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Collection of family and personal anamnesis. Consultations of highly specialized specialists - gastroenterologist, rheumatologist, neuropathologist, ophthalmologist, dermatologist, hematologist, gynecologist, andrologist. Ultrasonography of the abdominal and pelvic organs. Computed tomography of the thyroid and adrenal glands.
the patient undergoes a comprehensive examination, including:
Echocardiography. Hemogram. Biochemical blood test - to measure the level of total protein, glucose, urea, bilirubin, creatinine, alkaline phosphatase, ALT, AST, electrolytes, calcium, phosphorus, C-peptide, thyroid-stimulating, parathyroid and adrenocorticotropic hormones, free thyroxine, renin, cortisol, insulin, aldosterone. Immunological study - to detect and quantify antibodies to pancreatic β-cells, thyroperoxidase and glutamate decarboxylase (enzymes necessary for normal thyroid function and the synthesis of gamma-aminobutyric acid, an inhibitory neurotransmitter of the nervous system).
Patients with APGS are prescribed
permanent hormone replacement therapy with the use of glucocorticoids, mineralocorticoids, L-thyroxine; antimycotic drugs; immunosuppressive therapy. It is necessary to refuse to take alcoholic beverages, adhere to a sparing diet, consume large amounts of salt and ascorbic acid.
If an autoimmune polyendocrine syndrome is suspected
Broca's motor aphasia: with this pathology of the motor centers of the cortex, the ability to speak is lost (Fig. 78). This happens despite the fact that every single muscle involved in speech is perfectly innervated. Moreover, a person with this disorder may swallow, chew, scream, whistle, and sing. By singing phrases, he can "speak", but ordinary speech is impossible. This example shows that the cerebral cortex does not control specific muscles, but their systemic use.
Motor aphasia occurs with lesions of the lower parts of the left frontal lobe and is characterized by slow, laconic, poorly articulated speech, requiring great effort from the patient (it is difficult to merge words or even sounds). In severe cases, the patient utters only inarticulate sounds.
The patient's speech is difficult, with impaired articulation, often interrupted by pauses to search for words. Phrases contain almost no functional words and consist mainly of verbs and nouns. The word order is violated, edge morphemes are used incorrectly (the endings of words that express the tense and mood of verbs, case, gender and number of nouns).
Telegraph speech is typical - concise, but quite informative. For example, a 45-year-old man with motor cortical aphasia describes his illness as follows: "I went. Doctor. Doctor sent me. Bosson. Hospital. Doctor. There. Two, three days. Doctor sent me home."
YEARS IN BUSINESS
The patient's speech may be limited to lowing or a single word ("yes" or"no"), which he utters with different intonations, trying to express his attitude to what is happening. Violated naming and repetition.