Korzhenevskyy Y. Clinical and paraclinical characteristics of nervous system damage in chronic hepatitis

Thesis is devoted to the problem of improving the diagnostics of nervous system damage in chronic hepatitis by refining the nervous system characteristics, based on complex clinical and paraclinical examination. The study involved 133 young and middle aged patients (including 74 patients diagnosed with chronic hepatitis and 59 - with liver cirrhosis). The main neurological complaints, their frequency and specifics of presentation by examined patients were investigated. The necessity of active questioning was revealed for the purpose to complement clinical picture, because some patients did not present any complaints. In patients with chronic hepatitis central nervous system disorders were manifested by coordination and pyramidal insufficiency, asthenoneurotic syndrome, various psycho-emotional changes (raised level of anxiety and depression) and cognitive impairments. It was shown that in the most patients with chronic hepatitis peripheral nervous system damage was found. Damage of peripheral nervous system was manifested with polyneuropathy syndrome with sensational, vegetative and reflectory disorders. With rheoencephalographic and rheohepatographic study was showed features of main parameters of cerebral and hepatic haemodynamics in patients with chronic hepatitis in comparison with liver cirrhosis. Rheoencephalography showed more frequent venous flow failure in vertebrobasillar vessels and decreasing of volume blood vessel filling. Rheohepatography showed more frequent increasing of tone of large arteries and decreasing of small arteries, also a venous outflow elongation and decreasing of resistance of small vessels. Сorrelations among results of various neuropsychological tests, as well as among main rheoencephalographic and rheohepatographic parameters also were investigated.