The truth about the brain popular neuroscience fb2. Neurology textbook in two volumes

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1 A.S. Petrukhin CHILDREN'S NEUROLOGY TEXTBOOK IN TWO VOLUMES Ministry of Education and Science of the Russian Federation Recommended by the First Moscow State Medical University named after I.M. Sechenov" as a textbook for students of institutions of higher professional education studying in the specialty "Pediatrics" in the discipline "Nervous Diseases" Review registration number 7 dated February 25, 2009 Federal Institute for the Development of Education

2 A.S. Petrukhin CHILDREN'S NEUROLOGY TEXTBOOK VOL.

3 UDC (075.8) BBC 57.33 y73-1 P31 Authors: professor, chief freelance pediatric specialist neurologist of the Ministry of Health and Social Development of Russia A.S. Petrukhin; Candidate of Medical Sciences M.Yu. Bobylov. P31 Petrukhin, Andrey Sergeevich. Children's neurology: textbook: in 2 volumes / A. S. Petrukhin. M. : GEOTAR-Media, T s. : ill. ISBN (gen.) ISBN (vol. 1) The textbook is fully consistent with the program of teaching the discipline "Nervous Diseases" for students of pediatric faculties of medical universities. For ease of use, the textbook is divided into two volumes. The first volume contains an introduction to neurology, basic information on fundamental neurology, as well as topical diagnostics of diseases of the nervous system in children. The textbook is intended for students of pediatric faculties of medical universities, may be useful to students of other faculties, as well as pediatricians, neurologists and general practitioners. UDC (075.8) BBC 57.33 ya73-1 The rights to this publication belong to GEOTAR-Media Publishing Group LLC. Reproduction and distribution in any form of a part or the whole publication cannot be carried out without the written permission of GEOTAR-Media Publishing Group LLC. ISBN (gen.) ISBN (vol. 1) Petrukhin A.S., 2012 LLC Publishing Group "GEOTAR-Media", 2012 LLC Publishing Group "GEOTAR-Media", design, 2012

4 GENERAL NEUROLOGY Chapter 1. NEUROANATOMY 1.1. Brain The brain is a formation consisting of two cerebral hemispheres of the right and left, which are connected by a massive white commissure (corpus callosum) formed by large bundles of myelinated associative fibers, and two hemispheres of small cerebellum. In newborns, the brain mass averages 340 g, doubles by 6 months and triples by 3 years (600 and 1018 g, respectively). By the age of 7-8, the mass of the brain becomes equal to the mass of the brain of an adult and no longer increases (normally, individual fluctuations in brain mass can be significant). The total surface area of ​​the cerebral cortex (cloak) is 2500 cm 2, with 2/3 of the surface located in the depths of the furrows, and 1/3 on the visible surface of the hemispheres. Depending on the anatomical and physiological features of the structure, the following are distinguished: the forebrain (two hemispheres of the large brain, subcortical basal ganglia); diencephalon (thalamus, hypothalamus, metathalamus, subthalamus, epithalamus); midbrain; hindbrain (brain stem, cerebellum). The largest part of the cerebral hemisphere. In each hemisphere, the frontal, parietal, temporal, occipital lobes and insula are distinguished (Fig. 1.1). The lateral surface of the hemispheres is dotted with numerous furrows, the main of which are the lateral (Sylvian) furrow, which separates the frontal and parietal lobes from the temporal, the central (Roland) furrow, which separates the frontal lobe from the parietal, and the parieto-occipital, passing along the inner surface of the hemisphere and separating the parietal lobe from the occipital. Front

5 16 CHAPTER 1. Neuroanatomy a c b Figure Cerebral hemispheres: a upper lateral surface of the right hemisphere: frontal lobe (precentral gyrus, precentral sulcus, superior frontal gyrus, middle frontal gyrus, inferior frontal gyrus, central sulcus, lateral sulcus), parietal lobe (postcentral gyrus, postcentral sulcus, intraparietal sulcus, supramarginal gyrus, angular gyrus), occipital lobe, temporal lobe (superior temporal gyrus, superior temporal sulcus, middle temporal gyrus, middle temporal sulcus, inferior temporal gyrus; b medial surface of the right hemisphere: paracentral lobule, precuneus, parietal-occipital sulcus, wedge, lingual gyrus, lateral occipital-temporal gyrus, parahippocampal gyrus, uncus, fornix, corpus callosum, superior frontal gyrus, cingulate gyrus; into the inferior surface of the cerebrum: longitudinal fissure of the cerebrum, orbital sulci , olfactory nerve, optic chiasm, middle temporal sulcus, uncus, inferior temporal gyrus, mastoid body, base of cerebral peduncle, lateral occipitotemporal gyrus, parahippocampal gyrus, collateral sulcus, cingulate gyrus, lingual gyrus, olfactory sulcus, rectus gyrus

