Model of differential diagnosis of nervous system lesions in young children

2021 ◽  
Author(s):  
Т. С. Кривоногова ◽  
О. М. Гергет ◽  
В. А. Желев ◽  
Е. В. Голикова ◽  
Е. В. Михалев ◽  
...  
Keyword(s):  
Mathematical Model ◽  
Nervous System ◽  
Differential Diagnosis ◽  
Control Group ◽  
Diagnostic Model ◽  
Healthy Children ◽  
Morphological Examination ◽  
Term Infants ◽  
Traumatic Lesions ◽  
Area And Perimeter

Перинатальная патология центральной нервной системы занимает ведущие позиции в структуре детской заболеваемости, что диктует необходимость поиска оптимальных подходов к ранней диагностике гипоксически-ишемических и травматических поражений центральной нервной системы, в том числе с использованием технологий математического моделирования. Цель работы состоит в создании и апробации математической модели дифференциальной диагностики гипоксически-ишемических и травматических поражений нервной системы у детей с использованием метода кариометрии. В исследование были включены 290 доношенных детей первого года жизни: первая группа сравнения включала 120 новорожденных с гипоксически-ишемическим поражением центральной нрвной системы, вторая – 120 новорожденных с ее травматическим поражением, контрольная группа включала 50 здоровых детей. Всем детям в возрасте 1, 3, 6, 9 месяцев и 1 года оценивались физическое и нервно-психическое развитие, двигательные функции по методу Л. Т. Журбы. На первом месяце жизни проводились нейросонография головного мозга, рентгенологическое обследование головы и шейного отдела позвоночника в двух проекциях. В возрасте 1, 3 и 6 месяцев выполнялось морфологическое исследование лимфоцитов (кариометрия). Для создания математической модели дифференциальной диагностики гипоксически-ишемических и травматических поражений нервной системы были взяты 12 показателей нейросонографии и 4 показателя морфологии лимфоцитов периферической капиллярной крови (площадь и периметр ядра, площадь и периметр клетки). В построении диагностической модели использовали самообучающуюся искусственную нейронную сеть, работа которой воспроизведена при помощи созданного программного приложения. Исследование показало, что полученная нами модель проста в использовании, экономит время на постановку диагноза, обладает высокой степенью распознавания: специфичность модели – 89,2%, чувствительность 92%. Perinatal pathology of the Central nervous system (CNS) occupies a leading position in the structure of childhood morbidity, which dictates the need to find optimal approaches to the early diagnosis of hypoxic-ischemic and traumatic CNS lesions, including using mathematical modeling technologies. Objective: to create and test a mathematical model for differential diagnosis of hypoxic-ischemic and traumatic lesions of the nervous system in children using the karyometry method. The study included 290 full-term infants of the first year of life: the first comparison group included 120 newborns with hypoxic – ischemic CNS damage, the second group-120 newborns with traumatic CNS damage, the control group included 50 healthy children. All children aged 1, 3, 6, 9 months and 1 year were evaluated for physical and neuropsychic development, motor functions according to the method of L. T. Zhurba. In the first month of life, neurosonography of the brain, x-ray examination of the head and cervical spine in two projections were performed. Morphological examination of lymphocytes (karyometry) was performed at the ages of 1, 3 and 6 months. To create a mathematical model for differential diagnosis of hypoxic-ischemic and traumatic lesions of the nervous system, 12 indicators of neurosonography and 4 indicators of peripheral capillary blood lymphocyte morphology (area and perimeter of the nucleus, area and perimeter of the cell) were taken. A self-learning artificial neural network was used in the construction of the diagnostic model, the operation of which was reproduced using the created software application. The study showed that the model we obtained is easy to use, saves time for diagnosis, and has a high degree of recognition: the model specificity is 89,2%, and the sensitivity is 92%.

