus].

Motor fibers of the median nerve innervating the anterior forearm muscles during stimulation of the brachial plexus have been studied. A role of forearm muscles innervated by the cubital and radial nerves in the formation of the M-response recorded from the anterior forearm muscles has been determined. Surface stimulating and recording electrodes have been used, with the active recording electrode being placed on the border between the upper and the middle one third of the anterior forearm surface and the reference electrode--in the area of the lower one third of the forearm. Nerve stimulation was conducted at 5 points: in the region of elbow flexion (median nerve); in the border between the middle and the lower one third of the inner side of the shoulder (median and cubital nerves); in the Erb's point or in the axillary space (brachial plexus); in the sulcus of ulnar nerve (cubital nerve); on the border between the middle and the lower one third of the outer shoulder surface (radial nerve). During stimulation of the brachial plexus, the M-response recorded from the anterior forearm muscles is caused mostly by the median nerve. The radial nerve also exerts a significant influence on development of the M-response. A role of the cubital nerve is minimal (p>0.05). The M-response recorded from the anterior forearm surface during brachial plexus stimulation is a result of summed potentials of motor units both of the anterior forearm muscles innervated by the median and cubital nerves and of the lateral and posterior groups innervated by the radial nerve.

[Central nervous system damage in inflammatory demyelinating polyneuropathies]. / Porazhenie tsentral'noi nervnoi sistemy pri vospalitel'nykh demieliniziruiushchikh polinevropatiiakh.

The results of subclinical brain damage study of 20 patients with inflammatory demyelinating polyneuropathy, aged 46.5 +/- 3.7 years, are presented. Eleven patients were diagnosed to have Guillain--Barre syndrome and 9--chronic inflammatory demyelinating polyneuropathy. No clinical systems for central nervous system damage were found. Magnetic resonance tomography defected demyelination foci in periventricular and sub-cortical brain regions in 35% of the patients and diffuse atrophic process--in 55%. Registration of brainstem acoustic-evoked potentials showed bilateral latency increase and a change of a signal shape in 60% of the patients. Possible mechanisms of combined damage of central and peripheral nervous system in this pathology are discussed.

[Prophylaxis of neurological manifestations of lumbar osteochondrosis: intermediate results, unsolved problems and some methodologic aspects]. / Profilaktika nevrologicheskikh proiavlenii poiasnichnogo osteokhondroza: promezhutochnye itogi, nereshennye voprosy i nekotorye metodologicheskie aspekty.

Issues of prophylaxis and rehabilitation are considered as regards neurologic manifestations of spinal osteochondrosis (NMSO). NMSO primary prophylaxis requires investigation and quantitative evaluation of the disease risk factors, epidemiologic determination of both incidence and prevalence in different groups of population in various periods of time. The standard risk group of NMSO in Byelorussian consists of population of 40-49-year-olds. Some professions may be risk factors for both onset and relapse of NMSO. Secondary prophylaxis of NMSO concerns elevated relapse risk, screening for individuals with either subclinic or early clinic manifestations of the disease. The computer screening-system has been created to identify a group at high risk of NMSO onset or relapse, to keep records, to print documents. It also gives chance to carry out individual prophylaxis of the high risk in the course of mass examination of employees.

[Chronic inflammatory demyelinating polyneuropathies]. / Khronicheskie vospalitel'nye demieliniziruiushchie polinevropatii.

A chronic inflammatory demyelinating polyneuropathy (CIDP) is described both on the basis of authors' own observations and literary data. The disease is characterised by delayed onset with progredient, progredient-remittent and stable course of flaccid paresis of extremity together with mild distal sensitive disturbances, albumino-cytologic dissociation and dysimmunoglobulinemia. Cranial nerves damages and vestibulo-cerebellar disturbances were observed in a number of patients. This confirms the involvement of CNS in CIDP. The common character of clinical, immunological, laboratory and electrophysiological findings permits to consider CIDP and Guillain-Barré syndrome as autoimmune diseases. Meanwhile some recent findings on the formation of antibodies to peripheral nerves structures as well as high titers of antisulfamide and antigangliosides antibodies permit to suggest CIDP as separate nosological unit. Additional clinical data and the evaluation of the role of etiological and pathogenetic mechanisms are necessary for the final conclusion.

[Organization of the treatment of patients with neurological manifestations of lumbar osteochondrosis]. / Organizatsiia lecheniia bol'nykh s nevrologicheskimi proiavleniiami poiasnichnogo osteokhondroza.

Recommendations are given for staged treatment of lumbar osteochondrosis with neurological symptoms. The scope of therapeutic measures is specified for treatment stations (stage I), neurological aid at outpatient clinics (stage II), neurological departments of a hospital (stage III), aftertreatment department (stage IV), day hospital (stage V) and sanatorium (stage VI). The experience is presented gained in Byelorussian SSR in the treatment of patients with vertebrogenic disturbances of the peripheral nervous system.

