CLINICAL AND PATHOGENETIC ANALYSIS OF MONITORING OF CHILDREN WITH DISEASES OF THE PERIPHERAL NERVOUS SYSTEM

Abstract

In the structure of acute neuroinfections , diseases of the peripheral nervous system (PNS) and spinal cord occupy a significant place, accounting for 16%-32% in children. The polymorphism of clinical manifestations, due to different etiology and topic of the lesion, the incidence of disability , reaching 15% and possible mortality, determine the relevance of this problem.
Purpose of the study. To develop a clinical and pathogenetic mechanism for monitoring children with diseases of the peripheral nervous system.
Materials and research methods. The material for the clinical ENMG study was the analysis of 100 cases of infectious diseases of the PNS and SM in children aged 3 months and older. up to 15 years old. Registration of surface electromyograms were performed with bipolar electrodes. The biceps and triceps muscles of the shoulder, the superficial flexor of the fingers, the common extensor of the fingers of the hand, the rectus femoris, the anterior tibial muscle and the medial head of the gastrocnemius muscle were examined on both sides according to generally accepted criteria. Needle EMG was performed according to the standard method.
Research results. As a result of clinical and ENMG studies of various nosological forms included in the structure of IRD and SM, their clinical and neurophysiological features were identified. It was shown that IRI and SM are mainly caused by enterovirus infection (30.8%), borreliosis (10.3%), less often yersiniosis (6;0% X influenza (6.0%) and herpetic (6.0%) infection which determines the specificity of clinical manifestations.Neurological examination of PD in children with DPPH made it possible to identify the clinical features of early and late forms.Early DPN occurred on days 2-15 of diphtheria, manifested in all children with local cranial and bulbar symptoms with lesions of the vagus and glossopharyngeal nerves, as well as mild symptoms of generalized , movement disorders in 81% of patients, expressed in transient dissociation of tendon reflexes - preservation, some and the absence of others, the preservation of elementary motor functions (muscle strength and tone).In 29% of patients, bulbar symptoms were combined with sensory disorders : hyperesthesia and paresthesia of the polyneuropathic type.
Conclusions: Thus, monitoring of children with diseases of the peripheral nervous system showed that various etiological factors affect the course of the disease and determine its outcome and duration.