Doronina O M, Gurov A V, Zaslavsky D V, Egorova Yu S, Ogorodnikov D S
Pirogov Russian National Research Medical University of the Ministry of Health of Russia, Academician Preobrazhensky Department of Otorhinolaryngology, Moscow, Russia.
Sverzhevsky Research Clinical Institute of Otorhinolaryngology of the Moscow Healthcare Department, Moscow, Russia.
Vestn Otorinolaringol. 2020;85(2):73-77. doi: 10.17116/otorino20208502173.
The epidemiology of neurosyphilis is presented in article. The pathogenetic mechanisms of involvement in the syphilitic process are described already in the early stages of the disease of the central and peripheral nervous system and, in particular, of the auditory and vestibular analyzers. Described classical clinical forms of neurosyphilis. Statistical data on the incidence of syphilis in Russia from the 20-30s of the last century to the present are given. Presented analysis of the development of the incidence rate in Russia of syphilis and neurosyphilis, the main methods for the diagnosis of neurosyphilis. The changes in the structure of neurosyphilis disease that have occurred over the past 20 years, which are characterized by nonspecificity, course wear and inversion of typical clinical symptoms, as a result of pathomorphism, are described. The article describes the mechanism for the development of the pathological process in the inner ear with syphilitic infection. Described changes in the capillary wall of the vascular streak, leading to impaired hematolabyrinth barrier function and the development of the labyrinth hydrops. Literature data on the electron microscopic study of the vascular strip of the rabbit webbed snail infected with syphilis are presented. The article also collected literature data on indicators obtained by audiological and vestibulological studies of the inner ear in cases of early and late neurosyphilis. The article focuses on the possible only manifestation of neurosyphilis in the form of cochleovestibular symptoms.
本文介绍了神经梅毒的流行病学。阐述了在梅毒病程早期中枢神经系统和周围神经系统，特别是听觉和前庭分析器受累的发病机制。描述了神经梅毒的经典临床形式。给出了俄罗斯从上世纪20 - 30年代到现在梅毒发病率的统计数据。呈现了俄罗斯梅毒和神经梅毒发病率发展情况的分析、神经梅毒的主要诊断方法。描述了过去20年中神经梅毒疾病结构的变化，其特征为非特异性、病程迁延以及典型临床症状的倒置，这是病理形态改变的结果。文章描述了梅毒感染时内耳病理过程的发展机制。描述了血管纹毛细血管壁的变化，导致血迷路屏障功能受损和迷路积水的发生。展示了关于感染梅毒的兔蹼蜗血管条电子显微镜研究的文献数据。文章还收集了早期和晚期神经梅毒病例内耳听力学和前庭学研究所得指标的文献数据。文章重点关注神经梅毒可能仅以耳蜗前庭症状形式出现的表现。
