Search

Thirty-eight patients, 20 male, 18 female, mean age 61.8+/-7.7 years, illness duration 8.4+/-1.3 years, have been studied. The degree of severity of Parkinson's disease (PD) according to the Hoehn and Yahr scale was 2.6+/-0.4. Mild cognitive impairment was observed in all cases. Akatinol memantine was prescribed to patients, who have been receiving levodopa, in the following dosages: the first week--5mg daily, the second week--10 mg daily and from the third week--20 mg in fractional dosages. Treatment duration was 6 months. The patient's state before and after treatment was assessed clinically and with several scales measuring cognitive and motor functions. It was shown that akatinol memantine not only reduced disorders typical for PD (hypokinesia, rigidity, tremor) and increased the daily activity of patients but significantly improved the indices of logic and visual memory, speech functions and thinking.

The new integral coefficient between free-radicals oxidation (FRO) and antioxidant defense (AOD) during periodontitis is offered. This "residual" index may be used for evaluation of the decrease or increase in the balance between FRO and AOD in different fluids and organs under different conditions.

The status of the principal hormonal systems has been examined in women with generalized periodontitis. Thyroid, adrenohypophyseal, sympathoadrenal, and gonadal hormones were studied. Statistical processing of the results revealed excessive shifts in all hormonal systems and at the inter-system level. A concept explaining the causes of the detected disorders is proposed.

43 patients suffering from anejaculation were treated in 1983-1993 in the department of andrology of the N. A. Semashko Medical Institute urological clinic. Most commonly anejaculation is caused by prostatic and bladder neck surgery (25.6%), diabetes mellitus (18.6%) and presents as retrograde ejaculation, impaired sperm emission into the urethra, aspermatism (51.2, 27.9, 20.9% of patients, respectively). The leading pathogenetic factors are peripheral neuropathy, surgical injury to the bladder internal sphincter, psychosexual disorders. The authors propose classification and algorithm of the patients' examination to facilitate and enhance diagnosis. Special attention should be given to the presence or absence of orgasm, after-orgasm occurrence of spermatozoa in urine. Anejaculation treatment outcomes remain unsatisfactory. Good responses were achieved with selective adrenomimetic gutron, laser therapy and electrovibration. Prevention of anejaculation should be given more attention.

The pharmacokinetics of baclofen was studied in the rat blood plasma and brain. The concentrations of the agent were found to be considerably lower in the brain than in the plasma. This is associated with the weakly pronounced lipophilicity of the agent in question and with the protective properties of the blood-brain barrier. Baclofen penetrates into the brain middle regions to a greater extent than into cerebral hemispheres.

Presents analysis of the status of different levels of autonomic innervation in patients with generalized periodontitis. Sympathetic activation at both suprasegmentary and segmentary levels revealed in all the patients is a pathogenetic component in the disease development. A stable correlation has been detected between the degree of segmentary sympathetic activation and severity of generalized periodontitis.

Biopsy of the periodontal tissues was carried out in 29 patients with chronic generalized periodontitis in order to detect sex steroid receptors. Estrogen receptors in different levels were found in 58.6% of biopsy specimens. This implies that the trophic effect of sex steroids on the periodontium should not be ruled out.

Analysis of the function of the nervous system, based on clinical, neurological, and psychological studies in 78 patients with generalized periodontitis, revealed central regulation disorders without signs of organic lesions of the brain in 76% patients. The authors claim that stress and a high level of personal anxiety may be responsible for the development of these disorders, which was confirmed by the results of psychological testing.

The MMPI test, Hornblow and Kidson's visual-analog anxiety scale and two types of the painful "questionnaires" suggested by the authors were used to examine the status of emotional personality sphere in 61 patients with prosopalgias due to typical trigeminal neuralgia (n = 39), dental plexalgia (n = 13) and pulpitis (n = 9). It has been revealed that patients with typical trigeminal neuralgia demonstrate the predominance of the depressive syndrome, whereas dental plexalgia is mostly characterized by anxiety. Analysis of the semantic tests is very instrumental in helping the physician to deepen the idea of the structure of subjective sensations in facial pain. Meanwhile the indicators of the "daily pain scale" promote administration of the drugs from the standpoint of chronotherapy.

