Introduction: The majority of patients with severe COVID-19 suffer from delirium as the main sign of encephalopathy associated with this viral infection. The aim of this study was to identify early markers of the development of this condition. Materials: The prospective cohort-based study included patients with community-acquired pneumonia and confirmed pulmonary tissue infiltration based on CT data, with a lesion consisting of at least 25% of one lung. The main group included patients who have developed acute encephalopathy (10 patients, 3 (30%) women; average age, 47.9 ± 7.3 years). The control group included patients who at discharge did not have acute encephalopathy (20 patients, 11 (55%) women; average age, 51.0 ± 10.5 years). The study collected clinical examination data, comprehensive laboratory data, neurophysiological data, pulse oximetry and CT data to identify the predictors of acute encephalopathy (study ClinicalTrials.gov identifier NCT04405544). Results: Data analysis showed a significant relationship between encephalopathy with the degree of lung tissue damage, arterial hypertension, and type 2 diabetes mellitus, as well as with D-dimer, LDH, and lymphopenia. Conclusions: The development of encephalopathy is secondary to the severity of the patient’s condition since a more severe course of the coronavirus infection leads to hypoxic brain damage.
Introduction. Supplementary motor area (SMA) syndrome is a symptom complex resulting from damage to the premotor cortex and it’s subcortical projection. There is no generally accepted protocol for functional mapping of SMA during neurosurgical intervention in this area.The objective of the publication is to present a review of the literature and clinical cases from practice that describes the treatment of two patients with glioblastomas in the posterior regions of the superior frontal gyrus with IOM. Given the localization of the tumor in the dominant hemisphere, one operation was performed with awakening, the other according to the protocol of total intravenous anesthesia with mapping of only motor representative areas.Clinical cases. In both cases, during intraoperative direct electrical stimulation of the cortex subjected to resection, evoked motor responses were not recorded. The modalities used made it possible to continuously evaluate the viability of the cortico‑spinal tract. During the surgery with awakening, episodes of an instantaneous termination of the initia‑ tion of speech and counter directional movements in the arm were recorded – in the subcortical projection of the SMA at a current strength of 1–2 mA. Both patients in the early postoperative period showed the development of a gross transient neurological deficit in the form of hemiparesis and sensorimotor aphasia, which was a manifestation of pos‑ tresection SMA syndrome. During the follow‑up (control) examination 6–7 months after the operation, the following was observed in the clinical picture: mild hemiparesis up to 4–5 points, impaired bimanual coordination; difficulty the ini‑ tiation of speech spontaneous speech.Conclusion. When mapping the cortex and subcortical structures, the localization of SMA can be assumed in the event of a negative motor response of the cerebral cortex using the protocol of low‑frequency 1 Hz stimulation under EcoG control. Standardization of the SMA mapping protocol would be useful in clinical practice for determining the bounda
Modern electrodiagnostics (ED) and ultrasound examination of the neuromuscular system dictates the need to use unified terminology in order to avoid inter-expert variability in describing the results of the study and drawing up a conclusion in accordance with international criteria. The results of a survey of clinical electromyography specialists and the methodology of translation of the latest version of the English-language glossary on electrodiagnostic medicine are presented.The purpose of the publication is to popularize the use of modern nomenclature among the professional community. An anonymous survey was conducted on the use of the most common terms ED. The translation of the latest English-language version of the glossary on ED and ultrasound examination of the neuromuscular system was carried out, followed by editing and discussion by an expert group. 236 people from 68 cities of Russia and neighboring countries took part in the survey. The survey results demonstrated maximum disunity, as well as conservatism in the use of terms. The nomenclature of ED terms was first compiled in 1980 by the American Association of Electromyography and Electrodiagnostics and subsequently regularly revised and supplemented in accordance with new data. The unification of terms is necessary for the standardization of conclusions, multicenter research and scientific publications.
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