This is a description of the case of quite severe neurolisteriosis in an adult man resulting in the rare combination of neurological symptoms such as complete bilateral ophtalmoplegia and locked-in syndrome. The case illustrates clinical features that are special for this disorder and also highlights management of such patients.
While compression neuropathies of the nerves of the lower limbs are not a common pathology, peroneal nerve neuropathy is the most common of them. Peroneal nerve compression most commonly occurs at or around the head of the fibula, but can also occur in the lower leg, ankle, or foot. Neurophysiological and neuroimaging methods are effective in diagnosing peroneal nerve compression and determining the type of damage. The first line of therapy is lifestyle modification, avoidance of compressive postures, ankle joint orthotics, treatment of knee joint instability when detected, kinesiotherapy. An important role in the correction of symptoms is played using anticholinesterase drugs, the effectiveness of which in diseases of peripheral nervous system has been shown in a number of domestic studies. If conservative treatment fails, surgical treatment is recommended. The diagnosis of peroneal neuropathy is associated with a good prognosis and most patients experience complete recovery of nerve function.
Introduction. The assessment of the level of consciousness in patients with acute brain injury is a mandatory first step of neurological examination. There is a need for clinical scales which allow to assess the level of wakefulness and degree of patient non-responsiveness in 23 minutes. The Full Outline of UnResponsiveness (FOUR) scale is an optimal tool for such clinical assessment, which focuses on eye response, motor response, brainstem reflexes, and respiratory pattern. The absence of an officially translated and validated version impedes the use of FOUR scale in Russia, while the use of non-validated clinical scales carries a risk of erroneous diagnosis and reduces the quality and information value of research studies. Study aim: to develop an official Russian language version of the FOUR scale, taking into account its linguistic and cultural characteristics as part of the validation study. Materials and methods. The first stage of the validation process was completed, consisting of the linguistic and cultural adaptation of the FOUR scale. Medical professionals (Russian and English native speakers) performed forward and back translations of the original scale. The developed version then underwent review by the Expert Commission, which included a linguist, neurologists, anaesthesiologists and intensive care specialists. The next step was a pilot test of the scale. Results. The main difficulties in the translated text of the scale were solved during the first meeting of the Expert Commission. Then, taking into account the inclusion and exclusion criteria, a pilot test was performed by assessing 15 patients with the developed version of the FOUR scale. The statistics of this cohort are presented. Investigators had no difficulties in understanding and interpreting the scale instructions during the pilot test. Based on the results, the final version of the scale was adopted. The Russian version of the scale text with instructions and illustrations is presented in this paper. Conclusion. Translation, linguistic and cultural adaptation of the FOUR scale was conducted at the Research Centre of Neurology (Moscow, Russia). For the first time, the Russian version of the scale is officially presented and recommended for widespread use in clinical and research practice in Russia and other Russianspeaking countries based on the results of pilot testing. The next publication will present the results of the evaluation of psychometric properties (reliability, sensitivity, etc.) of this version of the scale
ВеСтНИК РоССИйСКой ВоеННо-МеДИцИНСКой АКАДеМИИ Всероссийская научно-практическая конференция 2018, ПРИЛоЖеНИе 3 (63) «Дегенеративные и сосудистые заболевания нервной системы» НАУчНЫЕ СТАТьИ ТЯЖЕЛЫЕ ИНФЕкЦИОННЫЕ ОСЛОЖНЕНИЯ ПРИ ВНУТРИМОЗГОВОМ кРОВОИЗЛИЯНИИ: кЛИНИчЕСкОЕ НАБЛюДЕНИЕ Лунева И
This is a description of the clinical case of severe toxic polyneuropathy in a 52-year-old man, caused by a confirmed exogenous intoxication with amphetamine. The clinical picture was remarkable for muscle weakness in different muscle groups: neck, back, arms and legs, respiratory muscles; as well as for the respiratory failure (requiring mechanical ventilation), rhabdomyolysis, mild nephropathy, liver cytolysis. A differential diagnosis was made between myasthenia gravis, myopathy, amyotrophic lateral sclerosis. After a course of intensive therapy, almost complete regression of symptoms took place, as well as the improvement of electroneuromyographic pattern. Taking into account a rapid partial regression of symptoms in the course of the disease, as well as the results of a neurophysiological study, an immunochromatographic urine drug screen was performed, positive for amphetamine. This clinical case demonstrates "rare" complications of amphetamine use to be kept in mind during a diagnostic search.