ABSTRACT
Polyneuropathy in patients with diabetes mellitus is manifested by a lesion of peripheral sensory, motor and autonomic nervous system. Different severity of damage of sensory, motor and autonomic fibers in typical and atypical forms of diabetic polyneuropathy, requires a differentiated approach to therapy, but not the rejection of its implementation. In an interdisciplinary consensus, consultations are held with physicians from different regions of the Russian Federation, and modern methods of diagnosing and assessing the severity of diabetic polyneuropathies, which determine the algorithm for treating patients, are discussed.
Subject(s)
Diabetic Neuropathies , Polyneuropathies , Diabetic Neuropathies/diagnosis , Humans , Polyneuropathies/diagnosis , Russia , Severity of Illness IndexABSTRACT
AIM: The study aimed at showing actual information about vestibular migraine and presenting different features of vestibular migraine for prevention of diagnostic mistakes and choosing an effective treatment. MATERIAL AND METHODS: Fifty patients with vestibular migraine were diagnosed according to the International Classification of Headache Disorders 3rd edition and examined in a neurological department. RESULTS: Problems with outpatient diagnosis and treatment were found. Many patients were not diagnosed correctly and, therefore, did not receive effective management of vestibular migraine. All clinical features, information of disease history and different objective signs were important for differential diagnosis with other types of dizziness. Management according to guidelines for migraine treatment and recent research of vestibular migraine showed its efficiency for patients. CONCLUSION: Spreading of actual information about vestibular migraine is important due to its underdiagnosis. Knowledge of clinical features is helpful for diagnosis and differential diagnosis. Treatment approaches according to guidelines and last research should be used.
Subject(s)
Headache/diagnosis , Migraine Disorders/diagnosis , Vertigo/diagnosis , Adult , Aged , Diagnosis, Differential , Diagnostic Errors , Female , Headache/drug therapy , Humans , Male , Middle Aged , Migraine Disorders/drug therapy , Outpatients , Treatment Outcome , Vertigo/drug therapyABSTRACT
Diagnosis and treatment of facial pain is a problem for physicians of different specialties (neurologists, dentists, surgeons, oculists, otolaryngologists and psychiatrists). A classification of this pathology is far from ideal and an interdisciplinary comprehensive approach is needed. Current approaches to etiotropic, symptomatic and pathogenetic treatment of patients with most frequent variants of orofacial pain are presented.
Subject(s)
Facial Pain/diagnosis , Facial Pain/drug therapy , Facial Pain/classification , HumansABSTRACT
The changes in the somatosensory system in aging and peripheral neuropathies are similar. Higher pain sensitivity thresholds in the presence of axonopathy are accompanied by paradoxically decreased pain tolerance associated with neuroplastic changes in the spinal cord and brain. The symptomatic treatment of neuropathic pain syndrome with antidepressants, anticonvulsants, and opioids is related to the lower quality of life in elderly patients and to the high risk of severe side effects. The pathogenetic treatment of polyneuropathies frequently increases the intensity of neuropathic pain at its beginning; however, it can recover the function of an axon and reduce the degree of deficiency states. The paper discusses methods for increasing the safety of treatment for neuropathic pain in elderly patients, a relationship between the pathogenesis of nervous system aging and distal diabetic polyneuropathy, and ways of their correction.
