Acute and chronic dysimmune polyneuropathies in the context of the COVID-19 pandemic: pathogenesis, features of the clinical picture, diagnosis and therapy (literature review)

Хрулев, А Е; Shiyanova, N. A.; Сорокоумова, С. Н.; Kasatkin, D. S.; Grigorieva, V.N.; Belyakov, K. M.; Romanova, Elena S.; Yankevich, D. S.

doi:10.17650/2222-8721-2021-11-2-17-27

Cited by 3 publications

(4 citation statements)

References 61 publications

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“…Однако на фоне распространения пандемии стало встречаться все больше педиатрических случаев, включая тяжелые и летальные исходы [19]. В ранних исследованиях предполагалось, что SARS-CoV-2 не относится к вирусам, первично тропным к клеткам нервной системы, однако в настоящее время доказана высокая вероятность развития при данной инфекционной патологии различных неврологических расстройств, в том числе дизиммунных ПНП [20]. Данное предположение подтверждает приведенный клинический случай, когда у пациентки на фоне отягощенного иммунологического статуса (наличие бронхиальной астмы) и инфекции SARS-CoV-2 развилась аксональная сенсорно-моторная ПНП.…”

Section: Discussionunclassified

“…С клинической точки зрения дизиммунные ПНП представляют собой этиологически гетерогенную группу заболеваний с аутоиммунным поражением периферической нервной системы [20]. Дизиммунные ПНП формально относятся к редкой патологии.…”

Section: Discussionunclassified

“…В сложных диагностических случаях необходимо проведение дополнительных лабораторных анализов и ЭНМГ, при этом при наличии явных признаков хронической демиелинизирующей ПНП рекомендовано максимально быстрое назначение терапии иммуноглобулинами или ГКС, Клинический случай иммуноопосредованной аксональной полиневропатии после перенесенной COVID-19-инфекции по возможности в амбулаторном режиме. Использование цитостатиков не рекомендовано [20]. Таким образом, тактика диагностики и ведения пациентов с дизиммунными невропатиями, ассоциированными с SARS-CoV-2, не должна отличаться от той, что использовалась до пандемии.…”

Section: Discussionunclassified

“…В лечении следует отдавать предпочтение высокодозной внутривенной иммунотерапии. При хронических дизиммунных ПНП не следует отменять или менять проводимую терапию в случае имеющейся ремиссии [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37].…”

Section: Discussionunclassified

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Clinical Case of Immune-Mediated Axonal Polyneuropathy after COVID-19 Infection

Чернуха¹,

Лихачев²,

Ким³

et al. 2022

Неврология И Нейрохирургия. Восточная Европа

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Механизмы развития и клинического течения полиневропатий в настоящее время широко изучены, однако остаются вопросы, требующие дополнительного внимания. В то же время новая коронавирусная инфекция SARS-CoV-2, вызвавшая пандемию, представляет собой достаточно опасное заболевание с крайне вариабельной клинической картиной, тяжесть симптомов может варьировать от легких до крайне тяжелых форм. Коронавирусная инфекция и ее роль в развитии поражения периферической нервной системы являются крайне актуальным направлением современной медицинской науки, однако на данный момент зафиксировано относительно мало доказанных случаев поражения периферических нервов у пациентов с COVID-19. В статье представлено описание клинического случая пациентки 71 года, у которой на фоне реконвалесценции двусторонней вирусной пневмонии, вызванной SARS-CoV-2, развилось поражение периферической нервной системы в виде аксональной полиневропатии, моторно-сенсорная форма, с легким нижним дистальным парапарезом, сенсорными нарушениями. The mechanisms of development and clinical course of polyneuropathies are currently widely studied, however, there are issues that require additional attention. At the same time, the new coronavirus infection SARS-CoV-2, which has become a pandemic, is a rather dangerous disease, with an extremely variable clinical picture, the severity of symptoms can vary from mild to extremely severe forms of the course. The coronavirus infection and its role in the development of lesions of the peripheral nervous system is an extremely relevant area of modern medical science, but now there are relatively few proven cases of peripheral nerve damage in patients with COVID-19. A description of a 71-year-old patient who, against the background of convalescence of bilateral viral pneumonia caused by SARS-CoV-2, developed damage to the peripheral nervous system in the form of axonal polyneuropathy, a motor-sensory form, with mild lower distal paraparesis, and sensory impairments, is presented.

