Orzheshkovskyi V. Polyneuropathies (pathogenetic mechanisms, сlinic and paraclinic features, diagnostic approaches)

Scientific work is devoted to a question of optimization of diagnostic approaches at polyneuropathies of various genesis by specification of pathogenetic mechanisms, being based on a complex clinical and paraclinic trial. On the basis of comprehensive clinical neurological and paraclinic examination of 444 patients with polyneuropathy who were distributed on 8 groups on an etiological factor and 32 almost healthy are specified pathogenetic mechanisms and their features at different forms of polyneuropathies that allowed to consider them rather correctional influence of possible medical factors, and also to predict the further course depending on the leading pathogenetic mechanisms. Possible influence a current, a clinical picture and nerve conduction studies' and electromyography's indicators of pathogenetic major factors of development of states which cause is designated or are associated with polyneuropathy, such as insulin resistance at disturbances of carbohydrate metabolism, a seropositivity at rheumatoid arthritis, hypofunction and extent of autoimmune aggression at diseases of a thyroid gland, etc. that is predictively significant concerning progressing of weight of neurologic deficit, negative dynamics of quality of life at patients with polyneuropathy, and further, can influence the treatment choice. The shown role of neuropsychological dysfunction, in particular a pattern of the relations to a disease, existence of the increased level of a chronic stress, an alexithymia, the dominating perceptual modality, in the general neurologic deficit. A certain correlation interrelation of the dominating frequency a rhythm alpha at rest with nerve conduction studies' and electromyography's parameters at polyneuropathy that opens new opportunities of influence on the polyneuropathy course. Certain states of microelement deficiency which can accompany polyneuropathy and their possible influence on pathological mechanisms of implementation of defeat of a peripheral nervous system. Clinical and nerve conduction studies' and electromyography's indicators in groups of patients with polyneuropathy are systematized and specified that all major pathogenetic factors which cause cover and realize defeats of a peripheral nervous system. In each group the main options of a current and characteristic clinical and neurophysiological patterns of development of polyneuropathy are defined that opens new opportunities of early identification of a disturbing factor which led to development of polyneuropathy.