Walking and balance disorders in elderly patients are the most common manifestations of various diseases of the nervous system. Balance imbalance is the leading cause of injuries in the elderly, leading to a limitation of both the patient’s ability to work and communication in the social environment, which in particular cases leads to a loss of independence, reducing the quality of life. Walking disorders are an important, difficult to resolve medical and social problem. The aim of the study was to identify the physiological and clinical aspects of age-related gait disorders with an emphasis on neurological pathogenetic causes. A detailed study of modern foreign medical literature and current international clinical guidelines was carried out with further systematization of the data obtained. Falls in the elderly are a common and major factor that threatens the independence of older people. The frequency of falls increases with age. Treatment for fall injuries does not always include identifying the cause of the fall. In the elderly, loss of balance is most commonly due to multiple causes, including impending threat to the homeostatic mechanisms that maintain postural stability combined with age-related impairments in balance, gait stability, and cardiovascular function. Gait disorders are a major cause of functional impairment and morbidity in the elderly. Most gait disorders in the elderly are multifactorial and have neurological components. In developed countries, there is a trend towards aging of the population: the percentage component of the elderly part of the population is growing. It is violations of balance, stability and walking, to a large extent, that lead to the inability of the patient to provide his quality of life at a satisfactory level on his own, to disability and failure in the workplace. Early diagnosis of gait disorders can prevent premature disability and limit the independence of elderly patients. It is important to note that a history of falls is a predictor of the risk of new falls.
This study allows understanding the course of the process of tissue regeneration in the pathology of the nervous and endocrine systems. These systems are closely interconnected. The integrity of their pathogenic actions on the body is called neroendocrinopathies. They affect body tissues and especially the skin epithelium, independently causing dystrophies and changing their healing rate and regeneration of wounds received during the course of the disease. The wound healing rate depends on many factors, such as age, nutritional status and body weight, body immune status, and chronic comorbidities. The endocrine and nervous system disorders affect oxygenation, hormonal imbalance and nutrient supply of local tissues and the whole body. A wide range of diseases in humans, such as atopic dermatitis, psoriasis, herpes zoster, arthritis, diabetes is characterized by a distinct neurogenic and endocrine component. Micro- and macroangiopathy develops, carbohydrate metabolism in tissues suffers and immunity disorders occur. This disrupts the course of the wound healing process and slows down the recovery processes.
Relevance. Damage to the nervous system during the progression of systemic lupus erythematosus (SLE) is not only one of the most common phenomena, but also an unfavorable prognostic criterion for the patient. At the moment, more than 19 types of neurolupus manifestations are known in both adult patients and children. The main problem is the non-specificity and variability of neuropsychiatric symptoms, which can be associated not only with the pathogenesis of SLE, but also with other factors caused by the influence of the environment, psychosomatics, and concomitant diseases. Currently, there is no "gold standard" for diagnosing this type of pathology, and sometimes the selection of therapy does not correspond to the etiology of the lesion. Also, the urgency of this problem proves the lack of a clear classification of neurological complications of SLE, which can be used by specialists at the present time. The links of the pathogenesis of the development of both systemic lupus erythematosus itself and lesions of the nervous system in this disease are not fully understood.The purpose of this study. To study the pathogenesis and symptomatic manifestations of neurolupus, presented in the studies of Russian and foreign scientists, with the subsequent systematization of the information obtained. Material and methods. A study was made of materials from foreign and domestic literature of recent years on the issue of classification, pathogenetic and symptomatic problems of the neurological manifestation of systemic lupus erythematosus.Results. The prevalence of neurolupus among SLE patients reaches 95% of cases, expressed both in a single syndrome and in multiple simultaneous clinical manifestations. Lesions of both the central and peripheral nervous systems, as well as psychological disorders, are caused by the toxic effect of actively produced cytokines and interleukins, the deposition of immune complexes and thrombotic vasculitis, an increase in the BBB permeability and the penetration of autoantibodies tropic to the structures of the nervous tissue through it. At the moment, the classification of 2018 most fully covers all possible morphological manifestations of neurolupus, highlighting focal and diffuse lesions of the central nervous system, as well as peripheral. The most common occurrence among SLE patients is headache, which is not a specific manifestation, strokes, aseptic encephalomyelitis, cognitive disorders and depression.Conclusions. Neurolupus is a very common and poorly understood complication of systemic lupus erythematosus, which needs more detailed coverage in the medical literature. With a wide polymorphism of clinical manifestations, the neuropsychiatric syndrome of SLE is a real threat to the patient's life. The lack of a clear classification in clinical guidelines, huge gaps in knowledge about the pathogenesis of nervous pathologies, the similarity of the clinical picture of other diseases and the undeveloped diagnostic tactics of this pathology can lead to ineffectiveness of the therapy, irreversible damage to the nervous tissue and even death.
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