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1.
Artigo em Russo | MEDLINE | ID: mdl-34481447

RESUMO

The review article provides a definition and classification of different nystagmus types, a comparative description of the central and peripheral vestibular nystagmus. The pathogenetic patterns of up-beating and down-beating nystagmus are accurately described. The features of nystagmus formation in various diseases are discussed, such as Wernicke encephalopathy, Arnold-Chiari anomaly, spinocerebellar ataxia and vestibular migraine. The authors provide their own data on oculomotor disorders in 100 patients with vestibular migraine and migraine with a brain stem aura. This article considers approaches to treatment: surgical and conservative. In conclusion, was noted the possibility of differentiating the central and peripheral vestibular nystagmus by means of clinical study. As well, the differences between vertical nystagmus associated with organic lesions of the brain stem or cerebellum and transient nystagmus with vestibular migraine are highlighted. The authors note the need for in-depth studies of nystagmus in vestibular migraine patients and methods of dealing with it.


Assuntos
Malformação de Arnold-Chiari , Transtornos de Enxaqueca , Nistagmo Patológico , Cerebelo , Humanos , Nistagmo Patológico/diagnóstico , Vertigem
2.
Vestn Otorinolaringol ; 86(3): 56-60, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34269025

RESUMO

OBJECTIVE: To assess the severity of daytime sleepiness and the level of sleep apnea/hypopnea index (AHI), as well as the possibility of their correction, in the long-term period after uvulopalatoplasty (UPP) in patients suffering from obesity and obstructive sleep apnea syndrome (OSAS). MATERIAL AND METHODS: We retrospectively analyzed the data of the patients, who requested a consultation due to nighttime snoring, witnessed sleep apneas and daytime drowsiness. We included men and women of ages 40 to 65 (24 male, 17 female) without cardiac or lung insufficiency. Group 1 consisted of 19 patients, who underwent UPP 3-5 years prior to current consultation. Group 2 consisted of 22 patients, who underwent UPP 6-12 earlier, despite prior diagnosis of severe OSAS. We performed cardiorespiratory sleep monitoring, additionally patients completed the Epworth scale and sleep quality scale. Patients were re-interviewed 2 months after initiation of CPAP therapy and or intraoral device treatment. RESULTS: Group 1 (n=19) displayed obesity (Body Mass Index 34.2±6.1 kg/m2), severe OSAS (AHI 55.2±18.5), high level of daytime drowsiness (Epworth score 18.7±6.3) and low sleep quality (13.0±6.8 sleep quality score). Group 2 (n=22) displayed reduction in AHI level - significant statistically, but not clinically without changes in daytime drowsiness and sleep quality, which were improved in 29 cases out of 41 with the help of CPAP-therapy (18 cases) or intraoral fixation devices (11 cases). CONCLUSION: UPP does not exert a clinically significant affect the severity of sleep disturbance in patients with obesity and severe OSAS. Night sleep study is essential before making a decision about UPP. Clinical state correction of patients in the long-term period of UPP is possible with the help of CPAP therapy or intraoral fixation devices.


Assuntos
Fissura Palatina , Apneia Obstrutiva do Sono , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia , Estudos Retrospectivos , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/cirurgia , Ronco
3.
Artigo em Russo | MEDLINE | ID: mdl-34283538

RESUMO

The article discusses the pathogenetic and clinical features of tinnitus. It is emphasized that various causes contribute to the appearance of tinnitus, including somatic diseases, excess body weight, iatrogenies, otological diseases with an outcome in hearing loss. The anatomical and physiological features of the structure of the central part of the auditory system are considered. It is suggested that the occurrence of tinnitus is associated with the processes of maladaptive neuroplasticity caused by pathological changes in the neuronal activity of cortical structures of the CNS, and not with changes in the peripheral part of the auditory analyzer - the structures of the cochlea. The results of recent studies, including those using functional neuroimaging methods, indicate the significance of cortical connection disorders (human connectome) in patients with tinnitus. In patients with tinnitus, there are changes in regional neuronal activity and connections not only in the auditory cortex, but also in areas not directly related to the analysis of auditory afferentation. Thus, tinnitus can be considered as one of the variants of dysfunction of the human connectome, triggered primarily from the «auditory input¼.