The paper relates the general principles of the treatment of trigeminal neuralgia by acupuncture. The authors' own research data are provided.

The results of immunologic investigation of patients with trigeminal neuralgia evidence that this condition involves impairments of local and central humoral immunity parameters: increased serum IgA and salivary secretory IgA. Such measurements may become a diagnostic test.

Cluster headache is a disputable and ill-defined problem of current neurology. The authors review data available on etiology, mechanisms of pathogenesis and therapy with special emphasis on biochemical and immunological disturbances; discuss nosology of the disease in the light of newly obtained evidence on its immunological aspects. An overall table of clinically justified treatments is presented.

The authors provide the results of an analysis of the interrelation between the immunologic and biochemical parameters in 6 groups of patients suffering from facial pains or headaches (a total of 153 patients). Significant correlations were revealed in the patients' groups with trigeminal neuralgia and periodic migrainous Horton's neuralgia. The main attention was concentrated on the following parameters: IgA in the serum, secretory IgA in the patients' saliva, % CD4 of lymphocytes and histamine concentration in the peripheral blood, concentration of beta-endorphin in the plasma, catecholamine content in the urine.

Altogether 85 patients with the painful syndromes in the facial and head areas were examined for secretion and transport of testosterone, the main androgen occurring in the body of adult man, by the blood proteins globulin- and albumin-binding sex steroids. All the women examined were in the menopause. The majority of the patients manifested hyperandrogenemia: a decrease in the concentration of sex steroids-binding globulin, rise of total testosterone and its free fraction in the blood serum as well as increase of the index of free androgens. Approaches to the correction of the revealed abnormalities and the role played by those abnormalities in the pathogenesis of the above-indicated diseases are under discussion.

Somatosensory evoked potentials, biochemical, immunological, pharmacokinetic and psychological research methods were used to examine 308 patients suffering from neuralgia of the trigeminal and glossopharyngeal nerves, neuropathy of the trigeminal nerve, neuralgias of the face and painful dysfunction of the temporomandibular articulation. New mechanisms of the pathogenesis of the diseases indicated were revealed. That made it possible to improve and devise new treatment methods.

The authors describe a new method of the treatment of patients with trigeminal neuralgias using electroconvulsive therapy. The method is based on the increase of beta-endorphin concentration as a result of electroconvulsive treatment. The treatment of 12 patients in accordance with the suggested method provided beneficial results and significant enhancement of the efficacy of therapy as compared to patients undergoing conventional treatment.

The authors describe the results of immunological examination of patients suffering from vegetative prosopalgias. A study was made of the initial status of immunity and of its dynamics after treatment. The majority of patients manifested an increase of immunoglobulin A concentration and activation of local humoral immunity. The treatment brought about a reduction of immunoglobulin A concentration in blood serum.

The authors examined electrical conductivity of acupuncture points on the face of 60 patients with trigeminal neuralgia. The results permitted the development of differential diagnostic criteria of trigeminal neuralgia of predominantly central and predominantly peripheral genesis.

A total of 66 patients with dental plexalgia have been examined and treated at the neurological dentistry department. A multiple-modality scheme for the treatment of this condition is suggested, whose basic methods are physiotherapeutic ones: longitudinal physiotherapy, diadynamic currents with a narcotic mixture, trimecain or lydase + analgin electrophoresis. The treatment was effective in the majority of patients.

Immunological investigation was performed in patients with trigeminal neuralgies and painful myofascial temporomandibular joint dysfunction before and after treatment. The data suggest a connection between the state of humoral immunity and the peculiarities of pain syndrome in trigeminal neuralgia and clinically related prosopalgies that was most probably due to different mechanisms of realization of pain syndrome.

