POLIOENCEPHALITIS (polioencephalitis; grech, polios gray + encephalitis) — the encephalitis which is characterized by preferential defeat of gray matter of a brain.
One of forms P. as a result of a drunkenness for the first time described Gayet in 1875 (Ch. J. A. Gayet) and in 1881 K. Vernike under the name of an upper hemorrhagic polioencephalitis (see. Alcoholic encephalopathies ). Carry a tick-borne encephalitis to P. (see. tick-borne Encephalitis ), cerebral form poliomyelitis (see), and also row encephalitis (see) at children's infections. The item can be observed at intoxications by alcohol, lead, manganese, at the nek-ry diseases which are followed by dysfunction went. - kish. path.
In pathogeny nevrol, at P. the vitamin deficiency of group B and disturbance of exchange of vitamins of this group, protein metabolism is important frustration.
Unlike leukoencephalitis (see), pathomorphologic changes at P. are noted preferential in gray matter of a brain, hl. obr. in the area, adjacent to a water supply system of a mesencephalon and the third ventricle where find multiple punctulate hemorrhages, destructive and proliferative changes of vessels, death of nervous cells. Also hemorrhages in mastoidal bodies, a thalamus, top and bottom olive kernels are described. Destructive changes of nervous cells of gray matter of a brain are combined with the expressed hypostasis and inflammatory reaction of white matter.
To the beginning of a disease prodromal symptoms in the form of nausea, vomiting precede, to a headache, apathy. Then the hyperphrenia, motive concern, spasms appear and accrue. Develops ptosis (see), the dispersing squint, sometimes full ophthalmoplegia (see) and blindness; reflexes from mucous membranes, cutaneous and tendon jerks decrease, the Meningeal syndrome and disturbances of century of N of page (a hyperthermia, tachycardia, frustration of a respiratory rhythm) are noted; there is a drowsiness, the soporous state passing sometimes into a coma. Gradually the cerebrate rigidity accrues, there are violent movements of the face muscles concerning the movements of lips, grasp reflexes, gormetonichesky spasms. At a disease beriberi (see) hemorrhagic P.'s phenomena can be observed — paralyzes of muscles of an eyeglobe with an ophthalmoplegia and a diplopia are noted, nystagmus (see), ataxy (see), mental disorders (an adynamia, hallucinations, a disorientation in time and space, etc.), coma sometimes develops.
Treatment conservative: introduction of high doses of thiamin (oryzamin), and also a pyridoxine (B6 vitamin), cyanocobalamine (B12 vitamin), ascorbic to - you, glucose is shown. At approach of coma hold resuscitation events, for elimination of a gipomagneziyemiya enter magnesium sulfate.
Forecast in most cases adverse. In case of recovery, as a rule, remain resistant nevrol, disturbances, including Gayet's syndrome — Vernike with a typical triad (oculomotor disturbances in combination with an areflexia and confusion of consciousness), an amaurosis, an ataxy, dementia.
Bibliography: Margulies M. S. Infectious diseases of a nervous system, page 660, M. — L., 1940; A. S's Cambell. River of a. Biggart J. H. Wernicke's encephalopathy (polioencephalitis haemorrhagica superior), J. Path. Bact., v. 48, p. 245, 1939; Handlexikon der medizinischen Praxis, hrsg. v. H. Braun, Bd 3, S. 1244, Stuttgart, 1970; Wernicke C. Lehrbuch der Gehirnkrankhei-ten, Bd 1 — 3, B., 1881 — 1883.
L. O. Badalyan.