EVALUATION OF PERIPHERAL LESIONS IN PARKINSON’S DISEASE

Tarianyk К. А.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The frequency and severity of non-motor symptoms in CP have led to the classification of painful sensations into one or more of several categories: pain in musculoskeletal problems, radicular or neuropathic pain, pain associated with dystonia, discomfort due to akathisia, primary, central parkinsonic pain. In addition to degenerative changes, one of the causes of motor restlessness in the extremities may be peripheral neuropathy. Among the causes are symptoms such as rigidity, tremor, forced posture. These are very important factors that emphasize the asymmetric severity of symptoms in patients with Parkinson’s disease.The article is devoted to the study of factors in the development of neuropathies in Parkinson’s disease and their impact on the course and severity of the disease. The nature of neurological disorders depends on the form of the disease. The aim of our study was to investigate the incidence and course of tunnel neuropathy of the upper extremities in patients with Parkinson’s disease. We examined 2 groups of patients with akinetic-rigid form and mixed forms of the disease, who were examined and treated at the Center for Patients with Parkinson’s disease and other neurodegenerative diseases on the basis of the neurological department of the utility company «Poltava Regional Clinical Hospital named after MV Sklifosovsky of the Poltava regional council». In addition to general clinical and neurological examination, motor function was assessed according to the Unified Scale of CP Assessment. The severity of the disease was assessed by Hoehn and Yahr, the assessment of cognitive function – using a short scale of mental status, the degree of daily activity was determined by Schwabe-England. A visual analog scale and a McGill questionnaire were used to assess pain. To assess the condition of the peripheral nerves performed stimulation electoneuromyography peripheral nerves of the upper extremities by the method of short intervals. Electroneuromyographic examination of the peripheral nerves of the upper extremities was performed to analyze the violation of neuromuscular conduction at different levels. Criteria for electromyographic examination for the diagnosis of tunnel neuropathy of the median nerve included a decrease in the amplitude of the muscular response above the wrist (for the median), increased residual latency, decreased conduction velocity on motor fibers and sensory conductivity for median and ulnar nerves. Thus, in patients with akinetic-rigid form, signs of impaired neuromuscular conduction along the median and ulnar nerves of demyelinating nature predominate. This can be explained by the predominance in the clinical picture of bradykinesia, staying in a forced position for a long time. In the group of patients with akinetic-rigid-trembling form of the disease, the predominance of signs of tunnel neuropathy of the median nerve at the level of the carpal tunnel was diagnosed, which may indicate traumatic injuries of the carpal tunnel due to frequent repetitive movements with tremor. Peculiarities of the course of various forms of the disease should be taken into account when managing patients at any stage of the disease.

Parkinson’s disease, tunnel syndrome, neuropathy, electroneuromyography

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«Bulletin of problems biology and medicine» Issue 2 (156), 2020 year, 170-174 pages, index UDK 616.858.616.833-07

10.29254/2077-4214-2020-2-156-170-174