[Comparative analysis of clinical and neurophysiological indices in patients with multiple sclerosis and acute demyelinating polyneuropathy]. / Sravnitel'nyi analiz klinicheskikh i neirofiziologicheskikh pokazatelei u patsientov s rasseiannym sklerozom i ostroi demieliniziruiushchei polinevropatiei.

A comparison study of some clinical and neuropsychological indices in two demyelinating disorders--multiple sclerosis (17 patients, mean age 31.6 years) and inflammatory demyelinating polyneuropathy (7 patients, mean age 49.5 years) was conducted, using electromyography with registration of impulse velocity conduction along the nerve and M-responses as well as of the parameters of movement units potentials. The data obtained suggest the presence of demyelinating lesions of central and peripheral nervous systems, namely, symptoms of axonal demyelinating polyneuropathy with the prevalence of demyelinating process, its dissemination and generalization, in both disorders.

[Diagnostic possibilities of neurophysiological methods in multiple sclerosis and acute demyelinating polyneuropathy]. / Diagnosticheskie vozmozhnosti metodov neirofiziologii pri rasseiannom skleroze i ostroi demieliniziruiushchei polinevropatii.

Electromyographic diagnostical possibilities are not limited within a sphere of beiromusclers damages. It is widely spread for estimation of neuromotoric apparatus functional conditions with segmentary and oversegnebtary damages of spinal cord. In this connection an analysis of clinical and neurophysiological parameters of patients with demyelinisational damages of the nervoys system has been carried out.

[Function of acoustic analyzer in multiple sclerosis in exacerbation]. / Sostoianie funktsii slukhovogo analizatora pri rasseiannom skleroze v stadii obostreniia.

Audiometric examination of 51 patients with aggravated multiple sclerosis included pure-tone threshold audiometry, assessment, of speech intensity function, of adaptation, masking, sound laterality, impedance tympanomanometry, perception of complicated speech, registration of short-latency acoustic evoked potentials. Acoustic analyzer disfunction, especially that of sound laterality, was discovered in 42-83% and 68% of patients, respectively. The hearing system was affected most frequently at the level of brain stem and occasionally at the level of the cochlea (15%). Sorption detoxication therapy produced response in 100% of patients by subjective and neurological criteria, while only in 59% by acoustic criteria. This disagreement is likely to reflect subclinical symptoms and may represent a prognostic value.

[UV irradiation of the cerebrospinal fluid in the treatment of patients with disseminated sclerosis]. / UF-obluchenie tserebrospinal'noi zhidkosti v lechenii bol'nykh rasseiannym sklerozom.

Cerebrospinal fluid (SF) in the quantity 5-7 ml from 26 multiple sclerosis patients was exposed to UV radiation with subsequent reinfusion. The assessment of clinical symptoms and immunological indices 7 days later showed that positive results (6 scores by Sipe scale) were achieved in 14 patients with cell abundance in the SF. The improvement was indicated by positive trends in pelvic functions, sensory and coordination disorders, normalization of the blood immunological picture. The responders exhibited elevated SF levels of B-lymphocytes, phagocytosing cells and IgM concentrations. High levels of IgG registered in 58% of the patients did not change. The only side effect was represented by short-term postpuncture syndrome in 4 patients with arterial hypotension. In 12 patients with progressive sclerosis the treatment was ineffective.

[Enterosorption in the combined treatment of patients with multiple sclerosis]. / Enterosorbtsiia v kompleksnom lechenii bol'nykh rasseiannym sklerozom.

Fifty-nine patients exhibiting an exacerbation of multiple sclerosis were examined for efficacy of enterosorption with the fibrous coal sorbent vaulen. The solvent powder was administered 3 times a day in a dose of 50-60 mg/kg for 20 days between meals. The relief of neurological symptoms started on treatment days 3-4 with subsequent attenuation within the course of treatment. This agreed with discontinuation of liquor hypertension and recovery of normal immunological spectra of serum parameters. The method of enterosorption is simple, safe and readily arrests the disease exacerbation.

[Status of local and general immunity in patients with multiple sclerosis]. / Sostoianie mestnogo i obshchego immuniteta u bol'nykh rasseiannym sklerozom.

A study was made of the general (blood) and local (CSF) immunity in 18 patients with clinically active multiple sclerosis running different course and in 14 controls. The relative and absolute count of T and B lymphocytes, phagocytizing cells, the content of IgA, IgM and IgG, circulating immune complexes, some fractions of complement, functional activity of blood granulocytes and mononuclears were measured. The patients with multiple sclerosis manifested appreciable alterations in cellular and humoral immunity of the blood and CSF. No correlation was observed in alterations of the immunological parameters of the blood and CSF whereas in some cases (E-RFL), the changes were of different character. The relationship was discovered between the intensity of alterations in local immunity and the type of the disease.

[Efferent methods of the treatment of cerebrospinal fluid hypertension in exacerbation of multiple sclerosis]. / Efferentnye metody lecheniia likvornoi gipertenzii pri ékzatserbatsii rasseiannogo skleroza.

Analysis is made of the efficacy of the treatment of CSF hypertension in 40 patients in the phase of exacerbation of multiple sclerosis. Use was made of sorption detoxication methods: hemoperfusion (the author's certificate No.1466754) and enterosorption (the priority certificate No.4465054/14 (115542) dated July 22, 1988). SKH-IK and SKH-2K sorbents were employed as hemoperfusion, using the venovenous scheme of perfusion, the volumetric rate of the blood flow being 100-120 ml/min during 2-3 hours. Altogether 2-3 sessions were carried out, with an interval of 5 to 7 days. For enterosorption, use was made of a crumbled up filamentous carbonic sorbent in a dose of 50-60 mg per kg bw 3 times a day for 20 days in 2 hourly intervals between food intake. Regression of the neurological symptoms began 2-3 hours after the first session of hemoperfusion and 5-6 days after the beginning of the intake of the filamentous carbonic sorbent, increasing throughout the whole treatment course. That coincided with the disappearance of CSF hypertension and normalization of the immunological spectrum of the blood serum. Sorption detoxication brought about no complications and is a method of choice in the treatment of CSF hypertension in patients in the phase of multiple sclerosis exacerbation.

Effect of hemoperfusion on the course of demyelinization processes: experimental and clinical picture.

The experiments on guinea pigs with experimental allergic encephalomyelitis showed, that hemoperfusion through fibrous and granulated activated carbon resulted in stable clinical effect solely on the early stages of the disease (10-11 days after sensitization). At the stage of advanced neurologic symptomatology the hemoperfusion proved effective when performed through binary adsorbent on the base of fibrous activated carbon and immobilized basic encephalitogenous protein. Forty nine patients with multiple sclerosis underwent 2-3 sessions of hemocarboperfusion on SKN coal with 7 day intervals. In patients at the initial stage of the disease the hemocarboperfusion was found to produce a stable and practically complete normalizing effect on the neurologic status. At the advanced stages of the disease the hemosorption eliminates only newly developed symptoms.

[Renogenic neurologic disorders]. / Renogennye nevrologicheskie rasstroistva.

A total of 137 patients with chronic diseases of the kidneys were examined, including 34 without and 103 with chronic renal insufficiency. The neurologic syndromes under study included encephalomyelopathy with a predominant damage to the coordination systems, polyneuropathy and myopathy. These neurological changes were expressed irrespective of chronic renal failure, while their degree directly correlated with its severity. Stabilography and tremorography proved adequate and objective methods of assessing coordination disorders and made it possible to detect the above changes at the preclinical stage.