Calprotectin (S100 A8/A9) and TNF-alpha in differential diagnosis of chronic abdominal pain in children

2017 ◽  
Vol 53 (1) ◽  
pp. 5-10
Author(s):  
Stanisław Pieczarkowski ◽  
Kinga Kowalska-Duplaga ◽  
Andrzej Wędrychowicz ◽  
Krzysztof Fyderek ◽  
Przemko Kwinta ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Functional Gastrointestinal Disorders ◽  
Fecal Calprotectin ◽  
Chronic Abdominal Pain ◽  
Tnf Alpha ◽  
Gastrointestinal Disorders ◽  
Control Group ◽  
Healthy Children ◽  
Inflammatory Bowel

<i>Introduction:</i> Chronic abdominal pain in children is a very frequent and sometimes challenging diagnostic issue. Differential diagnosis in that cases is difficult and often connected with numerous, time-consuming, expensive, and frequently stressful diagnostic studies. The aim of the study was to establish whether fecal calprotectin concentration (FCC) and TNF-alpha may be useful in children with chronic abdominal pain to differentiate between inflammatory bowel disease (IBD), other inflammatory gastrointestinal disorders, and functional gastrointestinal disorders. Methods. The study included patients (median age 13 years), who were assigned to functional gastrointestinal disorders group (n=33); inflammatory gastrointestinal disorders other than IBD (n=71), children with IBD (n=37) and 22 healthy children served as a control group. The concertation of FCC and TNF-alpha in stool samples was measured using ELISA. <i>Results:</i> In healthy children and in children with functional disorders FCCs were below 100 μg/g. In patients with IBD FCCs and TNF-alpha were markedly elevated as compare to children with functional gastrointestinal disorders, however using ROC discrimination of IBD patients was significantly better using FCC than TNF-alpha. <i>Conclusion:</i> FCC is better test for differentiation between IBD, other inflammatory gastrointestinal disorders, and functional gastrointestinal disorders as compare to TNF-alpha concentration in stool. FCC as screening test in patients with chronic abdominal pain should allow to diminish unnecessary diagnostic in cases of functional gastrointestinal disorders.

scholarly journals Mathematical modeling for prediction of complicated acute appendicitis in children

2018 ◽  
Vol 1 (1) ◽  
pp. 70-80
Author(s):  
V. S. Konoplitsky ◽  
V. V. Motygin ◽  
A. G. Yakimenko ◽  
D. V. Dmytriiev ◽  
T. I. Mikhalchuk
Keyword(s):  
Mathematical Model ◽  
Acute Appendicitis ◽  
Postoperative Period ◽  
Abdominal Cavity ◽  
Control Group ◽  
Toxic Substances ◽  
Healthy Children ◽  
Endogenous Intoxication ◽  
Complicated Course ◽  
Complicated Acute Appendicitis

Endogenous intoxication, which accompanies the complicated course of acute appendicitis in children, is one of the serious conditions, which are the main cause of complications in the postoperative period. Diverse clinical observations done by clinicians suggest that despite the use of modern technologies in operating equipment, anesthetic support, the number of complications in the postoperative period has no tendency to decrease, and the main cause of lethal outcomes with appendicular peritonitis is lightning development of severe degree of endotoxicosis, which develops as a result of resorbing toxic substances formed of many components, including pathogenic microflora and destruction metabolism. Purpose. Creation of a mathematical model for prediction of complicated acute appendicitis in children using the functions of regression analysis of EXCEL spreadsheet by approximating experimental data. Materials and methods. In the work, there is information about 59 patients with acute appendicitis treated at the clinic of pediatric surgery at the National Pirogov Memorial Medical University. The data on patients were divided into two groups: patients with not complicated course of pathology – 24 patients, and patients with complicated course of acute appendicitis – 35 children. The control group served the data of 37 healthy children. In each of the three groups, the following parameters were studied: gender, age, bed day, duration of the disease, presence of symptoms of peritoneal irritation, the nature of exudate in the abdominal cavity, the number of red blood cells, hemoglobin, leukocytosis, quantitative characteristics of white blood formula, ESR, cellogenic endogenous intoxication: leukocyte index of intoxication and hematological index of intoxication. All the data were determined directly at the time of hospitalization of a patient to the hospital. Results. Discussion. Based on multiple correlation x = f (x1 , x2 ) a two-factor mathematical model of probability of the complicated course of acute appendicitis in children was created. According to the obtained results of the study of the system of three equations with three unknowns, it was established that if the indicator of the form of the disease is y = 2.67 and above, when, in numerical terms, the result falls into the zone of complicated flow of acute appendicitis and completely coincides with data analysis of the three groups of patients. Conclusions. The components that determine the uncomplicated course of acute appendicitis in children, according to the developed two-factor model, include LII and GPI, which exceed the values intoxication of certain intervals studied at the time of hospitalization. The analyzed indices were determined by the degree of severity of the pathological process, duration of disease, virulence of microflora and age of patients against the background of the formed endogenous intoxication syndrome.

