RESUMO
AIM: To evaluate the dynamics of functional activity of brain structures underlying cognitive functions in patients with encephalopathy due to poisoning with neurotoxicants on the stage of rehabilitation. MATERIAL AND METHODS: Fifty-six patients were examined. The main group consisted of 40 patients treated with intravenous injections with mexidol (n=10), combination of mexidol with non-pharmacological methods - mesodiencephalic modulation (MDM) (n=10), hyperbaric oxygenation (HBO) (n=10) and the combination of MDM and HBO (n=10). The comparison group included 16 people. All patients underwent neurophysiological (EEG, auditory event-related potentials) and neuropsychological examinations. RESULTS: Marked EEG changes were noted in all patients. The domination of disturbances of functional activity on the diencephalic or mesodiencephalic levels was observed. After treatment, positive changes were found in 60% of patients. The positive dynamics was observed in 80% patients when the combination of mexidol, MDM and HBO was used. The negative dynamics was noted in 5 (12,5%) of patients of the main group, in particular when mexidol only was used. The results of the primary neuropsychological study revealed that cognitive impairment of different severity was found in 97,5% of patients of the main group and 100% of patients of the comparison group. After treatment, performance on neuropsychological tests improved by 62,5%, N200 and P300 latencies reduced, while the amplitudes increased, in the patients of the main group. CONCLUSION: The use of mexidol, MDM and HBO in the treatment of patients with encephalopathy due to poisoning with neurotoxicants on the stage of rehabilitation improved the indicators of functional brain activity and cognitive functions.
Assuntos
Antioxidantes/uso terapêutico , Encéfalo/fisiopatologia , Oxigenoterapia Hiperbárica , Síndromes Neurotóxicas/fisiopatologia , Síndromes Neurotóxicas/reabilitação , Picolinas/uso terapêutico , Adulto , Antioxidantes/administração & dosagem , Cognição/fisiologia , Disfunção Cognitiva/induzido quimicamente , Disfunção Cognitiva/reabilitação , Terapia Combinada , Eletroencefalografia , Potenciais Evocados , Feminino , Humanos , Injeções Intravenosas , Masculino , Testes Neuropsicológicos , Síndromes Neurotóxicas/tratamento farmacológico , Picolinas/administração & dosagem , Resultado do TratamentoRESUMO
The authors studied the time course of clinical and neuropsychological changes in the use of transcranial mesodiencephalic modulation in the complex treatment of patients with acute poisoning by neurotropic toxicants, which were complicated by toxicohypoxic encephalopathy. The findings suggest the beneficial impact of this technique on the autonomic functions of the brain stem, on the body's adaptive capacities and the psychoemotional sphere, which makes it possible to recommend the programmed use of this method in such patients.