PECULIARITIES OF EARLY DIAGNOSIS OF PATIENTS WITH HYPERTENSIVE DYSCIRCULATORY ENCEPHALOPATHY AND CONCOMITANT HYPOTHYROIDISM IN POLYCLINIC CONDITIONS
ARTICLE PDF

Keywords

hypertensive dyscirculatory encephalopathy
hypothyroidism
cerebrasthenic vestibulo-atactic mnestic syndromes

How to Cite

Kovalenko, O. Y., & Litvin, O. V. (2023). PECULIARITIES OF EARLY DIAGNOSIS OF PATIENTS WITH HYPERTENSIVE DYSCIRCULATORY ENCEPHALOPATHY AND CONCOMITANT HYPOTHYROIDISM IN POLYCLINIC CONDITIONS. Clinical and Preventive Medicine, (4), 21-26. https://doi.org/10.31612/2616-4868.4(26).2023.03

Abstract

Early diagnosis, timely prevention and treatment of comorbid and polymorbid conditions are extremely relevant in the practice of doctors of outpatient polyclinic institutions. Dyscirculatory encephalopathy is one of the most pressing problems of modern neurology due to its high prevalence. Currently, along with the growth of cerebrovascular diseases, there is an increase in endocrine pathology, especially hypothyroidism.

The aim: Therefore, the goal of our study was to improve the diagnosis of patients with dyscirculatory encephalopathy and concomitant hypothyroidism in conditions of polyclinics.

Materials and methods. A clinical-neurological, neuropsychological, instrumental, and laboratory examination of 97 patients was conducted, including 60 patients with HDE and accompanying hypothyroidism and 37 with hypertensive dyscirculatory encephalopathy (HDE) without hypothyroidism.

Results. According to the results of the study, it was proven that cerebral disorders in patients with HDE have a more pronounced progression in the presence of concomitant hypothyroidism. Patients with concomitant hypothyroidism complained more and more often about tearfulness (p=0.03), vertigo (p=0.01), dizziness (p=0.04). In patients with HDE and accompanying hypothyroidism, the severity of neurological deficits, such as unsteadiness in Romberg's pose, ataxia when walking, missed finger-nose test, mixed type of dermographism, significantly (p<0.05) prevailed over the indicators of patients with HDE without accompanying pathologies of the thyroid gland.

Thus, patients with comorbid pathology (HDE and accompanying hypothyroidism) need more meticulous dispensary supervision, in outpatient settings and close interaction of a neurologist, endocrinologist, therapist and family doctor.

 Conclusions. In patients with hypertensive dyscirculatory encephalopathy and concomitant hypothyroidism, there are cerebrasthenic, vestibulo-ataxic, and mnestic syndromes observed significantly more often (p<0.05),

https://doi.org/10.31612/2616-4868.4(26).2023.03
ARTICLE PDF

References

Mishchenko V.M., Zabrodina L.P., Mishchenko T.S., Bovt Y.V. (2021). New opportunities in the treatment of patients with chronic brain ischemia. International neurological journal, 17, 5, 47-57. DOI: https://doi.org/10.22141/2224-0713.17.5.2021.238522

Kravchun N. O., Dunayeva I. P., Kozakov O. O. (2021). Personifikovana stratehiya terapiyi hipofunktsiyi shchytopodibnoyi zalozy [Personalized strategy for the therapy of thyroid hypofunction]. Problems of endocrine pathology, 77, №3, 120-125.

DOI: https://doi.org/10.21856/jPEP.2021.3.17

Golovchenko YU.I. Treshchinskaya M.A. (2008). Obzor sovremennykh predstavleniy ob endotelial'noy disfunktsii [Review of modern ideas about endothelial dysfunction]. Consilium Medicum, 2, 11, 38– 40.

Lesiv M.I. (2019). Kohnityvni funktsiyi u khvorykh na hipertonichnu khvorobu ta hipotyreoz z retrospektyvnoyu otsinkoyu kontrolyu kompensatsiyi zakhvoryuvannya . [Cognitive functions in patients with hypertension and hypothyroidism with a retrospective assessment of disease compensation control]. Ukrainian neurological journal, 2-3, 40-44. DOI: https://doi.org/10.30978/UNJ2019-2-40

Chen H., Wu Y., Huang G. (2018). Low Tri-iodothyronine Syndrome Is Associated With Cognitive Impairment in Patients With Acute Ischemic Stroke: A Prospective Cohort Study. American journal Geriatric Psychiatry, 18, 1064-7481. DOI: 10.1016/j.jagp.2018.07.007

Quinlan P., Horvath A., Wallin A., Svensson J. (2018). Low serum concentration of free triiodothyronine (FT3) is associated with increased risk of Alzheimer's disease. Psychoneuroendocrinology, 5(99), 112-119.

Kovalenko O.YE., Lytvyn O.V. (2011). Oksydantnyy stres v patohenezi khronichnoyi ishemiyi mozku v umovakh defitsytu tyreoyidnykh hormoniv. [Oxidant stress in the pathogenesis of chronic brain ischemia in conditions of thyroid hormone deficiency]. A collection of scientific works of employees of the P.L. Shupyk NMAPO, 20, 2, 265-269.

Chrysant S.G. (2005). Possible pathophysiologic mechanisms supporting the superior stroke protection of angiotensin receptor blockers compared to angiotesin-converting enzyme inhibitors: clinical and experimental evidence. J. of human Hypertension, 19, 923-931.

Tovarzhnyansʹka O.L., Hryhorova IA, Tykhonova L.V. (2010). Klinichni osoblyvosti ta patohenetychni mekhanizmy formuvannya nevrolohichnykh syndromiv pry pervynnomu hipotyreozi. [Clinical features and pathogenetic mechanisms of formation of neurological syndromes in primary hypothyroidism]. International Journal of Neurology, 6 (36), 73.

Lytvyn O.V., Handzyuk V.A., Kondratyuk N.YU. (2019). Medyko-sotsialʹni ta klinichni aspekty dystsyrkulyatornoyi entsefalopatiyi u osib pratsezdatnoho viku [Medico-social and clinical aspects of dyscirculatory encephalopathy in persons of working age]. The world of medicine and biology, 3 (69), 100-105. DOI:10.26724/2079-8334-2019-3-69-100-105

Holovach I.YU. (2011). Dystsyrkulyatorna entsefalopatiya: deyaki patohenetychni, klinichni ta likuvalʹni aspekty. [Dyscirculatory encephalopathy: some pathogenetic, clinical and therapeutic aspects]. Medicines Ukraine, 4(150), 47–58.

Litvin O.V, Kovalenko O.YE. (2017). Khronichna ishemiya mozku u khvorykh z arterialʹnoyu hipertenziyeyu ta hipotyreozom. [Chronic brain ischemia in patients with arterial hypertension and hypothyroidism]. International journal of endocrinology, 13, 1, 120-127. DOI: 10.22141/2224-0721.13.1.2017.96764.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.