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Section: Discussionunclassified

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Clinical Case of Immune-Mediated Axonal Polyneuropathy after COVID-19 Infection

Чернуха¹,

Лихачев²,

Ким³

et al. 2022

Неврология И Нейрохирургия. Восточная Европа

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Dynamics of vegetative, insomnia and neuropsychological manifestations during the treatment of post-COVID syndrome

et al. 2022

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Introduction. Asthenia, vegetative manifestations, sleep disturbances and psycho-emotional background are companions of the coronavirus infection, the issue of drug correction of which is especially relevant. These symptoms disrupt the habitual way of life of patients for a long time, and in special cases lead to disability.Aim. To study the mental, somatoform and cognitive aspects of anxiety disorders after coronavirus infection during treatment with tofisopam (Grandaxin®) 150 mg/day.Materials and methods. The study included patients who had experienced a new coronavirus infection, who, after the end of treatment for the underlying disease, had complaints suggesting the presence of an anxiety disorder. The Hamilton scale was used to assess the level of anxiety. Examination of patients was carried out before the start of treatment, after 2, 4 and 6 weeks of therapy.Results and discussion. Prior to the start of therapy, all patients had an overall high level of anxiety: the average HAM-A score was 31.4 ± 2.92 points. At the end of Grandaxin® therapy, all patients showed a decrease in the level of anxiety: the average HAM-A score was 12.08 ± 2.27 points (p < 0.001). The maximum decrease in the severity of vegetative disorders was noted by the end of the 6th week of therapy with Grandaxin®. Thus, the indicator of this subscale decreased by more than 2 times – from 2.46 ± 0.54 to 1.05 ± 0.28 points (p < 0.001). The severity of insomnia during six weeks of therapy with Grandaxin® decreased from 2.56 ± 0.54 to 0.96 ± 0.45 points (p < 0.001).Conclusion. Psycho-emotional disorders (more often in the form of increased personal anxiety), sleep disorders, vegetative disorders, asthenic syndrome significantly affect the quality of life of patients who have had a new coronavirus infection. Involvement of the structures of the autonomic nervous system and central structures that regulate GABAergic transmission leads to significant vegetative failures, which requires pathogenetically substantiated drug correction of these disorders.

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Clinical Case of Covid-Associated Guillain-Barre Syndrome

Petrova

Garmash

Klimenko

et al. 2022

Clin. and prev. med.

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The aim of our article is to shed light on the problem of the development of Guillain-Barre syndrome after COVID-19 infection Materials and methods The main research methods we used were scientific research and the actual description of our own clinical case. Laboratory research methods, magnetic resonance imaging, and electromyography were used to confirm the diagnosis and perform differential diagnostics. Results. In 2021, the Center for Acute Neurology and Pain Treatment treated 12 patients with Guillain-Barre syndrome. Guillain-Barre syndrome (GBS) is an acute autoimmune inflammatory polyradiculoneuropathy. The clinical picture of GBS includes progressive motor and sensory disorders in the extremities and pain. We bring to your attention a clinical case of GBS in patient B., who was treated at the clinical hospital "Feofania". Patient B., 32 years old, was hospitalized in the Feofania Clinical Hospital with complaints of weakness in her arms and legs, inability to walk, foreign body sensation in the throat, difficulty swallowing, chest discomfort, and difficulty breathing. A few weeks before the disease, the patient was treated for a mild SARS-CoV-2 infection. The patient's condition gradually deteriorated by day 25 of the disease, despite plasmapheresis, intravenous immunoglobulin and glucocorticoid therapy. However, from day 29, the condition gradually improved and on re-examination after 2 months, the patient remained mild distal paresis of the leg muscles (up to 4 points), decreased tendon reflexes from the lower extremities. Disorders of sensitivity and function of the pelvic organs were not observed. Conclusion. In our article, we present a case of COVID-19-associated GBS with a classic clinical picture, increased peripheral paresis, stabilization, and gradual recovery of all functions (respiration, pelvic function, motor, sensory, and reflex) through pathogenetic treatment and follow-up rehabilitation measures.

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Acute and chronic dysimmune polyneuropathies in the context of the COVID-19 pandemic: pathogenesis, features of the clinical picture, diagnosis and therapy (literature review)

Cited by 3 publications

References 61 publications

Clinical Case of Immune-Mediated Axonal Polyneuropathy after COVID-19 Infection

Clinical Case of Immune-Mediated Axonal Polyneuropathy after COVID-19 Infection

Dynamics of vegetative, insomnia and neuropsychological manifestations during the treatment of post-COVID syndrome

Clinical Case of Covid-Associated Guillain-Barre Syndrome

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