Nervous diseases - treatment in Russia

Nervous diseases are diseases that develop as a result of damage to the brain and spinal cord, as well as peripheral nerve trunks and ganglia. Nervous diseases are the subject of a specialized area of ​​medical knowledge – neurology. Since the nervous system is a complex apparatus that connects and regulates all organs and systems of the body, neurology closely interacts with other clinical disciplines such as cardiology, gastroenterology, gynecology, ophthalmology, endocrinology, orthopedics, traumatology, speech therapy, etc. disease is a neurologist.

Nervous diseases can be genetically determined (Rossolimo-Steinert-Kurshman myotonia, Friedreich’s ataxia, Wilson’s disease, Pierre-Marie’s ataxia) or acquired. Congenital malformations of the nervous system (microcephaly, basilar impression, Chimerli’s anomaly, Chiari malformation, platibasia, congenital hydrocephalus), in addition to hereditary factors, can lead to unfavorable conditions of intrauterine development of the fetus: hypoxia, radiation, infection (measles, rubella, syphilis, chlamydia , HIV), toxic effects, the threat of spontaneous abortion, eclampsia, Rh-conflict, etc. Infectious or traumatic factors affecting the nervous system immediately after the birth of a child (purulent meningitis, newborn asphyxia, birth trauma, hemolytic disease) often lead to the development of such nervous diseases as cerebral palsy, childhood epilepsy, mental retardation.

Acquired nervous diseases are often associated with infectious lesions of various parts of the nervous system. As a result of the penetration of the infection, meningitis, encephalitis, myelitis, brain abscess, arachnoiditis, disseminated encephalomyelitis, ganglioneuritis and other diseases develop. A separate group is made up of nervous diseases of traumatic etiology: TBI, spinal cord injury, traumatic neuritis. Nervous diseases that occur in old age are mainly due to vascular changes (discirculatory encephalopathy, TIA, ischemic stroke, hemorrhagic stroke), less often metabolic disorders (Parkinson’s disease). The incidence of oncological nervous diseases remains high. The limited space inside the cranium or spinal canal leads to the fact that even benign tumors of this localization (astrocytoma, craniopharyngioma, ganglioneuroma) have a malignant course. In addition, the problematic complete removal of CNS tumors leads to their frequent recurrence.

The clinical manifestations of nervous diseases directly depend on which part of the nervous system was involved in the pathological process. So, nervous diseases with brain damage can be accompanied by headache, dizziness, gait and coordination disorders, speech impairment, hearing and vision impairment, paresis and paralysis of a central nature, and mental changes. Nervous diseases associated with pathology of the spinal cord are manifested by motor and sensory disorders below the level of the lesion. Diseases of the peripheral nervous system (trigeminal neuralgia, neuritis of the facial nerve, intercostal neuralgia, cervical plexitis, polyneuropathy, neuropathy of the radial nerve, neuropathy of the femoral nerve, etc.) are characterized by pain syndrome, sensory disorders, muscle atrophies, movement disorders, vegetative disorders, changes in the area of ​​innervation of the affected nerve.

The basis of instrumental diagnostics of nervous diseases is traditionally made up of such studies as X-ray of the spine, Echo-EG, EEG, REG, electromyography, in children 1 year of life – neurosonography. They are being replaced by more accurate diagnostic methods: computed tomography, MRI, PET of the brain, ultrasound of the head vessels, duplex scanning. And, if REG and echoencephalography, as methods for diagnosing nervous diseases, are gradually losing their importance, then EMG and EEG remain indispensable. They make it possible to identify functional changes occurring in many nervous diseases that are not diagnosed by neuroimaging methods. In some nervous diseases, the diagnostic search requires a lumbar puncture, stereotaxic biopsy, puncture of the ventricles of the brain, and other diagnostic operations. Since the nervous system is closely interconnected with other organs and systems of the body, for a more accurate diagnosis of nervous diseases, a neurologist (pediatric neurologist) often needs consultations from other specialists: an ophthalmologist, endocrinologist, cardiologist, orthopedist, etc.
Treatment of nervous diseases, as a rule, includes a whole range of measures aimed not only at combating the cause of the disease and its etiopathogenetic mechanisms, but also at the maximum recovery of the neurological deficit resulting from the disease. For this purpose, physiotherapy, exercise therapy, mechanotherapy, reflexology, and manual therapy are widely used in the therapy of nervous diseases. Treatment of aneurysms, tumors, intracerebral hematomas, abscesses and brain cysts requires surgical intervention. In some cases, surgical treatment is used for epilepsy and Parkinson’s disease. Brain surgeries and spinal cord interventions are performed by neurosurgeons. They carry out modern surgical treatment of nervous diseases using minimally invasive microsurgical techniques and under the control of neuroimaging. Methods of functional neurosurgery have been developed, which are successfully used for torsion dystonia, cerebral palsy, Huntington’s chorea and other nervous diseases accompanied by muscle tone disorders, tremors or hyperkinesis.