scholarly journals Assessment of heart rate variability and tone of the autonomic nervous system in puberty-aged children with undifferentiated connective tissue dysplasia

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
O V Sidorovich ◽  
S Y U Elizarova ◽  
A V Khizhnyak ◽  
N A Kuznetsova ◽  
E E Prosova
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Connective Tissue ◽  
Control Group ◽  
Healthy Children ◽  
Autonomic Nervous ◽  
Connective Tissue Dysplasia ◽  
End Of Puberty

Abstract   Within the framework of the research into pathological conditions and syndromes associated with undifferentiated connective tissue dysplasia (UCTD), an emphasis needs to be placed on the changes in heart rhythm. In puberty, the severity of neurovegetative disorders caused by the presence of UCTD might increase manifold. The features of heart rate variability (HRV) in pubertal children against the background of UCTD have been studied insufficiently and require more detailed analysis. This study aims to assess heart rate variability and tone of the autonomic nervous system (ANS) in puberty-aged children with UCTD. Two groups of children were examined, with methods including electrocardiography and cardiointervalography. The main group consisted of 36 puberty-aged children with UCTD, the control group consisted of 30 healthy children. ANS tone was assessed based on the HRV. In the control group of children aged 11, the value of variation range (VR) was 0.18±0.4, mode amplitude (MA) 35.2±2.4, stress index (IN) 72.8±4.3, which corresponds to the state of vegetative balance. As the puberty progresses, the state of eutonia is replaced by the activation of the sympathetic division of the ANS, which becomes most pronounced at the age of 13 years. In the control group of children aged 13, the value of VR was 0.08±0.02, MA 61.7±2.1, SI 210.6±8.6, which corresponds to moderate sympathicotonia. By the end of puberty, in healthy children, the severity of sympathetic activation begins to decrease, and at the age of 15 years, vegetative balance is again observed. However, this pattern is violated in children with UCTD. Upon entering puberty, moderate activation of the sympathetic division of the ANS is already observed in children with UCTD. At the age of 11 years in this group, the value of VR is 0.06±0.02, MA 72.4±3.1, SI 211.2±8.6. At the age of 13, pronounced sympathicotonia is observed, which is confirmed by the values of VR - 0.04±0.01, MA 80.2±4.3 and SI 34.3±14.7. By the end of puberty in children with UCTD, in contrast to the control group, the analyzed parameters indicate not an equilibrium of the ANS, but the predominance of parasympathetic activation. The research provides an insight into heart rate variability in puberty-aged children with UCTD. It was established that healthy children enter puberty in a state of equilibrium of the autonomic nervous system, which in the middle of puberty is replaced by moderate sympathicotonia, and then returns to its original values. Children with the presence of UCTD enter puberty with moderately pronounced sympathicotonia, which gradually increases to pronounced values and is replaced by moderate vagotonia. FUNDunding Acknowledgement Type of funding sources: None.

Primary and Secondary Central Nervous System Vasculitis

2012 ◽  
Vol 27 (11) ◽  
pp. 1448-1459 ◽  
Author(s):  
Peter Gowdie ◽  
Marinka Twilt ◽  
Susanne M. Benseler
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Differential Diagnosis ◽  
Clinical Laboratory ◽  
Early Recognition ◽  
Brain Diseases ◽  
Neurological Deficits ◽  
Healthy Children ◽  
Central Nervous System Vasculitis ◽  
Secondary Central Nervous System

Central nervous system vasculitis is an increasingly recognized inflammatory brain disease causing devastating neurological deficits and psychiatric manifestations in previously healthy children. Primary central nervous system vasculitis represents an isolated inflammatory attack targeting the cerebral vessels. In contrast, in children with secondary central nervous system vasculitis, an underlying condition can be identified. The spectrum of childhood primary and secondary central nervous system vasculitis is rapidly expanding, as is the differential diagnosis including nonvasculitic inflammatory brain diseases and noninflammatory vasculopathies. Early recognition, rapid diagnostic evaluation, and initiation of treatment have led to improved morbidity and mortality. This review focuses on clinical, laboratory, and neuroimaging characteristics of the distinct subtypes of primary childhood central nervous system vasculitis, reports the etiology of secondary central nervous system vasculitis, provides an overview of the differential diagnosis, and reviews the current approaches in treatment.

