Lyshenyuk S. Clinical Pathogenic Characteristics of Vegetative and Peripheral Nervous System Impairments During Diphtheria in Children.

Changes of functional state of vegetative and peripheral nervous system in diphtheria acuity and on the stages of early and late recovery have been studied on the basis of clinical symptomatology and indices of special researches. It has been proved that from 9 to 12 days of disease with all severity level of diphtheria stable vagotonia is set in patients with clinical forms of diphtheria independent from outgoing vegetative tonus. In bearers of toxigenic stock of diphtheria corynebacteria short-term initial disorders of vegetative homeostasis have been revealed, which gives an opportunity to interpret bacilli carrying as an active infectious process of subclinical level. Modifying impact of associated streptococcus infection on the character of disorders of vegetative homeostasis during oropharynx diphtheria in children, which is revealed, particularly, in apparent sympathicotonia of initial period of disease is determined.In patients with acute and medium-acute forms of diphtheria early mono and polineuropathy which reveals itself in bulbar syndrome. Expressiveness level and the corresponding neurological symptomatology duration are predetermined by severity of the disease clinical form, intensity and prevalence of local inflammatory changes in the fauces area. Delayed diphtheric polyneuropathies with prevailing disorders of lower extremities motor functions at diphtheria develop in children with complicated disease forms. The slow down of nervous impulse conduction through peripheral nerves is observed befor the disease clinical manifestation and after regeneration of the lost motor functions according to electroneuromiographic examination. This method allows prognosticating the development of delayed diphtheric polyneuropathies and assessing the recuperation completeness of peripheral nerves functional ability. Vulnerability of unmedulated nerve filament of heart muscle to damaging action of diphtheric exotoxin, demyelinating character of changes in peripheral nerves at delayed diphtheric polyneuropathies, and, at the same time, their reversibility are experimentally proved.