Blood plasma beta-endorphin concentrations were measured in 87 patients with various facial and head pain syndromes: trigeminal neuralgia or neuropathy Horner syndrome and migraine, facial autonomic pains. beta-endorphin concentrations were measured before and after treatment. In the groups under investigation, the neuropeptide showed opposite changes in plasma levels after the therapy depending on the type of the syndrome.

A total of 104 patients with bilateral facial pain were examined at a specialized neurostomatological department. The authors analyze the main mechanisms of the development of bilateral facial pain in patients with an impaired system of the trigeminal nerve (trigeminal neuralgias, dental plexalgia, syndrome of the nosociliary nerve), as well as the characteristics of their clinical manifestations. A classification of bilateral prosopalgias is proposed. The criteria of their diagnosis with the use of clinical and electrophysiological methods of examination (EEG, REG, EMG, electrothermometry, esthesiometry, electrical excitability of the exit sites of the trigeminal nerve branches and radioisotopic examination of the muscular blood flow in the face with the help of 133Xe) are also presented. The main principles of the treatment of bilateral prosopalgias are outlined.

Acupuncture was used in 82 patients with trigeminal neuralgila. In 17 patients trigeminal neuralgia was predominantly of the central and in 65 of the peripheral genesis. Selection of points for acupuncture was based on the findings about electrical conductivity of symmetrical acupuncture points on the patient's face. The study has shown that the method of acupuncture in patients with trigeminal neuralgia should be used differentially. It is effective only in patients with peripheral trigeminal neuralgia.

Patients with migraines, Horton syndrome and autonomic pains were subjected to immunological investigation that revealed different degrees of local and general immunity disorders: increase in blood serum IfA and salival IgAc concentrations. These changes are believed to be capable of serving as diagnostic and prognostic indices.

As many as 145 patients with painful syndromes in the face and head underwent immunologic examination. They manifested certain changes in cellular and humoral immunity. An increase in the content of secretory IgA in the saliva and in the serum and a decrease of the concentration of IgM and IgG in the serum were detected in the majority of patients. In patients with NTN of mainly peripheral genesis and with Horton's syndrome, the concentration of IgE in the serum was significantly (P less than 0.01) elevated. The changes in the immunologic status, seen in patients after the treatment are discussed.

Forty-one patients with dyscirculatory encephalopathy complicated by a transient impairment of the cerebral circulation were examined in a neurological department. A comparative analysis of the findings obtained during comprehensive study of the cerebral circulation showed that in the overwhelming majority of cases (37 out of 41), the results of isotope angiography and rheography coincided and corresponded to the clinical findings. To a certain degree these methods complemented each other: rheoencephalography was more informative in the diagnosis of cerebral atherosclerosis and essential hypertension while radioisotope angiography allowed a more accurate determination of the area affected.

A device permitting simultaneous fastening of such number of transducers which are required for investigation of any point on the face, and allowing for individual features of the facial scalp construction has been produced to make the rheoficiography procedure more perfect. The device prevents the face tissues pressing, and does not cause unpleasant or painful sensations. Face rheography by means of the proposed device was realized in 56 patients with different diseases of the face nervous system. Investigation performed showed higher quality, lesser time and simplified procedure of rheofaciography with the mask designed.

The treatment efficiency was compared to blood carbamazepine++ levels in patients with trigeminal neuralgia which were treated with the drug over a long period. The parameters displayed a good (r = 0.70) correlation that resulted in a tendency to increase treatment effect with carbamazepine++ plasma concentration increase. The treatment proved most efficient and side effect-free in a concentration range of 5 to 10 micrograms/ml. The data on blood carbamazepine++ concentrations may be helpful in designing a controlled course of treatment.

The paper is concerned with the problems of the etiology, pathogenesis, clinical picture and methods of the treatment of odontogenic neuropathies of the trigeminal nerve. The clinical manifestations of odontogenic neuropathies of the trigeminal nerve are described in detail. The data on the preclinical methods of examination are provided as are pathogenetically based schemes of the treatment for odontogenic neuropathies of the trigeminal nerves.

Studies of the major cell-mediated immunity parameters in patients with painful syndromes involving the face and neck have shown a reduction of the peripheral lymphocyte count.