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CLINICAL COURSE OF VIRAL ENCEPHALOMYELITIS
Xojimatova Malika Shuhratovna
Department of Neurology, Andijan Medical Institute
Encephalomyelitis is an inflammation of the brain and spinal cord, which can develop under the
influence of various factors, while manifesting itself with approximately the same general
cerebral, focal symptoms. Today, the problem of encephalomyelitis and inflammatory diseases
of the nervous system in general remain relevant, especially in our region, since not all patients
are aware of the severity and outcome of these diseases.
The aim of the study:
to determine the clinical, neurological, neuroimaging, immunological
features and outcomes of viral encephalomyelitis in the Andijan region.
To achieve this goal, we examined 32 patients treated in the neurological departments of the
Andijan Medical Institute clinic from 2015 to 2019 , with a diagnosis of acute viral
encephalomyelitis. Patients aged 18 to 70 years were observed; the ratio of men and women was
approximately equal. All patients underwent clinical neurological, neuroimaging and
immunological examination.
Results of the study:
all patients had an acute onset of the disease, with catarrhal symptoms in
the form of a runny nose observed at the onset of the disease. 1/3 of patients had a temperature
increase to 38 C. Lymph nodes were not enlarged upon palpation. Meningeal symptoms lasted 7-
20 days. The protein content in the cerebrospinal fluid was 0.5-2.0 ‰. Moderate leukocytosis
and increased erythrocyte sedimentation rate were found in the blood. The average age of the
patients was 33.7±13.7 years. In two cases (48.4%) the disease was registered predominantly in
women, more often in the postpartum period.
The diagnosis of viral encephalomyelitis was confirmed by the results of a specific serological
study (detection of IgM and IgG in dynamics). Almost 93% of patients sought medical care and
were hospitalized 3-4 days after the onset of the disease. In half of the cases, the febrile form of
the disease was observed (56.3%), in 10.9% - meningeal. It should be noted that focal forms
accounted for a third of cases of the disease (32.8%).
A third of patients (34.4%) had a severe degree of the disease, while the rest had a moderate
degree. The disease typically had an acute onset with fever lasting 9.4±3.9 days. Meningeal
syndrome was manifested by rigidity of the occipital muscles, and less frequently by a positive
Kernig and Brudzinsky sign . When examining the cerebrospinal fluid, predominantly
lymphocytic pleocytosis was recorded – 237.0±115.0 in 1 mm3.
The clinical picture of focal forms depended on the level of damage to the nervous system and
manifested itself in the form of persistent flaccid paralysis and paresis, predominantly in
paraplegic forms, symptoms of damage to the nuclei of the cranial nerves (III, VII, IX, X, XII
pairs) with the development of polioencephalitis and symptoms of dysfunction of the pelvic
organs (mixed type).
Complete recovery after encephalomyelitis was observed in 15% of patients, recovery as an
outcome of focal forms was registered in 77.5% of cases. In three cases, a fatal outcome was
registered. (7.5%).
Among the residual phenomena, tetraparesis or severe weakness of the lower limbs were
identified in 42.9%, with delayed urination and defecation , focal symptoms in the form of facial
asymmetry, eyelid ptosis or tongue deviation in 33.3%, cerebellar ataxia in 28.6%, and tremor of
the tongue or hands in 23.8%.
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volume 4, issue 2, 2025
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Neuroimaging studies of the brain and spinal cord in patients were conducted using magnetic
resonance imaging. The following changes were detected on the T1 and T2 mode tomograms :
Infiltrative lesions of both hemispheres and several segments of the spinal cord accounted for
40%, infiltrative changes in the brainstem and one segment of the spinal cord accounted for 35%.
Conclusion:
focal forms of viral encephalomyelitis occur in more than a third of cases and are
accompanied by persistent residual effects in 85.7% of cases, which depended on the moment the
patients sought medical help.
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Gromiko. St. Petersburg.Southern Publishing House "FOLIANT", 2003. - 128 p.
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