6 PART I. General neurology 17 from the central sulcus is the anterior central gyrus, in which the motor analyzer is represented - the highest center for regulating movements. It is formed by pyramid-shaped cells (Betz cells), giving rise to the corticobulbar and corticospinal tracts (pyramidal tract). Through it, signals for the regulation of voluntary movements are sent to the nuclei of the cranial nerves and cells of the anterior horns of the spinal cord. The frontal lobe is separated from the parietal central sulcus, from the temporal lateral sulcus. On the outer surface of the frontal lobe, four convolutions are distinguished: vertical (precentral) and three horizontal (upper, middle and lower). The vertical gyrus is enclosed between the central and precentral sulci. The superior frontal gyrus is located above the superior frontal sulcus, the middle one between the superior and inferior frontal sulci, and the inferior one between the inferior frontal and lateral sulci. On the lower (basal) surface of the frontal lobes, the direct and orbital gyrus are distinguished, which are formed by the olfactory and orbital sulci. The direct gyrus lies between the inner edge of the hemisphere and the olfactory groove. In the depths of the olfactory furrow lie the olfactory bulb and the olfactory tract. The function of the frontal lobes is associated with the organization of the program of voluntary movements, the motor mechanisms of speech, the regulation of complex forms of behavior, and thought processes. The parietal lobe is separated from the frontal central sulcus, from the temporal lateral sulcus, from the occipital imaginary line from the upper edge of the parietal-occipital sulcus to the lower edge of the hemisphere. In the parietal lobe on the outer surface, a vertical post-central gyrus and two horizontal lobules, superior parietal and inferior parietal, are distinguished. The postcentral gyrus is bounded by the central and postcentral sulci; the upper parietal lobule is located upward from the horizontal intraparietal sulcus, and the lower parietal lobule is located downward from the intraparietal sulcus. The part of the lower parietal lobule located above the posterior part of the lateral sulcus is called the supramarginal (supramarginal) gyrus, and the part surrounding the ascending process of the superior temporal sulcus is called the angular (angular) gyrus. The function of the parietal lobe is mainly associated with the perception and analysis of sensitive stimuli, spatial orientation, and the regulation of purposeful movements.

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Release year: 2008

Genre: Neurology

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Description: The story of the book "The whole truth about the brain" began in 1998. In June, when I was leading a meeting of neurologists and psychiatrists in Baden-Baden, I was approached by Dr. Bertram Schattauer of the publishing house and offered to take over the head of the neurology column. At first I hesitated (even more work!), but when I heard that it was one of the most popular journals in the field of neurology and psychiatry (with a circulation of approximately 32,000 copies), I agreed. When I asked if I could publish my articles, Dr. Bertram smiled and replied, “As many as you like!”
If only he knew I took him at his word! So I began my work, and my little column "Spirit and Brain" found a response in the hearts of readers. For four years now, I have received postcards, faxes, e-mails, grateful calls from readers, and pleasant conversations when meeting with colleagues. The work was not so easy, most often, due to the workload of the main activity, the opportunity to complete it appeared only at night, on weekends, on vacation. The stories were based on my direct observations or came to mind while reading specialized magazines. Often conversations with friends or within the family circle served as an occasion for another story, and often I told one of them in the clinic, when after the morning conference I still had five minutes of free time. After that, however, I waited for the reaction of my colleagues. If I saw their interested, smiling, excited faces and fire in their eyes, then I published these stories in my section.
These essays were published in three volumes and had unexpected popularity (the first two volumes were even reprinted). And then the thought came to my mind: why not publish a book with comments available to the general public? The publisher liked this idea, and the result of my work lies before you.
I have grouped the stories by chapter and added to some where I have outlined the issue covered in this chapter. The book should arouse the interest of readers and capture their attention. So, we are talking here not so much about spiritual food, but about a kind of spiritual "snack".
During the years of my work as an editor of the Neurology column, it was a great pleasure for me to communicate with my neuropathologist colleagues and employees of the publishing house. I would like to thank Prof. Dr. Dieter Soik and Dr. Wulf Bertram, as well as the charming collaborators Frau Fibiger, Frau Friedel and Dr. Frau Schurg. They supported me a lot. A good relationship between the boss and employees is just as important as mutual understanding between the captain and his team. Everyone in the team depends on each other - this is my belief.

