METHODICAL INSTRUCTIONS
FOR INDIVIDUAL WORK OF STUDENTS IN PREPARATION FOR
PRACTICAL CLASSES
Subject
Topic.
Year
Faculty
NEUROLOGY
Demyelinating diseases of the nervous system
IV
Medical
1. Topicality: Diseases studied at this class have different aetiology, pathogenesis and
clinical picture. But all these diseases result in bad complications and disablement often in
young persons. Therefore to prescribe a specific treatment a doctor has to estimate the disease on
the basic of diagnostic criteria in proper time.
2. Specific purposes:
1. To learn the classifications principles of demyelinating diseases of the nervous system.
2. To learn the clinic of demyelinating diseases of the nervous system
3. To interpret the forms of disseminated sclerosis.
4. Make up the schemes of the treatment, prevention and prophylactic of the demyelinating
diseases of the nervous system.
3. Basic knowledge, skills and competences which are necessary for topic studying:
№
1
Subject
Anatomy
2
3
Physiology
Anatomical pathology
4
Physiopathology
5
Microbiology
6
Pharmacology
Information to learn
Anatomy of the brain, the spinal cord and the brain
membrane
Medullispinal fluid, its circulation and its structure
Stages of the inflammatory and demyelinating processes,
morphological changes in the nervous system during
inflammatory and demyelinating processes.
Aetiology and pathogenesis of the inflammatory and
demyelinating diseases of the nervous system, kinds and
stages of the inflammatory process, immunological
impairments, pathological syndromes of the liquor
system impairments.
The characteristic of the causative agents of the nervous
system inflammatory diseases.
The treatment principles of the inflammatory diseases,
demyelinating diseases of the nervous system.
Medications from the group of antibiotics, antisensitizers,
diuretics, anticholinesterase drugs, nootropic drugs,
vitamins, steroid hormones, muscle relaxants,
immunomodulators.
4. Assignments for individual work during preparation for the classes:
The list of the basic terms, characteristics which students must learn during the
preparation for the classes:
-
Peripheral paresis
Central paresis
cerebellar ataxia
sensitive ataxia
syndromes of dissociation in liquor (cellular-protein and protein-cellular)
optic atrophy
dementia
The list of theoretical questions:
1. Acute disseminated encephalomyelitis.
2. Disseminated sclerosis. Modern theory of the pathogenesis (autoimmune disease, genetic
predisposition). Pathomorphology (numerous foci of demyelination in the brain and the
spinal cord). Disseminated sclerosis. Early symptoms. The basic clinical forms (cerebral:
brainstem, cerebellar, visual, hyperkinetic, spinal and cerebrospinal). Charcot's triad.
Marburg pentalogy. Forms of disease course. Differential diagnostics. Treatment (in
worsening – exchange plasmapheresis, pulse – therapy by corticosteroids, cytostatic
agents, desensitizing therapy, antihistamines, antioxidants; in remission - interferons –
medications which improve trophism of nervous system, vessels medications)
3.
Subacute sclerosing panencephalitis. Leukodystrophies: metachromatic, globoid cell,
sudanophilic, rapid methods of diagnostics.
The list of the necessary practical skills that are to be mastered at the classes:
1. Individual examination of the patients with neurological pathology, making up the case
history.
2. Estimating the main neurological syndrome in a patient.
3. Substantiation of the niveau diagnosis at the examined patient
4. Carrying out the differential diagnostics.
5. Обґрунтування виставленого клінічного діагнозу.
6. Estimating of the aetiology of the disease, peculiarities of the pathogenesis, the course of the
disease and its complications at the examined patient.
7. Confirmation of the treatment prescribed to the patient.
8. The prognosis estimating of the disease course at the given patient.
5. Student’s self-preparation curriculum:
1. To learn theoretical questions of the subject
2. To know the methods of the examination of the neurological state
3. To acquaint with the tests and situational task (collection of the tests and tasks).
6. Materials for self-control
To draw the table with a picture of the clinical forms, stages, symptoms and syndromes,
methods of diagnostics and treatment of the demyelinating diseases of the nervous
system.
2. To find right answers to the tests and situational tasks on the topic.
1.
Information Sources
Lecture
1.
2.
3.
4.
5.
Shcrobot S.I., Hara I.I. Neurology in lecture (Selected lectures) . Ternopil, TSMU, «Ukrmedknyha», 2008.
319 p.
Reinhard Rohkamm. Color Atlas of Neurology © 2004 Thieme. 440 p.
Crash course Neurology by Anish Bahra and Katia Cikurel. Copyright 2006, Elsevier, Inc. 244 p.
Adams and Victors. Principles of neurology. © 2005 McGraw-Hill . Medical Publishing Division.
Mayo Clinic Internal Medicine Review 2006-2007. Chapter 18. Editor-in-Chief Thomas M. Habermann,
MD