[Mechanisms of formation and a diagnostic algorithm of postural disorders in stroke]

Three hundreds and twenty-nine patients with stroke were examined. In the acute stage of stroke, disorders of postural balance dynamic disturbances were detected in 85% of patients, in a half of patients disorders of static balance were found either. Four variants of postural balance disorders were singled out: I -- afferent, with a prevalence of sensory deficiency, II -- efferent, with a prevalence of pyramidal and cerebellar symptoms, III -- integrative, with a domination of cognitive impairments, IV -- psychogenic with affective disorders. It was found that different variants of balance disorders differed not only in the structure of disturbances, but also by the degree of severity of individual clinical syndromes. These variants differed in the frequency of cerebral focal and atrophic changes of certain localization. Moreover, the severity of the disorders of postural balance was also depended on the location of affected areas of the brain. Based on the analysis of clinical and neuroimaging studies of patients, we suggest the concept of deafferentation and disintegration of blocks of the motor act. The algorithm for the clinical diagnosis of the variants of postural balance disorders was developed.