Clinical epileptology: a guide / M. Ya. Kissin. - M. GEOTAR-Media, 2011. - 256 p.: ill. - (Series "Library of a specialist doctor").

The manual presents epidemiological and clinical data on ictal and interictal mental disorders in patients with epilepsy, differentiates and systematizes a variety of paroxysmal and permanent psychopathological manifestations. Analyzed antiepileptic drugs with recommendations for choosing the optimal treatment tactics.

Diseases of the nervous system: A guide for physicians in 2 volumes, ed. Yakhno

The second volume presents modern ideas about degenerative, metabolic, congenital and toxic lesions of the nervous system. Sleep disturbances, headaches, facial pains, epilepsy, fainting, pains in the neck, back and limbs, geriatric aspects of neurological disorders and lesions of the nervous system in somatic diseases are described. New methods of diagnostics, treatment and prevention, general principles of neuroreanimatology and neurorehabilitation are presented.

What to read about the structure, work of the brain and its capabilities. Can the brain be trusted? How consciousness and the brain interact, and how its work can be considered in the context of neuroscience. Important works in this area in the recommended selection of books.

1. Chris Frith "Brain and soul. How nervous activity shapes our inner world." - M.: Corpus, Astrel, 2012

This is one of the rare books in Russian, which tells in a professional and accessible way how the mental world works. The world of our sensations, experiences and ideas. The author of the book, a famous English neurobiologist and neuropsychologist, analyzing the details of the anatomical structure of the human brain, talks about how mental images and ideas about the real physical world are born, develop and live. In his narrative, the author uses information gleaned from the latest publications on how the activity of various surface and deep structures of the brain changes with a particular behavioral action. The constructs and landscapes of these inner worlds of a person, it turns out, do not have to be copies of external realities. On the contrary, these are the fruits of the creativity of the owner of the brain to the full extent - creativity that is not divorced from reality, but only fills in the gaps in its cognition. Our inner world, according to the author of the book, is almost richer than the outer world, since it complements it with options for possible realizations and spiritual quests.

2. Vileyanur Ramachandran "Birth of the mind. Mysteries of our consciousness." - M.: Olymp-Business, 2006

Only two or three lines are given by the author to the description of some ailment or injury of this or that patient, and then the reader goes along with the author into a leisurely study of the structure of the brain and the origins of the mind. Here, in one patient with a missing right limb, as soon as the doctor touched his cheek on the left, the thumb of the hand that was not there immediately itched. As soon as the doctor touched his cheek just below the previous place, he would like to scratch the index finger of the same missing hand. Ramachadran, as if surprised at himself, investigates the causes of this phenomenon, and the reader suddenly notices that now he knows not only about the phenomenon, not only about its causes, but also about the very structure of the brain, and also about how all this “mechanics " works.

How do we perceive the world around us and where do errors come from in this process? Are there any universal criteria for artistic taste, or does it all depend on cultural differences and national characteristics of people? Why do some people feel a certain color when they hear a certain tone? How can the numbers printed on paper with the same ink appear colored? And why has such a mixture of modalities of sensation, synesthesia, been preserved in human evolution? What are these mirror neurons, beloved by the author, that are activated in the brain not only with some kind of own action, but also with a similar action of another person? Finally, a completely philosophical question: whether a person, for example, bends his finger of his own free will when he intentionally wants to do it. It turns out that a second before a person decides to bend a finger, the brain has already calculated everything and independently made a decision about bending a finger. So, we are secretly commanded by our brain, and not our own consciousness! So imperceptibly, Vileyanur Ramachandran not only tells us about the structure and work of the brain, about the mysteries of the mind, but also leads us to the conclusion that his favorite subject, neurology, is a storehouse of philosophy.