Assuntos
Córtex Auditivo , Conectoma , Zumbido , Cóclea , Humanos , Plasticidade Neuronal , Zumbido/diagnóstico , Zumbido/etiologia
4.
Artigo em Russo | MEDLINE | ID: mdl-33899448

RESUMO

Chronic pain syndromes in the neck and shoulder girdle are one of the important clinical problems due to their high prevalence. In addition, it's of great interest to study the mutual influence of the musculoskeletal system pathology, balance organs and dentoalveolar system due to the possible negative impact of these structures on each other which surely affects the treatment timing and its results. OBJECTIVE: To develop a diagnostic algorithm and a comprehensive program for the treatment and rehabilitation of patients with cervicobrachialgia combined with pathological dental occlusion. MATERIAL AND METHODS: The study involved 90 persons of both genders aged 18 to 55 years consisted of 3 clinical study groups (25 patients) and one control group (15 healthy persons). The clinical groups included 75 patients with chronic myofascial pain syndrome in the neck and shoulder girdle resistant to drug therapy, with temporomandibular joint (TMJ) dysfunction and/or pathological dental occlusion (PDO). The groups were formed depending on the chosen treatment methods: manual therapy was used in the 1st group; in the 2nd group - dental treatment aimed at correcting PDO; in the 3rd group the manual therapy was used together with the correction of the jaws' occlusal relationship. RESULTS: In the study course the most effective algorithm for the diagnosis and rehabilitation of patients with cervicobrachialgia caused by pathological dental occlusion was determined. Positive clinical results were noted in patients of all three groups; however, in the 3- group where manual therapy and complex dental treatment were carried out the results are not differing significantly from the controls. The study showed that in patients with myofascial pain syndrome at the cervical and shoulder levels caused by TMJ dysfunction and pathological dental occlusion it's advisable to include manual and osteopathic diagnostics in the algorithm. Manual muscle testing, posture tests in combination with 3D X-ray imaging and computerized functional studying the maxillofacial region should be used to identify etiology-pathogenesis links between these conditions. These methods are also applicable for quality control of treatment. CONCLUSION: Thus, as a study result the diagnostic algorithm was developed; it allows to determine the relationship of pharmacoresistant pain syndrome of the cervicobrachial region with dental pathology at high degree of accuracy; and a comprehensive interdisciplinary approach to the therapy and rehabilitation of this combined pathology was proposed.


Assuntos
Oclusão Dentária , Síndromes da Dor Miofascial , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Postura , Adulto Jovem
5.
Artigo em Russo | MEDLINE | ID: mdl-33728856

RESUMO

The article describes case history and multiphase treatment of the patient with attacks of vertigo, initially regarded as the onset of Meniere's disease, but later qualified as secondary positional attacks with combined musculoskeletal pathology of the craniovertebral region and temporomandibular joint. Medicinal, local and surgical treatment led to the perfect result. Thus, the team work of neurologist, otolaryngologist, maxillofacial surgeon and orthodontist led to the successful elimination of vertigo attacks.


Assuntos
Doença de Meniere , Vertigem , Humanos , Vertigem/diagnóstico , Vertigem/etiologia
6.
Vestn Otorinolaringol ; 85(4): 43-45, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32885636

RESUMO

Clinical data of seven patients with severe obstructive sleep apnea, in whom episodes of asystole were recorded at night, is analyzed. In five of seven cases against the background of initiated CPAP therapy (all patients were compliant with the therapy), episodes of asystole were eliminated, and only two cases required the installation of a pacemaker. Conclusions are drawn about the possibility of asystole developing in the background of obstructive respiratory episodes during sleep in patients with severe OSAS and the preventive effect of CPAP therapy.


Assuntos
Parada Cardíaca , Apneia Obstrutiva do Sono , Pressão Positiva Contínua nas Vias Aéreas , Humanos , Polissonografia
7.
Artigo em Russo | MEDLINE | ID: mdl-32490620

