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Nervous diseases

Table of contents
Nervous diseases
Anatomy of a nervous system
Peripheral nervous system
Vegetative nervous system
Brain covers, cerebrospinal liquid
Physiology of a nervous system
Blood supply of a head and spinal cord
Pathophysiological patterns of defeats of a nervous system
The anamnesis and the general survey in neurology
Neurologic survey
Tool methods of research in neurology
Spinal puncture
Motive disturbances
Ataxy
Extrapyramidal frustration
Sensitivity disturbances
Dizziness
Symptoms of defeat of a meninx
Disturbances of the highest brain functions
Vegetative frustration
Intracranial hypertensia
Coma
Syndromes of damage of a spinal cord
Pain syndromes at diseases of a nervous system
Headache
Secondary forms of a headache
Prozopalgiya
Dorsodynia and extremities
Tservikalgiya and tservikobrakhialgiya
Thoracalgia
Lyumbalgiya and lumbar ishialgia
Diagnosis and treatment of a dorsodynia and extremities
Reflex sympathetic dystrophy
Vascular diseases of a nervous system, stroke
Treatment of a stroke in the acute period
Prevention of the subsequent stroke, rehabilitation
Acute hypertensive encephalopathy
Distsirkulyatorny encephalopathy
Disturbances of spinal blood circulation
Meningitis
Acute serous meningitis
Tubercular meningitis
Tick-borne encephalitis
Acute disseminated encephalomyelitis
Subacute sclerosing panencephalitis
Brain abscess
Prionny diseases
Myelitis
Neurosyphilis
Neurologic displays of HIV infection
Brain parasitic diseases
Defeats of a vegetative nervous system
Vegetative crises
Neurogenic faints
Craniocereberal injury
Slight craniocereberal injury
Medium-weight and severe craniocereberal injury
Brain prelum
Effects of a craniocereberal injury
Vertebral and spinal injury
Epilepsy
Treatment of epilepsy
Sleep disorders and wakefulnesses
Hypersomnias
Parasomniya
Parkinson's illness
Essential tremor
Lateral amyotrophic sclerosis
Cerebellar degenerations
Family spastic paraplegia
Alzheimer's disease
Damages of cranial nerves
Polyneuropathies
Giyen's syndrome — Barret
Diphtheritic polyneuropathy, demyelinating poliradikulonevropatiya
Multiple mononeuropathy
Plexopathies
Mononeuropathies
The surrounding herpes
Myopathies
Myatonia
Inflammatory myopathies
Metabolic myopathies
Disturbances of a neuromuscular transmission
Neural amyotrophy
Spinal amyotrophy
Defeat of a nervous system at intoxication alcohol
Neurologic complications of drug addiction
Poisonings with heavy metals
Poisoning with organophosphorous connections
Poisoning with carbon monoxide
Poisoning with methyl alcohol
Poisoning with medicines
Poisoning with bacterial toxins
Brain tumors
Tumors of a spinal cord
Hydrocephaly
Kraniovertebralny anomalies
Myelosyringosis
Malformations of a backbone and spinal cord
Diseases of a nervous system at children
Children's cerebral palsy
Fakomatoza
Hereditary neurometabolic diseases
Tics and Turett's syndrome
Defeats of a nervous system at somatopathies
Defeat of a nervous system at a diabetes mellitus
Paraneoplastic syndromes
Care of patients with paralyzes
Food of patients
Care of patients with disturbances of an urination, the prevention of injuries
Care of patients with dysfunction of a digestive tract
Care of patients in a coma, with disturbance of the speech, mentality
Rehabilitation of patients with diseases of a nervous system

Shtulman D.R., Levin O. S.

The textbook is intended for training of nurses and paramedics. The main data on diseases of a nervous system, methods of their diagnosis, the main neurologic symptoms and syndromes are provided. The special attention is paid to features of care of patients with diseases of a nervous system, role of average medical personnel in diagnostic and medical process, to methods of the pre-medical help at medical emergencies.

MAIN STAGES OF DEVELOPMENT OF DOMESTIC CLINICAL NEUROLOGY

The foundation for domestic neurology was laid by a group of outstanding domestic physiologists: I.M. Sechenov, I.P. Pavlov, N. E. Vvedensky.
Ivan Mikhaylovich Sechenov (1829 — 1905) for the first time connected the mental phenomena with reflex activity of a brain. Its works indicating an important role of the return afferentation and the central braking in activity of a nervous system were important.
Ivan Petrovich Pavlov (1849 — 1936) created theory of higher nervous activity. Its researches roles of instinctive and conditioned reflexes, processes of excitement and braking in activity of a brain created qualitatively new basis for understanding of patterns of development of neurologic diseases.
In Russia the clinical neurology began to be made out in independent discipline in the middle of the 19th century. In parallel this process happened also in many European countries: in France where Jean-Martin Sharko (1825 — 1893) worked, in Germany — in many respects thanks to Karl Vernike (1848 — 1905) efforts, in England where the important contribution to formation of neurology was made by D. Hyulings Jackson (1835 — 1911).
Alexander Yakovlevich Kozhevnikov (1836 — 1902) became the founder of domestic neurology. It was not only the outstanding scientist and the clinical physician, but also had brilliant organizing abilities. In 1869 A.Ya. Kozhevnikov organized at the Moscow university the country's first department of nervous diseases and psychiatry which shortly before that (in 1863) were allocated from a course of private pathology and therapy. 20 beds for the "nervous patients" allocated in hospital therapeutic clinic (New and Ekaterina's hospital) became the first clinical base of department. In 1890 A.Ya. Kozhevnikov founded independent clinic of nervous diseases on the Maiden field (nowadays clinic of nervous diseases of A.Ya. Kozhevnikov at the Moscow medical academy). The brilliant works devoted to questions clinical and theoretical neurology, A.Ya. Kozhevnikov won the world popularity. In 1894 A.Ya. Kozhevnikov in detail described a special form of partial epilepsy and connected it with inflammatory defeat of a motive zone of bark of hemicerebrums. In the subsequent she received the name "kozhevnikovsky epilepsy".