scholarly journals Indicators of vegetative homeostasis in children with mitral valve prolapse before and after treatment

2019 ◽  
Vol 23 (2) ◽  
pp. 234-237
Author(s):  
A. V. Kuleshov ◽  
Y. A. Medrazhevska
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Nervous System ◽  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Medical Literature ◽  
The Body ◽  
Control Group ◽  
Healthy Children ◽  
Before And After

For children with mitral valve prolapse (MVP) characterized by disorders of vegetative homeostasis, especially pronounced effect on the body sympathetic link of the autonomic nervous system. In the medical literature, the question of correction of vegetative tone in children with primary MVP is now open. The purpose of the study was to study the parameters of vegetative homeostasis in children with mitral valve prolapse before and after treatment. 66 children with primary and primary MVP stage I and II at the age of 13–17 years were examined. The control group consisted of 23 practically healthy children. The evaluation of vegetative homeostasis was performed using a clinorostatic test and cardiointervalography, followed by an analysis of the parameters and parameters of the heart rate variability spectral analysis. To restore vegetative homeostasis to patients with PMC, an existing treatment regimen with our correction was prescribed. Namely, we added therapies levocarnitine and magnesium. According to the data obtained from the CP, we found that treatment led to the normalization of vegetative maintenance of the organism, mainly in the form of a decrease in the hypersympathicotonic tonic type after treatment, along with the baseline (p<0.05). Consequently, the proposed treatment scheme with the use of levocarnitine and magnesium, positively affects the autonomic system in children with primary MVP, reducing its dysfunction.

scholarly journals IMMUNOHISTOCHEMICAL MARKERS AND HISTOLOGICAL AND MORPHOLOGICAL CHANGES IN THE PLACENTA OF WOMEN, WHO GAVE BIRTH TO CHILDREN WITH ANENCEPHALY

2020 ◽  
Vol 22 (1) ◽  
pp. 22-27
Author(s):  
Veronika Melnikova V ◽  
◽  
Munavvara Dodkhoeva ◽  
Keyword(s):  
Endothelial Cells ◽  
Vascular Endothelial Cells ◽  
Morphological Changes ◽  
Inverse Correlation ◽  
Control Group ◽  
Healthy Children ◽  
Vascular Endothelial ◽  
Morphological Examination ◽  
Immunohistochemical Markers ◽  
Definition Of

Objective: To study immunohystochemical markers and features of histological and morphological changes in the placenta of women who have given birth to children with anencephaly. Methods: 15 women with anencephaly in the fetus (the main group) and 20 women, who gave birth to practically healthy children (control group), were examined. All women were tested for tumor marker alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG), morphological examination of placenta and levels of apoptosis, definition expression Nkx-2.2 in vascular endothelial cells of the villous chorion of the placenta of women in norm, and with congenital malformation (CM) of the central nervous system (CNS), in particular – anencephaly in the fetus. Results: A feature of the histochemical characteristics of placenta in women who have given birth to children with anencephaly is the predominance of chronic compensated deficiency with manifestations of dyscirculatory disorders. Statistically significant reduction of Nkx-2.2 expression levels in the vascular endothelial cells of the villous chorion placenta of women who gave birth to children with anencephaly, confirms the role of this factor in the differentiation of nervous structures. An inverse correlation between the level of Nkx-2.2 expression in the placenta and the level of AFP in the blood serum of pregnant women at the beginning of the second trimester of pregnancy determines the level of AFP as the most significant marker of the development of anencephaly in the fetus. Conclusions: Based on the conducted studies it is possible to assume the participation of the placenta in the formation of abnormalities of the CNS of fetuses and newborns. Consequently, properly organized antenatal surveillance with mandatory definition of AFP level at 14 weeks of pregnancy will improve the quality of care for women at risk development of CM of the CNS of the fetus, in particular – anencephaly. Keywords: Immunohistochemical markers, diagnostics of anencephaly, expression of Nkx-2.2 in the placenta, degree of apoptosis in the placenta

scholarly journals Nitric oxide as a biomarker of allergic inflammation in children

