THE AMYOTROPIC LATERAL SCLEROSIS AND FUNCTIONAL RATING SCALE (ALSFRS)

Аннотация

Research material and methods: During the last five years, 60 patients from different parts of Georgia, including Samegrolo, Kartli, Adjara, Abkhazia, Guria, Kakheti regions have been studied, searched and examined by us. The Georgian Neurologists Corps participated and helped us in finding patients. With the consent of the individual patient, which is confirmed in writing, the study was conducted in accordance with the modern requirements of research. We studied patient's anamnesis, physical data, evaluated their mental, cognitive functions and neurological status. We have also interviewed family members, as it was often difficult for the patient to accurately describe the symptoms. Brain MRI and electromyography were also performed. 60 patients with different forms of ALS participated in the study, including 34 (56.66%) men and 26 (43.33%) women. Their age ranges from 30 to 81 years. Patients were included in the study according to the El Escorial criteria. Among those examined by us, the disease began mainly with muscle numbness, weakness of the limbs, fasciculations, in 36 (60%) patients with speech difficulties. According to our research, the diagnosis of ALS is difficult until muscle atrophy and tremors are detected. There are relatively less cases of ALS (23 (38.33%) patients) with symptoms of one or both legs. At this time, the patients felt uncomfortable while walking, the ankle lost its flexibility, its range of motion was limited. muscle weakness is expressed; muscle spasms; increase of deep reflexes or expansion of the reflexogenic zone; pathological reflexes; pronounced muscle atrophy; increased spasticity; At this time, the upper limbs were less damaged, although the flexibility of the fingers in the upper limbs is limited. ALS with bulbar events was detected in 24 (40%) patients with difficulty speaking, the patient spoke "through the nose", later had difficulty swallowing. Disturbance of speech (dysarthria, anarthria), voice production disorder (dysphonia, aphonia). Disappearance of soft palate and throat reflexes, salivation, breathing disorders were soon added to the symptoms; While in the 11 (18.33%) patients with ALS confirmed by us, the symptoms included signs of both lower and upper motor neuron damage, the upper motor neuron showed: muscle hypertonia, hyperreflexia, pathological Babinski reflex; and in case of damage to the lower motoneurons: muscle weakness and atrophy, involuntary fasciculations. Thus, for the first time in Georgia, we determined the structure and characteristics of the most common syndromes of amyotrophic lateral sclerosis in over the last 5 years, and the prevalence of patients with this disease, taking into account age, sex, disease anamnesis, and other symptoms.