[Clinical polymorphism of neuroborreliosis at a late stage of the disease].
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Biomedical subjects
Publications and source records attributed to S A Drakina.
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Basing on the evidence provided by clinicomorphological and immunobiological studies, three, patients with progressive epileptic seizures were found to have chronic herpetic inflammation in the brain. The seizures took serial pattern with development of status epilepticus.
The results of the clinico-morphological studies carried out in 30 patients with the anterior-horn variety of amyotrophic lateral sclerosis (ALS) (CNS morphology was investigated in 6 cases) demonstrate this variety to be characterized by early fading of the tendinous periosteal reflexes, rapid development of amyotrophies, weak intensity of pyramid system lesions. This is supported by morphological studies of the CNS and allows advancing an opinion in favour of the priority of motoneuronal injury.
The authors describe the course of herpetic encephalitis in 52 patients aged 16 to 64 years. Five types of the initial manifestations of herpetic infection of the CNS were revealed. In 44.3% of cases the disease started from the general cerebral symptomatology and consciousness disturbance; in 13.6% it started in a brain stroke-like manner followed by the development of the comatose status; in 13.6% of cases from memory disorder and unmotivated actions; in the same percentage of cases, the disease onset was marked by the dominance of dizziness, diplopia, ataxia and central hemiplegia ; in 15.9% the disease started from pains in the stomach, loin and lower limbs. Hemispheric and pseudotumorous stem encephalitides (48.1 and 13.6% respectively) were predominant; in 25% meningoencephalitides and in the remainder, encephalomyelitis running their course in the form of disseminated encephalomyelitis (5.7%), focal myelitis (5.7%) or opticomyelitis (1.9%). The data presented attest to the pleomorphism of the clinical picture of herpetic lesions of the CNS.
Lincomycin was found to inhibit tick-borne encephalitis (TBE) virus. To test antiviral potential of this drug, a clinical trial was initiated entering TBE patients from known focuses of the disease (Novosibirsk, Kemerovo, Perm and Irkutsk Provinces). The drug was given to 23 patients with meningeal and meningoencephalitic TBE. A control group of 22 matched subjects received specific immunoglobulin. Resultant efficacy of lincomycin appeared not inferior to that of anti-TBE immunoglobulin. Lincomycin can be successfully introduced in the treatment of meningeal and meningoencephalitic TBE.
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HLA-antigen distribution in 93 patients with amyotrophic lateral sclerosis did not differ from that in the control group. Yet, there were significant differences in antigen levels both between different variants of the disease and as compared to the control values.
Cases are described of chronic zoster encephalitis presenting with the leading progressive focal epilepsy syndrome. The clinical presentation of the trouble can include both general cerebral signs and those of the focal affection of the central nervous system only. The progressive course and duration of remission suggest to us a persisting infection manifesting against the background of immune deficiency.