Vol 26, No 2 (2024): Неврология и ревматология

The article is devoted to the issues of peripheral nervous system damage in new coronavirus infection. Among the nosologic forms of peripheral nervous system lesions in new coronavirus infection are mononeuropathies, polyneuropathies, multiple neuropathies, and noninflammatory polyneuropathies. In the largest retrospective study to date of cranial nerve pathology in COVID-19, dysfunction was observed in 38% of infected individuals. Facial nerve involvement was most common (30%). The article presents a clinical observation of facial nerve neuropathy after a new coronavirus infection with an assessment of the clinical picture, data of laboratory and instrumental investigations, therapy and long-term results. A possible causal relationship between COVID-19 and peripheral nervous system lesions is discussed.

Degenerative stenosis is a common pathology of the lumbar spine, however, there is currently no consensus on the clinical significance of neuroimaging findings and management tactics for such patients. In this regard, the issues of diagnosis and treatment have been causing discussions among doctors of both therapeutic and surgical profiles for many years. The article presents an observation of a 65-year-old patient with mixed lumbar stenosis, in whom surgical intervention in the form of decompression and transpedicular screw fixation led to a complete regression of pain, motor disorders and a significant improvement in functional condition. The issues of diagnosis, conservative and surgical treatment of mixed lumbar stenosis are discussed.

The development of acute cerebrovascular events is one of the main causes of mortality and disability. Currently, in developed countries, due to the development of new technologies and improvement of medical care and prevention, there is a tendency to decrease the mortality and morbidity of cerebral venous thrombosis. Timely and adequate use of antithrombotic therapy in patients in this category for primary and secondary prevention of acute cerebrovascular events is an extremely important aspect of management and reliably reduces the risks of recurrent cerebrovascular accidents, increases survival and contributes to a more favorable prognosis for the recovery of impaired functions and quality of life in the long term.

Cerebral vein thrombosis or cerebral venous thrombosis (CVT) is a complex venous thromboembolic disease with a different clinical picture, etiology and multiple potential complications. The frequency of occurrence is 0.5–1% of all stroke cases. Clinical symptoms occur as a result of increased intracranial pressure caused by a violation of venous outflow and brain damage. CVT is associated with a wide range of clinical symptoms from isolated headaches (the most common symptom on admission, registered in 90% of cases) to focal deficits, seizures and changes in mental status. Careful collection of anamnesis with targeted identification of risk factors, full-fledged diagnosis and treatment contribute to achieving a favorable clinical outcome in patients. The article focuses on the degree of recanalization of cerebral venous thrombosis, assessment of venous collaterals according to the degree of Qureshi and clinical outcomes depending on risk factors. These indicators are little studied at present.

Elderly and senile people often suffer from cognitive impairment. One of the significant issues that develop as the severity of cognitive impairment increases is dysphagia. The article addresses various causes of dysphagia and ways to manage it. Due to the high prevalence of dysphagia in cognitively reduced patients, selecting therapy for cognitive disorders is often challenging. Since patients with dysphagia have difficulties taking solid dosage forms (DF) – tablets and capsules, alternative DFs are being discussed. In particular, studies of the positive effect on the cognitive status of Cereton and the use of its different DFs are presented, allowing for optimal therapy in various situations. The novel DF of Cereton, an oral solution, is convenient for use in patients with dysphagia.