ABSTRACT
Dorsalgia's is an actual medical and social problem. It gains prominent significance among railway workers, connected with railway communication. Pain syndromes among this group of patients have different complex pathogenetic mechanisms of the development. In a great number of cases it is usually seen the worsening of the condition in connection to concomitant anxiety and depression. There are also concomitant osteoporosis and autonomic trophical disturbances.
Subject(s)
Occupational Diseases/physiopathology , Pain/physiopathology , Railroads , Anxiety/pathology , Anxiety/physiopathology , Depression/complications , Depression/pathology , Depression/physiopathology , Female , Humans , Male , Occupational Diseases/etiology , Occupational Diseases/pathology , Osteoporosis/etiology , Osteoporosis/pathology , Osteoporosis/physiopathology , Pain/etiology , Pain/pathologyABSTRACT
Two hundreds and seventy-six patients including 43 patients with multiple sclerosis, 24 - with acute inflammatory demyelinating polyneuropathy (AIDP), 144 - with chronic inflammatory demyelinating polyneuropathy (CIDP), 27 - with motor multifocal neuropathy (MMN), 38 - with lateral amyotrophic sclerosis (LAS) have been examined. Symptoms of axonal degeneration, manifested in denervation phenomena in both clinical and instrumental studies (electromyography, transcranial magnetic stimulation, MRT), were revealed in all groups of patients. The formation of excitation conduction blocks is an universal pathophysiological mechanism of the axonopathy development in AIDP, CIDP, MMN and LAS. Symptoms of axonopathy and peripheral demyelinization in patients with multiple sclerosis and LAS suggest the possibility of transformation of immunopathological process from the central nervous system to the peripheral one.
Subject(s)
Amyotrophic Lateral Sclerosis/physiopathology , Axons/physiology , Guillain-Barre Syndrome/physiopathology , Multiple Sclerosis/physiopathology , Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/physiopathology , HumansABSTRACT
Multifocal motor neuropathy (MMN) is a rare disease of the peripheral nervous system pathogenetically related to local demyelinization and formation of excitation conduction blocks. MMN affect only those nerves and their segments that comprise excitation conduction blocks. Such blocks have a persistent character and show a mosaic pattern over motor fibres which accounts for the specific clinical picture of MMN.
Subject(s)
Electrodiagnosis/methods , Motor Neuron Disease/diagnosis , Neural Conduction/physiology , Diagnosis, Differential , Disease Progression , Follow-Up Studies , Humans , Motor Neuron Disease/physiopathology , Motor Neurons/physiologyABSTRACT
To estimate a qualitative and quantitative effects of axonal failure on the clinical and electromyographic (EMG) picture of diffuse and local demyelination, 24 patients with Guillain-Barre syndrome (GBS), 144 with chronic inflammatory demyelinating polyneuropathy (CIDP) and 27 patients with multifocal motor neuropathy (MMN) have been studied. All the patients underwent a complex clinical neurological and EMG examination. Along with significant association between muscular hypotrophies and weakness in the majority of patients (tau=0,51; p<0,001), in some cases weakness in extremities was found in the absence of amyotrophic syndrome specifying a "functional" axonopathy due to the disturbance of ionic transport and the blockade of potassium channels. The formation of persisting conduction block in 100% of MMN cases and in up to 75% of GBS and CIDP cases revealed the additional special mechanism of axonopathy. The primary autoimmune affection of axonal membrane in a case of acute motor axonal neuropathy is described. The data obtained suggest that secondary axonal pathology underlies formation of the pathological system manifesting with failure of neurotrophic influence of the affected axons in relation to muscles and leading to neurological plastic deficiency at a level of self-supporting dysregulation pathology.
Subject(s)
Axons/pathology , Demyelinating Diseases/pathology , Demyelinating Diseases/physiopathology , Disease Progression , Electromyography , Humans , Muscle, Skeletal/innervation , Muscle, Skeletal/physiopathology , Prognosis , Retrograde Degeneration/pathology , Retrograde Degeneration/physiopathologyABSTRACT
To evaluate the effect of Dexalgin on dysregulation mechanisms in the complex therapy of dorsalgia, 39 patients have been studied. They were divided into 2 groups: with vertebrogenic (23 patients) and without vertebrogenic (16 patients) pain syndrome. Dexalgin was prescribed in dosage 75 mg daily during 5 days. Its efficacy was measured using the Visual Analogue Scale (VAS), Mc Gill Pain Questionnaire, OBPDQ in case of low back pain. Electromyographic (EMG) and magnetic resonance imaging (MRI) examination was performed in radiculopathic patients receiving dexalgin. The results revealed a statistically significant decrease of the VAS values at the control examination in both groups of patients (p<0,001) with background RI values being 18,4 +/- 9,7 and 21,2 +/- 11,7, respectively. The considerable reduction of RI to 14,6 +/- 9,2 was observed in the second group (p=0,044) on day 5. Dynamic examination showed the predominant decrease of OBPDQ percentage values in patients with myofascial back pain (p=0,038). The EMG data demonstrated a tendency to reduction of spontaneous activity in muscular fibers and normalization of the H-reflex latency during the tibial nerve conduction study in patients with vertebrogenic dorsalgia (p=0,058 and p=0,064, respectively). Dexalgin is the new generation of nonsteroid analgesics possessing potential in treatment of both, acute and exacerbations of chronic dorsalgias. No significant between-group differences were found in the MRI study. The study revealed dexalgin efficacy in patients with myofascial low back syndrome.
