Abstract

Topicality: The research conducted by the authors shows that acute trauma in combat conditions is accompanied by persistent psychophysiological disorders of the central nervous system, but a significant part of these studies is based on clinical observation data. The technique of electroencephalography (EEG) allows you to objectively assess the state of the central nervous system and provides a better understanding of neurophysiological processes in patients with sensorineural deafness (SND) with acute trauma, which will contribute to the development of more effective rehabilitation methods for this contingent of patients. Aim: to evaluate the indicators of bioelectrical activity of the brain according to electroencephalography (EEG) data in servicemen who received acute trauma in real combat conditions, with different effectiveness of treatment measures. Materials and methods: 2 groups of servicemen with combat acute trauma were examined: 1 group - patients with positive dynamics of treatment, 2 group - patients with insufficient effectiveness of treatment, and 15 healthy normal-sensing individuals of the control group. The electroencephalographic study was carried out with the help of a computer electroencephalograph of the company "DH-systems" (Ukraine). Results: All patients underwent a comprehensive, instrumental examination. The examined subjects had sensorineural deafness with a descending, often abrupt, type of tonal audiometric curve, with the most pronounced and reliable increase in hearing sensitivity thresholds in the region of 4, 6, and 8 kHz. According to the analysis of EEG indicators, in the patients examined by us, the most characteristic were a decrease in the bioelectric activity of the brain and disorganization of cortical rhythms with signs of dysfunction of the diencephalon-stem structures. At the same time, the decrease in bioelectric activity most often occurred in the frontal and temporal leads. Thus, in patients of group 1, during the background recording, the content of the delta rhythm was (13,61±0,37) and (9,96±0,29) %, respectively, which significantly exceeds the control indicators (8,5±1,6) and (5,3±1,5) % (Р<0,05). During photostimulation and hyperventilation in the frontal leads, the content of slow-wave activity significantly exceeded the control indicators. During photostimulation, the content of the delta rhythm in patients of group 1 was (14,23±0,38) and (7,3±1,4) % in the control group. In the comparative analysis of EEG indicators between the studied groups, an increase in the representation of slow-wave activity in frontal projections and a decrease in the share of alpha rhythm in patients of group 2 is noted. Thus, in frontal leads during background recording in patients of groups 1 and 2, the delta rhythm content was (13,61±0,37) and (16,95±0,25) %, respectively. Moreover, these trends were preserved both during background recording and during functional loads. Therefore, patients with combat acute trauma have significant disturbances in the bioelectrical activity of the brain according to EEG data. Patients with pronounced disorders of the functional state of the central nervous system are more difficult to treat with SNP. Conclusions: 1. Military personnel with acute trauma received in real combat conditions have objective signs of functional disorders in the cortical and deep structures of the brain according to EEG data. 2. Prognostically unfavourable in terms of treatment effectiveness is the redistribution of the main EEG rhythms in the direction of growth of slow-wave activity on a disorganized background, especially in frontal projections. It is advisable to take this into account when carrying out treatment and preventive measures and developing rehabilitation measures. 3. Targeted treatment of sensorineural deafness in patients with combat acute trauma should be carried out taking into account extraural disorders, which allows to prevent the development of severe deafness.

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