http://repository.usmf.md:80/xmlui/handle/20.500.12710/17977 The 7th Congress of the Society of Neurologists of the Republic of Moldova with International Participation, September 16-18, 2021, Chisinau, Republic of Moldova 2026-04-07T11:45:24Z http://repository.usmf.md:80/xmlui/handle/20.500.12710/18166 The Moldovan Medical Journal. September 2021, Vol. 64, Neuro Congress Issue The Moldovan Medical Journal (MMJ) is a scientific double-blind peer reviewed periodical official edition of the Scientific Medical Association of the Republic of Moldova, designed for specialists in the areas of medicine, dentistry, pharmacy, social medicine and public health. The Scientific Medical Association of Moldova has become the owner and publisher of the journal in 2017. Before that year, since the time of foundation in 1958, the journal was guided by the Ministry of Health. At present, the MMJ publishes independently submitted original researches and review articles, clinical studies and cases, lectures, brief reports and correspondence as well as official papers and editorials in medicine and health sciences. Founder: The Scientific Medical Association of the Republic of Moldova 2021-01-01T00:00:00Z http://repository.usmf.md:80/xmlui/handle/20.500.12710/18165 Neuropathies associated to malignant lymphomas Gherghelegiu, Evelina Background: Malignant lymphomas account for 3 – 4% of all cancers. The nerve damage in non-Hodgkin’s (NHL) and Hodgkin’s lymphoma (HL) may occur prior to the clinical expression of lymphoma or develop over time. Often, patients address neurologists without known lymphoma. Lymphomaassociated neuropathy shall be differentiated from the complications and side effects of lymphoma treatment. NHL is responsible for the most peripheral nerve complications. Diffuse nerve infiltration is the major cause of neuropathy with axonal damage. The clinically developed entities vary from multiple asymmetric mononeuropathy, polyneuropathy or plexopathy to more generalized patterns like polyradiculoneuropathy. The alteration of the peripheral nerves in HL is less common. HL implies immunological mediated inflammation and extensive demyelination, such as Guillain-Barré syndrome. Some patients, including those with neurolymphomatosis, register a positive response to immunomodulatory treatments, such as steroids and IVIG. In this regard, neurolymphomatosis is frequently misdiagnosed as chronic inflammatory demyelinating polyneuropathy. The electrodiagnostic criteria of definite chronic inflammatory demyelinating polyneuropathy of European Federation of Neurological Societies (EFNS) and Peripheral Nerve Society increase the accuracy of the diagnosis. Conclusions: Accurate clinical assessment combined with electrophysiology exam facilitate the early diagnosis and interventions in malignant lymphoma. A lymphomatous neuropathy should be considered even if the diagnostic criteria of chronic inflammatory demyelinating polyneuropathy are met, particularly in patients with associated pain syndrome. Electrophysiological evaluation is mandatory in any neuropathy of obscure etiology where lymphomas are placed for differential diagnosis. 2021-01-01T00:00:00Z http://repository.usmf.md:80/xmlui/handle/20.500.12710/18164 Nonconvulsive status epilepticus – a diagnostic and therapeutic challenge Munteanu, Cristina Background: Nonconvulsive status epilepticus (NCSE) is certainly an underdiagnosed pathology with chameleonic presentation. NCSE represents a persistent change in the level of consciousness, behavior, autonomic function, and sensorium associated with continuous epileptiform electroencephalographic (EEG) changes, but without major motor signs. NCSE comprises a group of syndromes with a wide range of response to anti-epileptics from self-limiting to refractory forms. It lacks prominent motor characteristic, but may have subtle motor signs (twitching, blinking). NCSE occurs in 8 – 37% of the ICU patients. The diagnosis and treatment are not straightforward and depend on clinical presentation, etiology, EEG findings. However, it is not always clear how electrographic activity contributes to clinical impairment or to ongoing neuronal injury. EEG criteria for NCSE are – definite electrographic seizure activity with typical evolution; periodical epileptiform discharges (EDs) or rhythmic discharge with clinical sign; rhythmic discharge with either clinical or electrographic response to treatment. More difficult is when there are EDs on EEG but they do not achieve the diagnostic criteria, we must look for: subtle motor signs time-related with EDs; spatio-temporal evolution; EEG and clinical improvement with anti-epileptics. Conclusions: Thus, NCSE diagnosis requires high index of suspicion in patients with risk factors and suggestive clinical features. Availability of continuous EEG is lacking in many centers and diagnosis is delayed. Early recognition and treatment are essential to optimize therapeutic response and to prevent neurological and systemic consequences. Overdiagnosis and aggressive treatment can contribute to high morbidity and mortality. 2021-01-01T00:00:00Z http://repository.usmf.md:80/xmlui/handle/20.500.12710/18163 Comorbidities and cognitive decline: relations and interactions in stroke patients Melnic, Adrian; Pascal, Oleg Background: Cognitive decline in stroke patients represents a common issue that can result in poor rehabilitation outcomes and require bigger resources from healthcare systems. Although cognitive conditions can be regarded as separate diagnosis, it is clear that presence of several comorbidities are more common in patients with cognitive disorders. The aim of our study was to determine the most common associations of comorbidities in patients with stroke and cognitive decline. Material and methods: A retrospective analysis of patients with stroke admitted to rehabilitation unit was performed. Patients with cognitive decline were analyzed separately in order to highlight main comorbidity groups. Results: Comorbidity number was identical in patients with or without cognitive decline, counting about 4 – 5 additional diagnosis. Cognitive disorders were registered in 11% of the patients. Among most common comorbidity groups were observed the cardiovascular conditions mainly hypertensive cardiopathy in 56 % and atrial fibrillation in 48 % followed by metabolic pathologies, such as diabetes in 24% and hyperlipidemia in 22% of the patients. Among the most common functional deficits in patients with cognitive decline were hemiparesis and speech disorders. Conclusions: Cardiovascular and metabolic group of conditions are the most common groups of comorbidities in patients with stroke and cognitive decline. A more sensitive research including clustered/ group analyses should be performed in order to determine comorbidity interaction in patients with stroke and cognitive deficits. 2021-01-01T00:00:00Z