RESUMO

OBJECTIVE: To develop an integrated therapy for the combination of pain syndrome and cochleovestibular syndrome (CVS) in patients with temporomandibular joint (TMJ) dysfunction. MATERIAL AND METHODS: Forty-five patients (42 women and 3 men), aged from 23 to 54 years, with TMJ dysfunction, signs of CVS and complaints of pain in the ear area were stratified into three groups (15 patients each). Patients received pharmacological and osteopathic therapy (group 1); splint therapy followed by orthodontic treatment (group 2) and a combination of the abovementioned methods (group 3). Re-examination was carried out 3 months after completion of treatment. RESULTS: After treatment, complaints of pain, tinnitus, dizziness and nystagmus, the degree of TMJ dysfunction decreased significantly (p<0,05) compared to baseline in groups 1 and 2. In group 3, the most significant and persistent results were obtained, which significantly differed not only from the initial level, but also from the final level of indicators in the first and second groups (p<0,05), including a decrease in the degree of maladaptation associated with vertigo and trait anxiety. CONCLUSIONS: Differential diagnosis of CVS in patients with TMJ dysfunction requires the joint participation of dentist, neurologist and ENT doctor and should be comprehensive, including medical, orthodontic and osteopathic components.


Assuntos
Síndrome da Disfunção da Articulação Temporomandibular , Zumbido , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor , Vertigem , Adulto Jovem
8.
Vestn Otorinolaringol ; 85(2): 6-13, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32476382

RESUMO

Spontaneous otoliquorrhea (SOL) often mimics the picture of exudative otitis media (EOM), which leads to delayed diagnosis of the underlying disease. PURPOSE OF STUDY: Is to evaluate causes, clinical features and diagnostic algorithm for patients with SOL. PATIENTS AND RESEARCH METHODS: From 2007 to 2018, 33 patients with SOL underwent examination and treatment in the Department of Ear Microsurgery of the Institute. At the preoperative stage, all patients underwent a complete examination, including examination of ENT organs, anthropometric, biochemical, audiological, ultrasound and radiological tests, which made it possible to make the correct diagnosis. RESULTS: SOL was more likely to occur in women over 50 who are obese (69.7%, stage II-III). The disease onset in 51.6% of patients was preceded by conditions accompanied by a short-term or prolonged increase in intracranial pressure. SOL was manifested by the clinical picture of EOM in 72.7% of cases, only in 45.5% of cases was accompanied by release from the ear and nose, was often intermittent and complicated by meningitis in 12.1% of patients. Difficulties in diagnosing the disease are caused by clinical manifestations of exudative or acute otitis media in the absence of a causative factor, which led to the verification of SOL from 1 to 4 years in 81.9% of patients who received long-term treatment for other ENT diseases. CONCLUSION: The master factors in the diagnosis of SOL are otomicroscopy and endoscopy of the nasopharynx, Halo test and screening determination of glucose level in the obtained discharge, as well as high-resolution CT of the temporal bone, which allows to localize the cerebrospinal fluid fistula and to determine the size of the defect.


Assuntos
Otite Média com Derrame , Otite Média , Endoscopia , Feminino , Humanos , Nasofaringe , Osso Temporal
9.
Zh Nevrol Psikhiatr Im S S Korsakova ; 120(12): 118-122, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33459551

RESUMO

Panic attack is a separate episode of fear or anxiety with the simultaneous development of typical autonomic and mental symptoms. Attack is a widespread phenomenon that makes up the central core of panic disorder and affects about 5% of the population. Up to 71% of patients suffering from attacks report panic episodes not only in wakefulness, but also during sleep. This review focuses on the distinctions of night panic attacks, the particular qualities of sleep disturbances associated with them, and methods of treating these conditions.


Assuntos
Transtorno de Pânico , Transtornos do Sono-Vigília , Transtornos de Ansiedade , Humanos , Pânico , Transtorno de Pânico/diagnóstico , Sono , Transtornos do Sono-Vigília/diagnóstico
11.
Vestn Otorinolaringol ; 84(6): 132-136, 2019.
Artigo em Russo | MEDLINE | ID: mdl-32027336

RESUMO

The results of treatment of 38 patients suffering from sensorineural hearing loss with the Gliatilin (solution 3 ml intravenously for 10 days, capsules 400 mg 3 times a day or solution for ingestion 600 mg 2 times a day for 3 months) are presented. All patients in dynamics were given a comprehensive audiological, neurological examination, as well as an assessment of psycho-emotional status and cognitive function. Subjective improvement of ear noise tolerance by patients by 40 days of observation and continuation of this trend during the whole period (100 days) outside of the form of the medicinal preparation is noted. A reliable improvement in the 50% speech intelligibility threshold by day 100 of observation was established in patients of both groups, with a tendency towards earlier (on day 70 of the study) onset of this effect when taking the drug inside as a solution. The Gliatilin has been proven to reduce anxiety and depression, as well as reliably improve cognitive function. Thus, Gliatilin (injection solution, ingestion solution, capsules) can be used to improve the subjective tolerance of ear noise, speech intelligibility and quality of life of patients in chronic sensorineural hearing loss.