3. Manfred Spitzer "The whole truth about the brain. Popular neuroscience." - M.: AST, Astrel, Harvest, 2008

A discerning reader, after reading a dozen pages, may call this book not very interesting. However, some patience is required here. Indeed, the book does not have that density of information flow, that aura of mystery in the descriptions of the brain and its activities, there are not even refined theories that usually attract attention to a popular science work. But there is a leisurely presentation of all sorts of different stories about cases of medical practice that the psychiatrist and neuropathologist, the wonderful Dr. Manfred Spitzer, has seen in his lifetime. In the book, the author pays relatively little attention to the actual medical aspects of a particular case, but fully reveals its deep meaning and significance from the point of view of the structure of the brain, the content of mental processes and errors in everyday interpretations of brain activity. We can say that Manfred's book is a collection of all kinds of stories that in one way or another shed light on the mechanisms of the brain and mind. These are either direct observations of the author of the book, or the fruits of random reflections, conversations with friends. “The Whole Truth About the Brain” is a very balanced story, thought out from all sides, about various aspects of the human brain, which, on the one hand, would seem to be absolutely clear from the school bench, and on the other hand, if you think about it, turn out to be completely mysterious, revealing the secret life of the brain. Somewhere after reading the first third of the book, it becomes obvious that the unhurried pace of the author's presentation of his stories corresponds to the speed of the natural perception of this topic and is the only acceptable for a thoughtful reader. It becomes obvious that babies begin to adapt to the external environment while still in the womb; that chocolate, of course, has a positive effect on brain activity, that healthy sex itself controls the level of the sex hormone testosterone, and not vice versa. By the end of the book, the reader is surprised to find that he has become the owner not only of a mass of new knowledge about the brain, but has learned to independently evaluate and interpret any new information or his own observations about how the human brain works in the context of his own experiences and when viewed from the outside.

4. Norman Doidge "Brain plasticity. Amazing facts about how thoughts can change the structure and function of our brain." - M.: EKSMO, 2009

The author of the book is an unusual person. Not only is he an M.D., psychiatrist, psychoanalyst, and professor at Columbia University in New York and the Department of Psychiatry at the University of Toronto, but he is also a gifted essayist, poet, and great promoter of brain science. His book Plasticity of the Brain is a rare example of a combination of scientific rigor in presenting the most incredible hypotheses, medical scrupulousness in describing clinical cases, and dramatic presentation of material. And all this for the sake of popularizing the brilliant idea that the brain is able to change its own structure and functioning due to the thoughts and actions of a person. Norman Doidge considers the understanding of the brain as a substratum of our behavior and intellect, constantly modified depending on the cognitive needs of the organism, to be a revolution. “This revolution, due to the neuroplasticity of the brain,” writes Norman Doidge, “cannot but affect our understanding of how love, sex, sadness, relationships with people, learning, addictions, culture, technology and psychotherapy change our brain” . Indeed, a new understanding of the brain, the structure and content of which is constantly being rebuilt to suit the current needs of the intellect, cannot but affect not only the biological and medical fields of research, but also the humanities, social and natural sciences, which to one degree or another deal with human nature. . Bright, accessible, always with intrigue, Norman Doidge talks about both outstanding scientists who prove the plasticity of the brain, and about patients whose lives have changed much for the better due to the fact that their traumatized brain itself has improved so much that its healthy parts began to work completely. in a new way, compensating for the failed brain mechanisms. Norman Doidge's book has an undoubted charge of optimism, it gives faith that the mind and will of a person can not only improve the brain of a healthy person, but also make him overcome any illness.

5. Sandra Amodt, Sam Wong "Secrets of our brain, or Why smart people do stupid things." - M .: EKSMO, 2009

Sandra Amodt and Sam Wong are well known for their work on the mechanisms of the human brain in normal and pathological conditions. Perhaps that is why their popular science book on how the brain works contains a minimum of digressions into the textbooks of anatomy and physiology, but is full of fascinating information and facts from the life of the brain, explaining our behavior, our abilities and the causes of some brain diseases. The book is a kind of invitation to explore your own brain. It is called in the original version "Welcome to your brain." In fact, the reader will not be deceived. In six large sections, he will learn whether you can trust your brain, how sensations are formed and how deceptive they are, why not everyone becomes a child prodigy and whether there are chances to remain in full mind until old age, why emotions are needed and whether they are related to states of happiness, what is more important and more important: heredity or upbringing - and, finally, to what extent we are rational, reasonable, and to what extent our consciousness is subject to the action of pharmacological and psychological influences? Sandra Amodt and Sam Wong talk about all this and much more in an accessible and exciting way, and most importantly, with the knowledge of professionals and the enthusiasm of the guides leading their first tourist group. The book by Sandra Amodt and Sam Wong is also useful in that it justifies the stupidity of even the most intelligent people by saying that this is due to the appropriate design and content of their brain.

About the author: Alexander Kaplan, Doctor of Biological Sciences, Psychophysiologist, Professor of the Department of Human and Animal Physiology, Head of the Laboratory of Neurophysiology and Neurointerfaces at the Faculty of Biology of Lomonosov Moscow State University. M.V. Lomonosov.

