Meningomyelitis (meningomyelitis; from the Greek. meninx, meningos - mater and myelos - brain - inflammatory process, exciting at the same time shell and the substance of the spinal cord. The process starts with soft shells and further goes to the roots and the substance of the spinal cord. Meningomyelitis is not an independent disease, but rather syndrome diffuse lesions of the nervous system, which is dominated by the effects of the defeat of shells and substance of the spinal cord.
In the etiology of meningomyelitis are various local and systemic infections. In General infection (measles, scarlet fever, fever), and allergic forms of inflammation (rheumatoid arthritis) process often expressed only in the beginning of common diseases. Pia mater are almost always involved in the inflammatory process of the spinal cord (see Myelitis, Encephalomyelitis); inflammation of the membranes when it is short and mild, as in General infection. More important are the chronic meningomyelitis observed in AIDS, brucellosis, chronostasis and sometimes tuberculosis. Pia mater in these cases thickens, soldered with the spinal cord and the inner surface of a rigid shell. Spinal cord seems to be thinning, denser than usual. Microscopically in a soft shell marked redness, infiltration of vascular walls, sometimes lymphoid nodules and fibrosis tissue membranes; such inflammation spread along vessels and the substance of the spinal cord, often in the thoracic Department; mostly affected white matter, but sometimes the process involved and grey matter. Along with shells process spreads to spinal roots, especially early in the disease.
The clinical picture of meningomyelitis at the beginning of the disease appear pain and paresthesia damage of the meninges and roots, pain surrounds, radicular in the chest, abdomen and extremities. Marked paresthesias in the form of crawling, tingling and burning. If you experience symptoms of Cernica and Brudzinskogo. In further developing the weakness in the legs, increasing often to complete paraplegia, increased muscle tone, appear pathological reflexes, the delay urination and constipation, violations of all kinds of sensitivity lower extremities and torso to the level of the affected segment. In the cerebrospinal fluid in the initial period of the disease is observed the increase of protein and pleoticus.
When meningomyelitis on the basis of a common infections or allergic diseases in the spinal fluid is dominated by lymphoid elements, and in septic processes neutrophilia, which lasts a long time. When syphilis M can be positive Wasserman in the spinal fluid and blood.
Usually meningomyelitis develops gradually, there may be some variations in the intensity of symptoms and short-term remission, which makes it difficult differential diagnosis M with multiple sclerosis; however, in patients M not found symptoms, pathognomonic for multiple sclerosis. Gradual development, chronic and initial radicular symptoms when M hamper the difference M. from tumors of the spinal cord; but by tumors include protein cellular dissociation in the spinal fluid, a symptom of herniation before surgery, spinal cord after the puncture (M. Ya. Razdolsky), x-ray changes of the spine, in some cases, the diagnosis is finally established only when myelography with yodolipola or isotope of radon, xenon. Sometimes it is necessary to distinguish M. from acute myelitis, but at last the disease occurs suddenly on the background of acute infection, runs hard, with incontinence and bedsores, cerebrospinal fluid rarely changed.
Treatment of meningomyelitis is determined mainly by the reason that caused the disease. When syphilitic meningomyelitis shown specific treatment, and at the monastery of other etiology - symptomatic, balneophysiotherapy (massage, physiotherapy, hydrogen-sulphidous baths, electrophoresis with 2-5% potassium iodide), when expressed spastic paralysis - the drugs that reduce muscle tone (milletin 0.01 g 3 times a day, Latin 0.01 g Once a day, medical 0.01 g 2-3 times a day).