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

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),