2007 ◽  
pp. 69-78
Author(s):  
S. E. Tsyplenkova ◽  
Yu. L. Mizernitsky
Keyword(s):  
Nitric Oxide ◽  
Differential Diagnosis ◽  
Respiratory Diseases ◽  
Allergic Inflammation ◽  
Clinical Importance ◽  
Diagnostic Methods ◽  
Control Group ◽  
Healthy Children ◽  
Chronic Respiratory Diseases ◽  
Asthmatic Children

The aim of this study was to analyze clinical importance of exhaled nitric oxide (NOex) measurement for early detection, differential diagnosis and control of treatment of chronic respiratory pathology in children. The study involved 412 children of 5 to 18 years old with different chronic bronchopulmonary diseases. Apart from a typical clinical, laboratory, and instrumental diagnostic methods, NOex was measured in all the children using the chemiluminescent gas analyzer 280i (Sievers, USA). The control group included 30 healthy children aged 5 to 18 with mean NOex 14.8 ± 1.4 ррb (9.2 ÷ 21.4 ррb). The majority of asthmatic children had high NOex (> 20 ppb in 284 (90 %) asthmatic children), р < 0.01, both in stable asthma and exacerbation. The NOex level was directly correlated to the severity and period of the disease (frequency of asthma attacks, time from the last asthma attack, lung function parameters), and blood levels of allergic markers (eosinophils, total IgE, circulating immune complexes, IL-4). Therefore, NOex monitoring was useful in evaluating the efficacy of different treatment modes. In other chronic respiratory diseases, NOex level was also elevated but to lesser degree. In children with primary ciliary dyskinesia, NOex was significantly below the normal level that could be used as a preliminary screening tool. In conclusion, NOex measurement is a reliable and objective method to control allergic inflammation in the airways. It is of great clinical importance and is helpful in differential diagnosis of chronic respiratory diseases and confirmation of the diagnosis. It allows individual choice of therapy, control of the patient's adherence to treatment and prognosis of future exacerbations.

scholarly journals Initial vegetative tone in mild atopic asthma in children

2021 ◽  
Vol 12 (2) ◽  
pp. 13-18
Author(s):  
Vladimir N. Buryak ◽  
Tatyana I. Antonova ◽  
Maria V. Dudko ◽  
Inna V. Malysheva ◽  
Kirill K. Shepelenko
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Bronchial Asthma ◽  
The Body ◽  
Atopic Asthma ◽  
World Health ◽  
Control Group ◽  
Healthy Children ◽  
Autonomic Nervous ◽  
Atopic Bronchial Asthma

Background. In most industrialized countries, allergic diseases affect up to 20% of the population. This pathology belongs to the most common in children: according to the World Health Organization, more than 15% of the world's child population suffers from it. In recent years, there has been a significant increase in the frequency and more severe course of these diseases, in connection with which they are considered in modern society as a major medical and social problem. Thus, the prevalence of bronchial asthma, according to domestic and foreign authors, ranges from 0.2 to 8.1%. Purpose. In order to clarify the role of the autonomic nervous system in the genesis of the mild course of atopic bronchial asthma in childhood, the features of the interaction of the sympathetic and parasympathetic divisions of the autonomic nervous system in the examined children were clarified. Materials and methods. 126 children aged 10 to 14 years were examined. Atopic bronchial asthma was diagnosed in 91 children. At the same time, 61 of them were diagnosed with an intermittent course, 30 a mild persistent course of the disease. The control group consisted of 35 healthy children also aged 10 to 14 years. Complaints, anamnesis data were studied in all children, an objective and generally accepted laboratory and instrumental examination was carried out. All examined children underwent daily monitoring of the electrocardiogram, according to the results of which, based on the analysis of time and frequency indicators of heart rate variability, a variant of the initial autonomic tone was established. Results. In children with atopic bronchial asthma, both with intermittent and mild persistent course, an absolute or relative dominance of sympathetic influences was revealed against the background of varying degrees of decrease in parasympathetic activity, which was interpreted as a compensatory reaction of the body in response to chronic allergic inflammation.

scholarly journals Differential diagnosis of hematogenous osteomyelitis and malignant bone tumors

2018 ◽  
Vol 177 (5) ◽  
pp. 58-62
Author(s):  
A. N. Tkachenko ◽  
O. F. Nur ◽  
A. A. Korneenkov ◽  
L. E. Sharova ◽  
I. E. Itskovich ◽  
...  
Keyword(s):  
Mathematical Model ◽  
Differential Diagnosis ◽  
Predictive Value ◽  
Bone Tumors ◽  
Bone Neoplasms ◽  
Pathological Process ◽  
Diagnostic Model ◽  
Malignant Bone Tumors ◽  
Hematogenous Osteomyelitis ◽  
Validity Indicators