[The prognostic selection of subjects with neurological manifestations of lumbar osteochondrosis during mass prophylactic examinations of the population (screening)]. / Prognosticheskii otbor lits s nevrologicheskimi proiavleniiami poiasnichnogo osteokhondroza pri massovykh profilakticheskikh osmotrakh naseleniia (skrining).

Several types of tabulated and computerized screening systems have been developed for the selection of subjects at high risk of the development or a relapse within 1-3 years of marked lumbosacral pain involving a temporary disability. The systems are intended to be used during wide-scale prophylactic medical examinations but may also be employed on an individual basis. Some of the proposed systems are based on a self-interview (7-9 questions), others take into consideration objective neurological findings. The authors present a simple calculation table to assess the probability of a relapse of vertebrogenic lumbosacral pain within 12 months. The prognostic coefficients were calculated with the help of modified Bayes' method.

[Characteristics of work-loss in diseases of the peripheral nervous system]. / K kharakteristike trudopoter' pri zabolevaniiakh perifericheskoi nervnoi sisteme.

Diseases of the peripheral nervous system (PNS) rank fourth among all causes of temporal loss of working ability and first in the structure of neurological morbidity causing temporal disability. Statistical service based on the principles of the International Classification of Diseases, Injuries and Causes of Death does not provide the neurologic service with data about loss of the working time due to PNS diseases. In the comprehensive work on the improvement of neurologic care of patients with PNS diseases conducted in Byelorussia an important place has been recently given to the systematic monitoring of the temporal disability rate which decreased by 28.3% over a period of 3 years (1983-1985).

[Pathogenesis and diagnosis of osteochondrosis of the spine and its neurologic manifestations: status of the problem and research prospects]. / Patogenz i diagnostika osteokhondroza pozvonochnika i ego nevrologicheskikh proiavlenii: sostoianie problemy i perspektivy izucheniia.

On the basis of a critical analysis of literature data and his own observations the author puts forward a concept of the pathogenesis of vertebral osteochondrosis and attendant neurological disturbances. The article also deals with the diagnosis and prospects of investigation of these fairly prevalent diseases which have a large socio-economical impact.

[Role of various endocrine glands in the pathogenesis of the neurologic symptoms of lumbar osteochondrosis]. / O roli nekotorykh éndokrinnykh zhelez v patogeneze nevrologicheskikh simptomov poiasnichnogo osteokhondroza.

Parathyroid hormone, thyrocalciotonin, testosterone, estradiol, aldosterone and renin activity of the blood plasma were radioimmunoassayed in 142 patients with neurological manifestations of lumbar osteochondritis. The blood levels of parathyroid hormone and, to a lesser degree, those of thyrocalciotonin were elevated. The levels depended on the severity and duration of the pain syndrome while thyrocalciotonin excretion depended on the degree of the degenerative dystrophic process in the spinal column. Prolonged pain syndrome was associated with an inhibited function of the gonads and the mineralocorticoid layer of the adrenals. A hypothesis is advanced, which explains the participation of the endocrine glands in the etiopathogenesis of lumbar osteochondritis and its neurological manifestations.

[Clinical and experimental amyotrophic leukospongiosis (progressive spinal amyotrophy)]. / Amiotroficheskii leikospongioz (progressiruiushchaia spinal'naia amiotrofiia) v klinike i éksperimente.

The authors succeeded in reproducing amyotrophic leukospongiosis in experiments on two squirrel monkeys 16-23 months after challenge with cerebral suspension obtained at autopsy from a human patient. The clinico-morphological studies showed the similarity of the disease in humans and monkeys. A previously unknown agent belonging by its properties to "slow" viruses was isolated. The successful reproduction of amyotrophic leukospongiosis under experimental conditions proved its infectious nature.

[Problems in the classification and formulation of diagnoses of diseases of the peripheral nervous system]. / Voprosy klassifikatsii i formulirovka diagnoza zabolevanii perifericheskoi nervnoi sistemy.

The author reports on the classification of peripheral nervous system diseases approved at the expanded plenary meeting of the All-Union Task Commission on Peripheral Nervous System Diseases (Kiev, June 16-17, 1983) and recommended (pending the publishing of methodological recommendations) to be introduced into health service practical work. Approximated models of the diagnostic wording for this pathology are presented.

[Neurologic manifestations of chronic arterial insufficiency of the lower extremities]. / Nevrologicheskie proiavleniia khronicheskoi arterial'noi nedostatochnosti nizhnikh konechnostei.

Neurological manifestations of lower limb chronic arterial insufficiency were studied in 1004 patients with abdominal aorta and its branches occlusion. Several often met neurological syndromes--neuritic, sympathicoalgetic, radicular (mono-, bi- and polyradicular), plexitis lumbosacralis and spinal, induced mainly by regional hemodynamic disturbances were singled out. Clinical peculiarities of these syndromes helping in differentiation of vascular surgical diseases from neurological ones are shown.