14
Prion etiology is typical of Creutzfeldt-Jakob disease with spongy encephalitis and
rapidly progressive dementia. At the same time revealed is the growth of the contents of
various cytokines and oxidants, contributing to brain damage [Burwinkel M et al., 2004;
Geschwind MD et al., 2008; Riemer C. et al., 2009]. Treatment of such diseases is not
possible now, however, like with
other “accumulated diseases”
efferent therapy can be
effective enough.
Ischemic attacks and ischemic strokes in many cases are the consequences not
only of atherosclerosis, but also antiphospholipid syndrome [Greenberg SM, Hyman
BT, 1997]. Probability of the latter increases with the occurrence of a disease at a young
age that redefines treatment policy conventional in such cases, increasing the
anticoagulant therapy with attracting and efferent methods. Amount of anticardiolipin
antibodies increases with age from 60 to 70 years, as well as in patients with diabetes
and hypertension, which does not exclude the influence of the mechanisms of
autoimmune disorders of cerebral circulation [Tanne D. et al., 1999]. Furthermore, after
acute cerebral stroke period there are detected autoantibodies to myelin basic protein
[Evdokimov A.V., Gerasimova M.M., 2006]. There is information of occurrence of
vascular lesions of the brain on the type of vasculitis on the basis of the appearance of
autoantibodies to myeloperoxidase, which are markers of vasculitis. Marked increase in
2-3 times the level of antiphospholipid autoantibodies in patients with vertebral-basilar
circulatory insufficiency, especially with its prolonged duration [Fomina L.A.,
Gerasimova
М
.
М
., 2006].
All of this allows us to consider plasmapheresis very promising for vascular
diseases of the central nervous system and its wide application is a matter of the near
future. Indeed, even a course of plasmapheresis in the acute phase of ischemic stroke
on the basis of the antiphospholipid syndrome enables quick regression of speech and
of brain disorders [Elchaninov A.P. et al., 2003]. Y. Hasegawa et al. (2003) using
cascade plasmapheresis for 5-7 days after a stroke on the basis of the middle cerebral
artery occlusion achieved reduction in plasma viscosity and a significant increase in
cerebral blood flow from 36.4 to 40.7 ml/100g/min on the affected side with the rapid
regression of hemiplegia almost immediately after the procedure. Plasma exchange
was effective for acute stroke on the basis of thrombotic thrombocytopenic purpura
[Sevy A. et al., 2011].
Refsum
’s
disease is the result of accumulation of phytin acid and is characterized
by loss of sense of smell, hearing, retinitis pigmentosa with loss of vision (night
blindness), ichthyosis, ataxia and symptoms of chronic polyneuropathy. In the future,
what can join is heart failure on the basis of cardiomyopathy. In the treatment, in
addition to a diet that excludes the reception of phytin acid, in severe cases of
increasing weakness and arrhythmias is used and plasmapheresis [Wanders RJA et al.,
2010; Perera N.J. et al., 2011].
15
Severe consequences are suffered from ixodes encephalitis. Already in the acute
stage of the disease develop severe brain damage with symptoms and multiple organ
disorders
–
a toxic cardiomyopathy, and hepato-renal failure, which in turn is reflected in
the activity of the central nervous system. So there is a chain reaction in the process of
developing
the
disease.
This
in
itself
calls
for
measures
to
detoxify.
On the other hand, as a result of destruction of neurons and other structures of the
nervous system under the influence of viruses translocation happens of autoantigens
previously hidden from the immune system that causes the formation of autoantibodies
and immune complexes. In the transition to the chronic form of the disease entering
these autoantibodies and immune complexes in the brain is supported by degenerative
processes which started there [Shapoval A.N., 1980]. There is an additional indication
for program plasmapheresis at such consequences of ixodes encephalitis.
There is also quite a heavy, though not fatal, disease which is not amenable to
conventional therapeutic effects - migraine, followed by an abrupt onset of severe
headache with nausea and vomiting. Pathological processes of this disease may be
similar in nature to atopic allergy, especially since it such as paroxysmal local
Quincke’s
angioedema. When migraines are also likely to arise is a crisis violation of local vascular
permeability with edema of the relevant department of the brain, the more that
headache often also has a local character (for example - the left parietal region).
Biologically active substances cause histamine release and proteolytic enzymes that
convert inactive kininogens in plasma kinins and other active substances that may
cause pain.
Such patients can help detect antiphospholipid antibodies (anticardiolipin antibodies
and lupus anticoagulant), especially in cases of transient neurological disorders
associated with migraine with aura [Tietjen GE et al., 1998]. These packages also make
the indications for efferent therapy. So, A.K.Marchuk and N.M.Bulanova (1999) reported
that after plasmapheresis could stop an attack of migraine with normalization of platelet
aggregation and increased levels of cortisol.
We cannot exclude any autoimmune or metabolic disorders in the genesis of
diencephalic syndrome and some other kinds of neurotic disorders - or neuro
vascular dystonia, and neurological disorders can carry not a primary but secondary.
This could be seen in detectable shifts of hormonal and neuro-mediator regulation.
To summarize the description of nervous diseases, it is necessary to emphasize
that virtually all of the above components of the pathogenesis of autoimmune diseases
are in some degree confirmed by the results of numerous studies, which means that the
efferent therapy should take their proper place in the complex therapy. Presented are
specific examples of the successful use of plasmapheresis with one hand and certain
risks and side effects of alternative therapies. In conclusion, we present results of a
multicenter analysis of long-term experience with the use of plasmapheresis in nervous