The objective of the study was to develop a mathematical model of differential diagnosis of hematogenous osteomyelitis and malignant bone tumor.Material and methods. In this research we performed a retrospective analysis of the data on 127 patients with differential diagnosis between hematogenous osteomyelitis and malignant bone tumors. Retrospective validity indicators: sensitivity (Se) – 53.12 % (42.66–63.39 %), specificity (Sp) – 70.97 % (51.96–85.78 %). Data on 96 patients with subsequently diagnosed hematogenous osteomyelitis was compared with data on 31 patients with morphologically confirmed malignant bone neoplasms. In the research we.Results. The database was created based on studying the data of the retrospective group. It became the basis for the development of a mathematical model for the differential diagnosis of hematogenous osteomyelitis and malignant bone tumors. 13 prognostic criteria were identified, each of which is quantified. These criteria included the age of the patient, sex, the data on concomitant pathology, information about the localization of the pathological process, the indices of some laboratory studies, etc. An algorithm for the differential diagnosis of hematogenous.Conclusion. Our differential diagnostic model was tested in the prospective study (63 cases). Indicators of the validity of the test was: Sensitivity – 83.05 %, Specificity (Sp) – 86.67 %. Positive Predictive Value (PPV) was 96.08 %, Negative Predictive Value (NPV) – 56.52 %, Accuracy – 83.78 %, which allowed to shorten the time of examination and send patients to specialized hospitals.

scholarly journals Neurophysiological aspects of enuresis in children

2020 ◽  
pp. 58-65
Author(s):  
G. I. Safiullina ◽  
R. A. Yakupov ◽  
A. A. Safiullina
Keyword(s):  
Nervous System ◽  
Pathological Condition ◽  
Self Control ◽  
Alternative Methods ◽  
Controlled Study ◽  
Control Group ◽  
Healthy Children ◽  
And Gender ◽  
Excitation Processes ◽  
State Medical Academy

Introduction. Enuresis is a pathological condition, manifested by involuntary urination during sleep or in the wakeful state. It is believed that enuresis is associated with unformed or impaired self-control skills for emptying the bladder. The significance of the problem is determined by the widespread prevalence of pathology, social and psychological maladaptation of children with enuresis. An important role in this plays the development of their personality by an accentuated type often, difficult adaptability, and lack of ability to integrate into the team, especially into the semi or closed type. According to modern concepts, enuresis can be caused by the following reasons: delayed maturation of the nervous system, urological pathology and urinary tract infection, impaired activation reaction during sleep, impaired rhythm of secretion of antidiuretic hormone, adverse heredity, psychological factors and stress. The results of Russian and foreign scientists studies revealed the polyetiological character of enuresis and the impossibility, in most cases, of identifying its obvious cause. This explains the relatively wide variability of outcomes: from spontaneous cure to apparent resistance to all existing treatments. The significant prevalence of enuresis, the relative severity of this pathology and the lack of effective treatment methods necessitate the search for alternative methods of therapy or fundamentally new approaches to using existing ones, which is impossible without a thorough study of this disease etiopathogenesis.The goal of research — is to study the neurophysiological characteristics of enuresis in children.Materials and methods. Prospective controlled study was conducted in Kazan State Medical Academy — a branch of the RMACPE (Kazan) in the period 2003–2019 years. To study enuresis mechanisms we carried out a comprehensive clinical-electroneurophysiological examination of 93 children aged 5 to 15 years, suffering from bedwetting. The control group consisted of 40 healthy children who were comparable in age and gender to those in the main group. All patients underwent a comprehensive examination, which included the study of complaints, anamnesis, clinical and electroneurophysiological research.Results. Clinical examination of children with enuresis revealed signs of minimal cerebral dysfunction. An electrophysiological examination made it possible to determine an increase in the refl ex excitability of brain stem structures against the background of a decrease in downward inhibitory control.Conclusion. The predominance of excitation processes over inhibition in the central nervous system is mainly observed in children with enuresis. The weakness of the inhibitory mechanisms due to constitutional factors, pathology of the nervous system that took place earlier, allows making an assumption about the diffuse nature of the disorders of the nervous system in this urination disorder. 

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