Assuntos
Perda Auditiva Neurossensorial , Zumbido , Limiar Auditivo , Perda Auditiva Neurossensorial/tratamento farmacológico , Humanos , Qualidade de Vida , Inteligibilidade da Fala , Zumbido/tratamento farmacológico
12.
Zh Nevrol Psikhiatr Im S S Korsakova ; 118(4. Vyp. 2): 107-112, 2018.
Artigo em Russo | MEDLINE | ID: mdl-30059059

RESUMO

Sleep disorders and pain syndromes are widespread in the general population. This review presents data on comorbidity of these phenomena and possibility of their mutual influence on each other including data based on long-term prospective studies. Studies of pain syndromes and sleep disorders dynamics are analyzed in detail. Anatomical basis of sleep-pain interactions is described, and results of the emotional influence on sleep and pain associations are presented. Non-pharmacological and drug-based approaches to treatment with detailed description of the biochemical basis of their action are considered. The authors conclude that pain syndromes and sleep disorders have reciprocal relations; the improvement of sleep quality helps in various pain syndromes; sleep normalization could play a preventive role with regard to pain.


Assuntos
Dor Crônica , Transtornos do Sono-Vigília , Dor Crônica/complicações , Humanos , Polissonografia , Estudos Prospectivos , Sono , Transtornos do Sono-Vigília/complicações , Síndrome
13.
Artigo em Russo | MEDLINE | ID: mdl-29927397

RESUMO

AIM: To explore the possibility of cerebral hemodynamic reserve (CHR) normalization in patients with obstructive sleep apnea syndrome (OSAS), aged over fifty, who received continuous positive airway pressure (CPAP) therapy. MATERIAL AND METHODS: The main group (20 patients, aged 50-65 years, with severe OSAS) and the control group (20 volunteers without snoring and OSAS matched for age and physical status) were studied. Diagnosis included cardio-respiratory monitoring of nocturnal sleep and ultrasound examination of cerebral blood flow with functional tests (breath holding and hyperventilation) and calculating the coefficient of vasomotor reactivity (CVMR) before the start of CPAP-therapy and after one month therapy. RESULTS: The significant CVMR decrease in vertebral (VA) and basilar arteries (BA) in patients with OSAS compared to the control group was identified: 38.9±8.5 and 55.7±11.3 for VA, 36.8±15.7 and 54.0±5.4 for BA. After one month CPAP-therapy, no significant coefficient gains was observed: 38.9±8.5 and 42.3±9.1 for VA, 36.8±15.7 and 37.2±7.7 for BA. CONCLUSION: The reduction of CVMR in patients older than 50 years with severe OSAS suggests the disturbance of CHR. The absence of its recovery within one month of CPAP-therapy may be indicative of the irreversible damage of the cerebral blood flow regulation mechanisms. Continued observations for a longer period are needed.


Assuntos
Apneia Obstrutiva do Sono/terapia , Idoso , Pressão Positiva Contínua nas Vias Aéreas , Humanos , Pessoa de Meia-Idade , Polissonografia , Ronco
14.
Artigo em Russo | MEDLINE | ID: mdl-29927409

RESUMO

The article describes a series of seven cases characterized by a change in the type of attack in the perimenopausal period: migraine attacks before menopause and cochleovestibular paroxysms after the onset of menopause. Clinical data and results of diagnostic tests are presented and the possible link of both attack variants with cervical pathology is discussed. The authors explain this dynamics by stem neural integrator dysfunction during hormonal changes.


Assuntos
Doença de Meniere , Transtornos de Enxaqueca , Feminino , Humanos , Menopausa
15.
Artigo em Russo | MEDLINE | ID: mdl-29652314

RESUMO

Cervical vertigo (CV) hasn't yet been recognized by many neurologists, as it has no specific clinical symptoms and reliable diagnostic criteria. However, over the past 150 years, there has been accumulated numerous experimental and clinical evidence to support the legitimacy of CV allocation as a separate nosology. This review presents data regarding the vertigo associated with neck pathology: possible evidence of CV existence and the description of its type as well. The principles of CV diagnosis and treatment are considered, an attempt to create a unified concept is proposed.


