Karnaukh Y. Clinical-neurophysiological characteristics of peripheral nervous system lesion in multiple sclerosis and chronic inflammatory demyelinating polyneuropathy, contemporary approaches to treatment

Subjects of research are multiple sclerosis, chronic inflammatory demyelinating polyneuropathy, study target – increase the efficiency of diagnostics for the atypical forms of multiple sclerosis with the lesion of peripheral nervous system and chronic inflammatory demyelinating polyneuropathy by means of the clinical and electroneuromyography techniques and substantiation of the adequate approaches in the treatment; methods – common, electroneuromyographical, immunological, biochemical, statistical and mathematical ones; novelty- for the first time the characteristics of the clinical and subclinical manifestations for of peripheral nervous system lesion in patients with multiple sclerosis and chronic inflammatory demyelinating polyneuropathy were defined on representative clinical materials. There was the first complex clinical and electroneurophysiological examination enabling to reveal subclinical manifestations of of peripheral nervous system lesion with multiple sclerosis and chronic inflammatory demyelinating polyneuropathy; Basing on the data of the clinical, electro neurophysiological and immunological examinations there was established relationship between the type and severity of of peripheral nervous system impairment and the disease performance, severity and status; prevalence for myelinopathy type for lesions of peripheral nervous system was established; the severity of the lesion of peripheral nervous system correlated with the severity of the multiple sclerosis and chronic inflammatory demyelinating polyneuropathy; the highest degree of lesion severity was observed for secondary progradient performance of the disease, that is exacerbation stage, and the mildest one – for the stage of remittance; for the first time the method of assessment of the grade for of peripheral nervous system lesion through the stimulation electroneuromiography values was developed and patent protected (No 23236 U Ukraine А61В 5/0488); for the first time there was established relationship between of peripheral nervous system impairment in the patients with multiple sclerosis and citoxyne level – of peripheral nervous system lesion is accompanied by significant increase of the level of the pro-inflammatory and anti-inflammatory cytotoxins; the management of the peripheral nervous system for the patients with multiple sclerosis with use of the agents of -lipoic acid and pyrimidine nucleotides - nucleo-cmp-forte, those having the effect on the mechanisms of remyelination and axonal transport, was justified and implemented within clinical practice. It is inculcated in practice of neurological separations of the Olexander clinical hospital and Regional clinical hospital №4, Cyti centr of management multiple sclerosis of the Kiev and also in a pedagogical process in National medical university Bogomolca. Field of using is treatment and diagnostic process of neurological separations, pedagogical process of neurologic chairs of medical educational institutions.