I.Ya.Kozhevnikov (1836 — 1902)

A.Ya. Kozhevnikov possesses numerous works on separate neurologic problems (in particular, on aphasias, an ophthalmoplegia, bulbar paralysis, a children's cerebral palsy, poliomyelitis, etc.). He created the Moscow neurologic school, world famous scientists — V. K. Roth, S. S. Korsakov, L.O. Darkshevich, V.A. Muratov, G. I. Rossolimo, L.S. Minor were among his pupils.
Grigory Ivanovich Rossolimo (1860 — 1928) is a founder of children's neurology in Russia. Being professor of department of nervous diseases of the Moscow university, he opened the first children's neurology unit at clinic. A number of the works devoted to studying of anatomy of a spinal cord, a symptomatology of diseases of a nervous system is written to them; one of symptoms of defeat of a pyramidal way is called by his name.
In the second half of the 19th century and at the beginning of the 20th century important discoveries in the field of anatomy of a nervous system were made. Vladimir Alekseevich Bets (1834 — 1894) for the first time described huge pyramidal neurons in a motive zone of bark of hemicerebrums, studied their topography and development. V.A. Bets conducted a series of researches on studying of the nerve centers located on a surface of hemicerebrums, having laid the doctrine foundation about cytovery tectonics of a brain.

The important contribution to development of anatomy and physiology of a nervous system, and also clinical neurology was brought by Vladimir Mikhaylovich Bekhterev (1857 — 1927). It the first described some forms of diseases of a nervous system (for example, a special form of a front tic, an acute cerebellar ataxy at alcoholism) and neurologic symptoms, including one of pathological-foot reflexes which in the subsequent received his name. Under its management the Russia's first Research psychoneurological institute (nowadays St. Petersburg research psychoneurological institute of V. M. Bekhterev) was founded. The fundamental management published by it "Conduction paths back and a brain" (1896 — 1898) long time was the main source of data on a neuroanatomy.
The valuable contribution to development of domestic neurology was made by M. I. Astvatsaturov, M. B. Crolles, M. S. Margulies, E.K. Sepp, N. I. Grashchenkov, E.V. Schmidt, N. K. Bogolepov. Works of domestic neurologists in the field of studying of neuroinfections, first of all a tick-borne encephalitis and poliomyelitis, works of the founder of domestic neurogenetics S. N. Davidenkov, and also N. V. Konovalov's researches devoted to gepatotserebralny dystrophy (a hepatolenticular degeneration) were of great importance. The world popularity got a job of the founder of a domestic neuropsychology A.R. Luriya studying neuropsychological manifestations at focal damages of a brain. The doctrine about mechanisms of activity of a nervous system is normal and pathologies were added substantially by domestic physiologists — N. A. Bernstein and P. K. Anokhin.
Fast improvement of diagnostic methods of diseases of a nervous system became feature of the present stage of development of clinical neurology. A long time careful neurologic survey of the patient was almost only way of diagnosis of diseases of a nervous system. Investigating the motive sphere, sensitivity, reflexes, neuropsychological functions, neurologists learned to define precisely defeat localization, i.e. to make the topical diagnosis. With the advent of a X-ray analysis, an electroencephalography, an electromyography, an angiography, high-quality research of cerebrospinal liquid diagnosis accuracy significantly increased. But original revolution in diagnosis of neurologic diseases happened in 70 — the 80th years of this century to implementation of computer (KT) and magnetic and resonant tomography (MRT) which allow to estimate visually a condition of brain structures during lifetime of the patient.
More exact and early diagnosis created conditions for improvement of specific methods of treatment of neurologic diseases. Identification in the central nervous system (CNS) of a large amount of chemicals and establishment of their role in transfer of excitement from one neuron on another was led to emergence in the second half of the 20th century of a large amount of medicines which allowed to eliminate or at least to facilitate symptoms of many neurologic diseases. Physical and neuropsychological rehabilitation of the patients who had a stroke, a craniocereberal injury or other acute diseases of a nervous system became the major direction in their treatment which gained powerful development in the last decade. Also the organization of the neurologic help to patients is improved, the All-Russian and regional centers specializing in treatment of multiple sclerosis, extrapyramidal diseases, a stroke, neuromuscular diseases, sleep disorders, pain syndromes, etc. are formed.
In recent years development of clinical neurology is closely connected with achievements of all complex of sciences about a nervous system — a neurobiology, neurophysiology, a neuropharmacology, neurogeneticists, neuroimmunology, etc. Studying of thin molecular and biological mechanisms of activity of a nervous system is normal also of pathology, detection of genetic defect at hereditary neurologic diseases promise emergence of new methods of treatment of a number of the diseases which are considered now as incurable in the near future.



 
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