Assuntos
Transtornos de Enxaqueca , Neurologistas , Vertigem , Humanos , Pescoço
16.
Vestn Otorinolaringol ; 82(4): 56-59, 2017.
Artigo em Russo | MEDLINE | ID: mdl-28980599

RESUMO

The objective of the present work was to study the influence of the dry extract from the leaves of Ginkgo biloba EGb 761 (used as monotherapy at a dose of 120 mg twice daily during 4 months) on the vestibular function of the patients presenting with cochleovestibular pathology of peripheral and mixed genesis. We present the results obtained by the objective and subjective methods for the evaluation of the vestibular function as well as the neurological and psychoemotional state of the 40 patients that was carried out during the four months of memoplant monotherapy. It is concluded that monotherapy with the use of the dry extract from Ginkgo biloba leaves can be applied for the purpose of improvement of static and dynamic balancing state. Moreover, this memoplant preparation can be used as a means of prophylaxis of recurrent dizziness that in addition reduces the severity of anxiety and depression without producing adverse side effects.


Assuntos
Tontura , Ginkgo biloba , Fitoterapia/métodos , Extratos Vegetais , Qualidade de Vida , Doenças Vestibulares , Adulto , Tontura/tratamento farmacológico , Tontura/etiologia , Tontura/psicologia , Monitoramento de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Exame Neurológico/métodos , Extratos Vegetais/administração & dosagem , Extratos Vegetais/efeitos adversos , Resultado do Tratamento , Doenças Vestibulares/complicações , Doenças Vestibulares/diagnóstico , Doenças Vestibulares/tratamento farmacológico , Doenças Vestibulares/fisiopatologia , Testes de Função Vestibular
17.
Vestn Otorinolaringol ; 82(4): 72-76, 2017.
Artigo em Russo | MEDLINE | ID: mdl-28980603

RESUMO

At present, the skeptical attitude toward the term 'cervical vertigo' (CV) predominates in the ENT-community. Such point of view is attributable to the absence of specific CV symptoms and well-defined diagnostic criteria. The present literature review was designed to consider the results of the clinical observations and experimental investigations obtained during the past 150 years that give evidence of the possibility to regard cervical vertigo as a separate nosological entity. The characteristic signs of this condition are analyzed and systematized. Four CV variants are currently distinguished. The principles of diagnostics and treatment of cervical vertigo are discussed and general concept of CV is formulated.


Assuntos
Vertigem , Diagnóstico Diferencial , Humanos , Transtornos de Enxaqueca/diagnóstico , Equilíbrio Postural , Transtornos das Sensações/diagnóstico , Vertigem/classificação , Vertigem/diagnóstico , Vertigem/fisiopatologia , Doenças Vestibulares/diagnóstico
18.
Artigo em Russo | MEDLINE | ID: mdl-28635794

RESUMO

The data of the literature on epidemiology, clinical manifestations, diagnosis and treatment of Behcet's disease are presented. Particular attention is paid to international recommendations (2014) on the classification, diagnostic criteria and treatment of neurological symptoms of BehÒ«et disease.


Assuntos
Síndrome de Behçet/psicologia , Transtornos Mentais/complicações , Síndrome de Behçet/complicações , Humanos
20.
Vestn Otorinolaringol ; 80(3): 54-56, 2015.
Artigo em Russo | MEDLINE | ID: mdl-26288212

RESUMO

The present article is focused on the detailed analysis of the history of a patient suffering from combined dizziness including the entire course of the disease, the complicating complex of complaints, and the increasing number of abnormal components of the patient's condition. The specific features of various nosological forms of the disease are described as arising from different clinical entities causing vertigo. The special emphasis is laid on the diagnostic algorithm for the elucidation of these disorders.


Assuntos
Tontura , Qualidade de Vida , Vertigem , Audiometria/métodos , Diagnóstico Diferencial , Gerenciamento Clínico , Tontura/diagnóstico , Tontura/etiologia , Tontura/fisiopatologia , Tontura/psicologia , Tontura/terapia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Exame Neurológico/métodos , Avaliação de Sintomas/métodos , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Vertigem/diagnóstico , Vertigem/etiologia , Vertigem/fisiopatologia , Vertigem/psicologia , Vertigem/terapia
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