"Gomel State Medical University"
Department of Neurology and Neurosurgery

EDUCATIONAL AND METHODOLOGICAL AID

TO PRACTICAL CLASSES IN NEUROLOGY

AND NEUROSURGERY FOR THE IV YEAR STUDENTS OF THE FACULTY OF MEDICINE AND THE FACULTY FOR TRAINING SPECIALISTS FOR FOREIGN COUNTRIES AND THE V YEAR STUDENTS OF THE MEDICAL DIAGNOSTIC FACULTY OF HIGHER MEDICAL

EDUCATIONAL INSTITUTIONS

Gomel, 2014

UDC 616.8+616.8-089(072)(076.5)

V. Ya. Latysheva, V. I. Kurman, N. V. Galinovskaya, M. V. Olizarovich,

N. N. Usova, E. V. Serebrova, Yu. V. Tabankova
Reviewers:

doctor of medical sciences, associate professor,

Head of the Department of Neurology and Neurosurgery

Educational Establishment "Grodno State Medical University"

S. D. Kulesh

Candidate of Medical Sciences, Leading Researcher

Republican Scientific and Practical Center

radiation medicine and human ecology

A. N. Tsukanov
Educational and methodical manual for practical exercises in neurology

U91 and neurosurgery for IV-year students of the medical faculty and the faculty for training specialists for foreign countries and the V-year medical-diagnostic faculty of higher medical educational institutions / V. Ya. Latysheva [et al.]. - Gomel: educational institution "Gomel State Medical University", 2014. - 160 p.
ISBN
The teaching aid was compiled in accordance with the standard program in neurology and neurosurgery for students of higher medical educational institutions, approved, Minsk, 02.11.2011 Registration No. TD-L.263 / type.
Approved and recommended for publication by the Central Educational Scientific and Methodological Council of the Educational Institution "Gomel State Medical University", Protocol No.

UDC 616.8+616.8-089(072)(076.5)

BBC 56.1ya73
ISBN © Educational Institution

"Gomel State

Medical University", 2014

list of symbols

TOPIC 1. MOTOR SYSTEM AND SYNDROMES OF ITS DEFEAT
1. Introduction (relevance of the topic)

Most diseases of the nervous system are accompanied by damage to the structures responsible for voluntary and involuntary movements, which are formed with the participation of the pyramidal, extrapyramidal system and the cerebellum. Moreover, the most severe diseases, such as strokes, injuries of the nervous system, multiple sclerosis, amyotrophic lateral sclerosis, as a rule, are accompanied by disorders of motor functions, leading to disability of patients. Damage to the extrapyramidal system (basal nuclei) causes the development of hypertonic-hypokinetic (akinetic-rigid) and hypotonic-hyperkinetic syndromes.

Knowledge of the symptoms that develop when the structures responsible for the motor act are damaged is one of the fundamental foundations for the topical diagnosis of diseases of the nervous system.

Without an understanding of the anatomy and physiology of movement control systems, the treatment of movement disorders is impossible.

2. Purpose:

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  development by students of topical diagnostics of lesions of the pyramidal and extrapyramidal systems responsible for the motor act, methods of studying the motor sphere of a person.

The student must know:

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  anatomical and physiological features of the organization of the human motor sphere, the structure of the pyramidal system;
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  methodology for studying the function of the motor sphere (studying the volume of active and passive movements, determining muscle strength and tone, studying deep and superficial reflexes, studying pathological reflexes);
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  classification of reflexes;
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  principles of topical diagnosis of lesions of various parts of the pyramidal system;
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  methodology for studying the extrapyramidal system. Parkinson's syndrome and types of hyperkinesis.

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  determine the volume of active and passive movements;
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  examine the muscle strength of the limbs;
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  examine muscle tone;
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  explore deep and superficial reflexes;
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  determine pathological reflexes;
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  to determine the symptoms that characterize the extrapyramidal system in the norm and in violation of its function.

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  the technique of a special survey and examination of patients with lesions of the pyramidal and extrapyramidal systems.

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  The motor sphere is the interaction of the system of voluntary movements, the extrapyramidal system and the system of coordination of movements.
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  The structure of the cortical-muscular pathways of the system of voluntary movements.
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  Reflexes, classification (superficial, deep), levels of closure, options for changes.
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  Symptoms of central paralysis. Symptoms of peripheral paralysis.
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  Terminology of disorders of voluntary movements: paresis, plegia, mono-, hemi-, tetra- and paraparesis.
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  Syndromes of movement disorders in the defeat of the hemispheres, brain stem, spinal cord, roots and plexuses, peripheral nerves.
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  Syndromes of lesions of the extrapyramidal system (basal nuclei, red nucleus, substantia nigra and other formations).
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  The role of electrodiagnostics in determining central and peripheral paralysis.