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5ISSN: 2181-3337 | SCIENTISTS.UZ
INTERNATIONAL SCIENTIFIC JOURNAL SCIENCE AND INNOVATION
ISSUE DEDICATED TO THE 80TH ANNIVERSARY OF THE ACADEMY OF SCIENCES OF THE REPUBLIC OF UZBEKISTAN
FREQUENCY OF NEUROLOGICAL COMPLICATIONS IN CHILDREN WITH JUVENILE RHEUMATOID ARTHRITIS Khamidova N.A.
Tashkent Pediatric Medical Institute, Department of Neurology, Child Neurology and Medical
Genetics
https://doi.org/10.5281/zenodo. 8372512
Abstract. Unlike adult patients with rheumatoid arthritis, information about the damage to the nervous system in rheumatoid arthritis in childhood is poorly presented in the available literature. Even more rare are statistically significant observations of large samples of JRA patients with this type of complications. Much more common are publications on isolated cases of JRA neurological complications presented in the form of clinical examples. RA is a systemic disease, and almost all human organs and systems, including nervous tissue, are gradually involved in the pathological process. The statement that the pathology of the nervous system in RA leads to aggravation of disability and a reduction in life expectancy is beyond doubt by the vast majority of researchers.
Keywords: nervous system, rheumatoid arthritis, complications, cephalgic syndrome, paresthesia.
Relevance: Neurological manifestations have a vivid clinical picture in juvenile rheumatoid arthritis (JRA) inferior to the symptoms of damage to the joints and internal organs. Severe complications of arthritis, such as compression lesions of the spinal cord and peripheral nerves (tunnel syndromes), cerebral vasculitis are extremely rare and are described in the literature as isolated clinical cases (T. Yamamoto 2000, R. Pedersen 1998, Carbajal-Rodrigues L. 1991).
Purpose: to study the frequency of neurological complications in sick children with juvenile rheumatoid arthritis (JRA).
Materials and methods: We observed children in the cardio-rheumatology department of the TashPMI clinic. The study included 45 children aged 4 to 18 years with a clinical diagnosis of juvenile rheumatoid arthritis (JRA). In the neurological status of children, 38 (84%) examined children with juvenile rheumatoid arthritis: headache - 9 children (24%), paresthesia and numbness in the distal extremities - 7 (18%), convulsions (hyperkinesis) - 4 (11% ), dizziness -2 (5%), decreased mood background (in children under 7 years of age, emotional lability, tearfulness) - 5 (13%), social maladjustment (lack of permanent friends, impaired contact with teachers and peers) - 3 ( 8%), excessive sweating - 5 (13%), nocturnal enuresis - 3 (8%).
Results and discussion: In JRA, ENMG was performed in 10 patients (25%). Changes during ENMG in patients with JRA were in most cases (60%) a decrease in the conduction of impulses along n.medianus, along n.radialis 30% and n. ulnaris (10%), i.e. the amplitude of the M-response caused by stimulation of a more distal area decreases (partial conduction block). With JRA, an EEG was performed in 30 patients (75%). Changes during EEG in patients with JRA were diffuse in most cases (90%). Of the 4 patients with epileptic seizures, spontaneous epileptic activity was detected on the EEG only in 12.5% of cases (5 patients), in one patient, focal changes were detected against the background of diffuse changes in the bioelectrical activity of the brain, and in the rest, only diffuse changes occurred in the interictal period.
ISSN: 2181-3337 | SCIENTISTS.UZ
INTERNATIONAL SCIENTIFIC JOURNAL SCIENCE AND INNOVATION
ISSUE DEDICATED TO THE 80TH ANNIVERSARY OF THE ACADEMY OF SCIENCES OF THE REPUBLIC OF UZBEKISTAN
Conclusions. Lesions of the nervous system occur in patients with juvenile rheumatoid arthritis 48.9%. The most common clinical variants are cephalgic syndrome (37.5%), sensory disturbance (9.4%), and seizures (2%).
REFERENCES
1. Andersson, G.B. Epidemiology of rhematic disease in children / G.B. Andersson // Zur Zeitschrift fur Rhematologie. 2000. — Bd. 59: Abstracts des 29 Kongresse der Deutschen Gesellschaft fur Rheumatologie. — S. 3.
2. Badokina Sh. B. Rheumatology. Clinical lectures. Moscow 2014, pp. 268-283.
3. Epidemiology of juvenile spondyloarthropathies in Spanish hospital/ M.C.Castro —Villegas, R. Roldan, V.C. Perez et al. // EULAR-2004
