DAĞINIQ SKLEROZUN İLK ƏLAMƏTİ KİMİ OPTİK NEVRİT İLƏ PASİYENTLƏRİN KLİNİKİ XARAKTERİSTİKASININ TƏHLİLİ

Xülasə

SUMMARY

Aim – to analyze the clinical characteristics of patients with multiple sclerosis and optic neuritis in the debut.

Material and methods
The study presents data from 41 patients with multiple sclerosis with the onset of optical neuritis, 19 of them women and 22 men. The age of patients ranged from 19 to 56 years, the average age was 33.2 ± 1.5 years. The average duration of the disease is 2.6 ± 0.3 years. The control group consisted of 12 practically healthy people with no signs of neurological diseases, the average age of the control group did not differ from the average in the group of patients. The complex neurological examination including visometry, ophthalmoscopy, perimetry, visual evoked potentials (VEP), assessment of neurologic status, the brain. Statistical processing of the results of the study was carried out by calculating the arithmetic mean (M), the root-mean-square deviation (σ), and represented as M ± σ. Differences between the groups were assessed using the Student's test, the results were considered reliable at p <0.05.

Results
Clinical signs of bilateral disease were observed in 14 patients (34.1 ± 7.4%), unilateral neuritis was diagnosed in 27 patients (65.9 ± 7.4%). in 12 patients (29.3 ± 7.1%) there was a relapse of previously transferred OH. Analyzing the data of clinical and electrophysiological examinations in 31 patients (78.0 ± 6.5%), elongation of the latency of the visual induced response was revealed with stimulation of clinically healthy and in 36 patients (87.8 ± 5.1%) - the affected eye. Subclinical changes in the contralateral "healthy" eye indicate dissemination within the visual system. Thus, in 31 patients (78.0 ± 6.5%) without clinical manifestations of visual disturbances in the healthy eye, the involvement of the visual pathway into the pathological process at the subclinical stage of its lesion was detected.

Conclusion
The obtained results allow to draw a conclusion that the visual functions registered with the traditional ophthalmological examination do not refect the functional state of the optic nerve. Thus, the process of myelin destruction of the central nervous system's pathways is the basis of the development of the clinico-neurophysiological changes at the MS in VEP. As a result, there is an increase in LP of the cortical response in the primary zone, a decrease in the amplitude of the responses with loss of axons or pronounced chronodispersion, or complete disappearance of responses in the presence of a block of conduction. These changes can be noted in isolated ON and in MS. As evidenced by the data from the survey of EP of other modalities and the observation of multimodal potentials in dynamics.